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vanDETanib

( van-DET-a-nib )
Funding:
Exceptional Access Program
  • vanDETanib - Monotherapy for symptomatic and/or progressive medullary thyroid cancer (MTC), with specific criteria
Other Name(s): Caprelsa®
Appearance: white tablet In various strengths and shapes

Medication Information Sheet
vanDETanib (van-DET-a-nib)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Caprelsa®

Appearance:
white tablet

In various strengths and shapes

What is this medication for?
  • For treating a certain type of thyroid cancer

What should I do before I have this medication?
  • Tell your doctor and pharmacist if you have or had significant medical condition(s), especially if you have or had:
    • heart problems
    • high blood pressure
    • abnormal heartbeat
    • low salt levels in blood
    • liver/kidney problems
    • recent or upcoming surgeries
    • any allergies.
  • People with cancer have a higher risk of getting other cancers or developing blood clots. Some cancer medications may increase these risks, especially if used for a long period of time. Discuss any concerns about this medication with your health care team.
How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding.
     
  • If there is any chance that you or your partner may become pregnant, you and your partner together must:
    • Use 2 effective forms of birth control at the same time while taking this drug: Keep using birth control until at least 3 months (for female patients) or 2 months (for male patients) after the last dose.  Discuss with your health care team.
       
  • Do not breastfeed while taking this drug.
     
  • This medication may affect fertility (ability to get pregnant).
How is this medication given?
  • This medication is usually taken once a day by mouth.

  • Swallow whole with a glass of water, with or without food.

  • If you miss a dose, take it if it is within 12 hours from the missed dose, otherwise skip and take your next dose as scheduled. Do not double the dose to make up for the forgotten one.

  • If you have difficulty swallowing the tablet(s), you may mix it with water as follows:
    • Put the whole tablet into half a glass (50mL) of non-carbonated water. Do not use other liquids.
    • Stir the water until the tablet disintegrates. This may take about 10 minutes.
    • Drink the mixture immediately. 
    • Rinse the empty glass well with another half a glass of water and drink it.
What else do I need to know while on this medication?
  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • DO NOT eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while taking this drug. They may increase the amount of drug in your blood and increase side effects. 

  • If you injure yourself or have surgery, your wounds may take longer to heal or may not fully heal. Check with your health care team before you have any surgery or visit your dentist.

  • For mild aches and pain or fever:

    • If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever. 
       
    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
       
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding. Talk to your health care team before you start or stop these medications.
       
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.

What are the side effects of this medication?

You may not have all of the side effects below. You may have side effects that are not listed.

Side effects and what to do When to contact doctor?
Very Common Side Effects (50 or more out of 100 people)

Salt imbalances

It may cause muscle twitching, severe weakness or cramping, confusion and irregular heartbeat.
 

Get emergency medical help right away

Diarrhea (may be severe)

May happen days to weeks after you get your treatment.

If you have diarrhea :

  • Take anti-diarrhea medication if your health care team prescribed it.
  • Avoid foods or drinks with artificial sweetener (e.g. chewing gum, “diet” drinks), coffee and alcohol.
  • Eat many small meals and snacks instead of 2 or 3 large meals.
  • Drink at least 6 to 8 cups of liquids each day. Talk to your health care team if you can’t drink 6-8 cups of liquids each day when you have diarrhea. You may need special liquids with salt and sugar, called Oral Rehydration Therapy.

​See the Diarrhea pamphlet for more information.

Contact your health care team if no improvement or if severe

Abnormal liver lab tests

  • You may have yellowish skin or eyes, unusually dark pee or pain on the right side of your belly. Talk to your health care team if this happens.
  • Your doctor may monitor your liver regularly with a blood test.

 

Contact your health care team if no improvement or if severe

Changes in thyroid activity

  • May happen in weeks to months after you receive your treatment.
  • Your doctor may monitor your thyroid function regularly with a blood test.

Underactive thyroid: Look for unusual weight gain with some of the following: Feeling tired or having low energy, dry skin, nails or hair that breaks easily, and sensitivity to cold.

Contact your health care team as soon as possible

 

 

Side effects and what to do When to contact doctor?
Common Side Effects (25 to 49 out of 100 people)

Rash; dry, itchy skin (may be severe)

Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away.

To prevent and treat dry skin,

  • Use skin moisturizer.
  • Protect your skin from the sun and the cold.
  • Use sunscreen with UVA and UVB protection and a SPF of at least 30.
Contact your health care team if no improvement or if severe

Nausea and vomiting (generally mild)

May occur in hours to days after your treatment. 

If you have nausea or vomiting:

  • Take anti-nausea medication(s) as prescribed to you by your doctor. 
  • Drink clear liquids and have small meals. Get fresh air and rest.
  • Do not eat spicy, fried foods or foods with a strong smell.
  • Limit caffeine (e.g. coffee, tea) and alcohol.
  • Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.

 

Contact your health care team if no improvement or if severe

High blood pressure (may be severe)

  • Check your blood pressure regularly. Your doctor may prescribe medication to treat high blood pressure.
  • If you have a severe headache, severe dizziness, or if you faint get emergency help right away as it may be a sign your blood pressure is too high.
Contact your health care team if no improvement or if severe

Headache

  • Take your pain medication as prescribed by your doctor.
  • You can take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
  • Talk to your doctor or pharmacist first before taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin. These medications  may increase bleeding risk.
  • Rest often and try light exercise as it may help.
Contact your health care team if no improvement or if severe

 

Side effects and what to do When to contact doctor?
Less Common Side Effects (10 to 24 out of 100 people)

Fatigue (tiredness)

  • Be active and aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days. Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Eat well and stay hydrated by drinking at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired

See our Fatigue pamphlet for more information. 

Contact your health care team if no improvement or if severe

Low appetite

  • You may not feel like eating or you may lose weight.
  • Try to eat foods that you like and eat small meals throughout the day. 
  • You may need to take meal supplements to help keep your weight up.
  • Talk to your health care team if you have a low appetite.
  • See our Loss of appetite pamphlet for more information.
Contact your health care team if no improvement or if severe

Kidney problems (may be severe)

  • Signs of a kidney problem include swelling, passing very little or no pee, or new unusual weight gain. If you have these signs, call your health team or go to your closest emergency department.
  • To prevent bladder or kidney problems, drink lots of water or other liquids. Your doctor may ask you to drink at least 6 to 8 cups (2 L) per day on treatment days, unless you have been told otherwise.
  • Your doctor may check your kidney function regularly.
Get emergency medical help right away

Pains or cramps in the belly

  • If you have constipation or diarrhea it may be causing the pain in your belly.
  • If the pain is severe, gets worse or doesn’t go away, talk to your health care team about other possible causes.
Contact your health care team if no improvement or if severe

Irregular heartbeat (may be severe)

Get emergency medical help right away

Trouble falling asleep

  • This may be caused by one of your medications and may improve once your body gets used to the medication or when your treatment ends.
  • Talk to your doctor if this bothers you.
Contact your health care team if no improvement or if severe

Skin sensitivity to sunlight

Your skin may be more sensitive to the sun. You can have an itchy rash and other skin reactions when you are exposed to the sun.

  • Try to stay out of the sun if you can.
  • Apply sunscreen with UVA and UVB protection and an SPF of at least 30.
  • Use a lip balm with sunscreen for your lips.
  • When you are in the sun, wear long sleeved shirts, long pants and a hat to protect yourself.
  • Use a daily moisturizer on your skin.
Contact your health care team if no improvement or if severe

Cough

You may have cough without any signs of infection, such as a sore throat or a stuffed nose.

 

Contact your health care team if no improvement or if severe

Heartburn; stomach upset

To help prevent heartburn:

  • Avoid fatty or spicy foods.
  • Remain upright after eating.
  • Drink clear liquids and eat small meals.
Contact your health care team if no improvement or if severe

Unusual bleeding or bruising

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting chemotherapy treatments:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often.
  • Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.


If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Get emergency medical help right away

Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:

  • Sudden loss of vision or trouble speaking or using your arms or legs, confusion
  • Chest pain, shortness of breath, pain in your chest or arm
  • Sudden severe pain in your upper back, that moves up your neck or down your back, when you didn't hurt yourself
  • Weakness on one side of your body
  • Pain, swelling and hardening in an arm or leg
  • Unusual pulsating or throbbing feeling in your chest or belly
  • Fainting spells or swelling in your legs, ankles and belly
  • Sudden, severe pain in your belly or stomach area, trouble swallowing
  • Pain in the centre of your belly that may extend to your back
  • Breathing problems or cough up blood
  • Vision loss or blurred
  • Severe headache, fainting, seizures
  • Wounds that take longer to heal or not fully heal

 

Who do I contact if I have questions or need help?          

My cancer health care provider is: ______________________________________________

During the day I should contact:________________________________________________

Evenings, weekends and holidays:______________________________________________

 

Other Notes:

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October 2020 Updated rare side effects section

For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.