Vismodegib (Erivedge®)

Vismodegib (Erivedge®) is a targeted therapy drug used to treat advanced basal cell skin carcinoma. It’s best to read this with our general information about skin cancer.

Vismodegib is given as tablets. Your cancer doctor or nurse will tell you how often you will have it.

Like all targeted therapy drugs, vismodegib can cause side effects. Some of these can be serious so it’s important to read the detailed information below. How targeted therapy affects people varies from person to person. Your healthcare team can talk to you more about this and give you advice on how to manage any side effects.

Tell your doctor or nurse straight away if you have a temperature, feel unwell or have severe side effects, including any we don’t mention here. If you need to see a health professional for any reason other than cancer, always tell them that you are having this treatment.

What is vismodegib?

Vismodegib (Erivedge®) is a targeted therapy drug used to treat basal cell carcinoma.

Usually, basal cell skin cancers are very slow-growing and don’t spread to other parts of the body. Rarely, they can spread into surrounding skin tissues, which is known as locally advanced cancer. Very rarely, they can spread into other parts of the body. This is known as metastatic cancer.

How targeted therapies work

This animation shows how targeted therapies work and what effect they have on the body.

About our cancer information videos

How targeted therapies work

This animation shows how targeted therapies work and what effect they have on the body.

About our cancer information videos


How vismodegib works

Vismodegib is a type of targeted therapy drug called a cancer growth inhibitor. Proteins in cells send signals that tell the cells to grow and divide. Vismodegib blocks (inhibits) the proteins from sending signals to the cancer cells, so that they don’t grow and divide.


When vismodegib is given

Vismodegib (Erivedge®) is used when treatment with surgery or radiotherapy is not possible. It is also used when basal cell carcinoma has spread to other parts of the body (metastatic) and is causing symptoms.

Vismodegib may only be available in some situations. Your cancer doctor can tell you if it's appropriate for you. Some people may be given it as part of a clinical trial.

If a drug isn’t available on the NHS, there may be different ways you can still have it. Your cancer doctor can give you advice.


Taking vismodegib

You take vismodegib as a tablet once a day. Try to take it at about the same time each day. You should swallow the tablet whole with a glass of water. You can take it with or without food.

Always take your tablets exactly as your nurse or pharmacist explained. This is important to make sure they work as well as possible for you.

Do not stop taking any of your tablets unless your doctor tells you to. Here are some important things to remember:

  • If you forget to take your tablet, just take your usual dose the next day. Don’t take a double dose.
  • If you are sick after taking your tablet, just take your next dose at the usual time.
  • Keep them safe and out of sight and reach of children.
  • Return any remaining tablets to the pharmacist if your treatment is stopped.

You usually take vismodegib for as long as it controls the cancer.


Preventing pregnancy while taking vismodegib

Vismodegib can cause severe abnormalities in developing babies. It’s very important not to get pregnant or to father a child while taking it. Check with your doctor or specialist nurse if you’re not sure whether you are still able to have children.

Your doctor or nurse will give you specific information to read about the risks of vismodegib and pregnancy. They will talk to you about the risks and the recommended contraception to use. You will be asked to sign a form once you have been given and read all of the information.

For women

Women who are still able to have children need to take a pregnancy test before treatment, and then each month during treatment. You will need to use two types of contraception. One should be a very effective method, such as an IUD or the contraceptive injection. The other one should be barrier contraception, such as the condom or diaphragm.

You need to use contraception during treatment and for 24 months after treatment finishes. If you think you may be pregnant during this time, contact your doctor or specialist nurse straight away.

For men

Vismodegib passes into semen. You must use a condom when you have sex with a woman during treatment and for two months after it finishes. You must use a condom even if you have had a vasectomy. If your partner thinks they might be pregnant during or after treatment, contact your doctor or specialist nurse straight away.


About side effects

We explain the most common side effects of this treatment here. We also include some less common side effects.

You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we haven’t listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.

Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.

Serious and life-threatening side effects

Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

Contact the hospital

Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

More information

We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.


Possible side effects of vismodegib

Muscle or joint pain

You may get pain in your muscles or joints, and spasms in your muscles. This may be worse at night. Tell your doctor if this happens. They can prescribe painkillers or other medicines to help. Let them know if the pain does not get better.

Taste changes

You may get a bitter or metallic taste in your mouth or find that food tastes different. This should go away when your treatment finishes. Try using herbs and spices (unless you have a sore mouth or ulcers) or strong-flavoured sauces to give your food more flavour. Sucking boiled sweets can sometimes help get rid of a bitter or metallic taste. Your nurse can give you more advice.

Loss of appetite and weight loss

You may lose your appetite during your treatment and lose weight. Try to eat small meals regularly. If your appetite doesn’t improve after a few days, let your nurse or dietitian know. They can give you advice on getting more calories and protein in your diet. They may give you food supplements or meal replacement drinks to try. Your doctor can prescribe some of these and you can buy them from chemists.

Feeling tired

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.

Feeling sick

Your doctor can give you anti-sickness drugs to help prevent or control sickness. If you still feel sick, tell your doctor. They can prescribe other anti-sickness drugs that may work better for you.

Diarrhoea

If you have diarrhoea, contact the hospital for advice. Try to drink at least 2 litres (3½ pints) of fluids every day. It can help to avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods.

Constipation

This treatment may make you constipated and cause tummy pain. Drinking at least two litres (three and a half pints) of fluids every day will help. Try to eat more foods that contain fibre, such as fruit, vegetables and wholemeal bread. Try to do some regular, gentle exercise too.

Skin changes

Vismodegib may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day. Vismodegib can cause a rash, which may be itchy. Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.

Liver changes

This treatment may cause changes in the way your liver works. This will return to normal when the treatment finishes. Your doctor or nurse will take regular blood samples to check your liver is working properly.


Other information about vismodegib

Other medicines

Some medicines, including those you can buy in a shop or chemist, can be harmful to take while you are taking vismodegib. St Johns wort may affect how vismodegib works. Tell your doctor about any medicines you are taking, including ones you can buy for yourself, complementary therapies and herbal drugs.

Fertility

Doctors don’t yet know how vismodegib may affect your fertility. If you are worried about this, talk to your doctor before treatment starts.

Changes to your periods

Vismodegib can sometimes stop the ovaries working. You may not get a period every month and they may eventually stop. In some women this is temporary, but for others it is permanent and they start the menopause.

Breastfeeding

Women are advised not to breastfeed during treatment and for 24 months after. This is in case there is any of the drug in their breast milk.

Medical or dental treatment

If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses that you are taking vismodegib. Tell them the name of your cancer doctor so they can ask for advice.

Always tell your dentist you are taking vismodegib.