Erivedge (vismodegib) is a targeted medicine used to treat advanced basal cell carcinoma (BCC), a type of skin cancer. It is used when the cancer cannot be removed with surgery, has spread to other parts of the body, or has come back after surgery. Erivedge is a Hedgehog pathway inhibitor.

How it works:

Most advanced basal cell carcinomas have an abnormally activated Hedgehog signalling pathway, which drives cancer cell growth. Vismodegib blocks a protein called Smoothened (SMO) that is a key part of this pathway. By blocking SMO, Erivedge interrupts the signals that cause cancer cells to multiply.

Your dose:

Always take it exactly as prescribed by your doctor.

How to take it:

• Take Erivedge at the same time every day
• It can be taken with or without food
• Swallow the capsule whole. Do not open or crush it

Important precautions regarding pregnancy:

Erivedge can cause severe birth defects or pregnancy loss. This is one of the most serious risks associated with this medicine.

The following precautions are essential:

• Women who could become pregnant must have a negative pregnancy test before starting, use two forms of contraception during treatment, and continue contraception for 24 months after the last dose
• Men taking Erivedge must use a condom during sexual activity and for 3 months after stopping, even if they have had a vasectomy, as vismodegib is present in semen
• Women must not breastfeed during treatment or for 24 months after stopping
  

Before you start:

• Tell your doctor about all medicines, vitamins, and supplements you take
• Let your doctor know if you have any kidney or liver problems

• Skip the missed dose and take your next capsule at the usual time the following day
• Do not take a double dose to make up for a missed one

If you think you have taken more than prescribed, call 000 or go to your nearest emergency department. Bring your medicine packaging.

• Store below 30°C
• Keep in the original packaging, away from moisture and light
• Keep out of reach of children and pets

Side effects with Erivedge are common.

Many are manageable but some can significantly affect quality of life.

• Muscle cramps and spasms: Very common and often one of the most bothersome side effects. They can be severe. Tell your doctor if this is affecting you
• Hair loss (alopecia): Very common. Hair usually regrows after stopping treatment, though this can take time
• Loss of taste or altered taste (dysgeusia): Very common. Food may taste different or have little taste. This usually improves after stopping
• Fatigue: Common
• Nausea, diarrhoea, and decreased appetite: Common, usually manageable
• Weight loss: Can occur due to reduced appetite and taste changes
• Amenorrhoea (absence of periods): Women may find their menstrual periods stop during treatment. This is reversible after stopping in most cases

Contact your doctor or pharmacist if any side effect concerns you.

Tell your doctor and pharmacist everything you are taking.

Key interactions include:

• Medicines that affect stomach acid (such as proton pump inhibitors or antacids): May reduce vismodegib absorption
• P-glycoprotein inhibitors: Some medicines can increase vismodegib levels in the blood

Never start, stop, or change any medicine without speaking to your doctor first.

How long will I need to take Erivedge?

Treatment continues for as long as your cancer is responding and side effects are acceptable. Your doctor will assess your response regularly through skin examinations and imaging if needed. Some people need a treatment break due to side effects and then restart. Discuss any concerns about side effects with your oncologist.

Will my hair grow back?

Hair loss with Erivedge is very common and can be significant. In most people, hair does regrow after stopping treatment, though it may take several months. If hair loss is particularly distressing, speak to your doctor about whether a treatment break or alternative options are appropriate.

I am a man. Why do I need to use a condom?

Vismodegib is present in semen and could potentially expose a partner to the medicine. Because Erivedge can cause severe birth defects, men taking it must use a condom with every sexual encounter during treatment and for 3 months after stopping, regardless of whether their partner is pregnant or could become pregnant.

Ace provides accurate and independent information medically reviewed on prescription medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.