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Vandertanib effectively controls the growth and spread of tumors by inhibiting the EGFR, VEGFR and RET signaling pathways of tumor cells.
1. Generic name: Vandetanib
2. Trade name: Caprelsa
It is used to treat unresectable locally advanced or metastatic symptomatic or progressive medullary thyroid carcinoma (MTC). For patients with asymptomatic or slowly progressive disease, the risks and benefits of treatment need to be carefully evaluated.
1. Tablets: 100mg, 300mg
2. Main ingredients: vandetanib sesquihydrate, excipients include calcium hydrogen phosphate dihydrate, microcrystalline cellulose, etc.
1. Standard dosage: 300mg once a day, orally, with food or on an empty stomach.
2. Treatment of missed doses: If the missed dose is ≥ 12 hours before the next dose, you can take it again, otherwise skip it.
3. People with difficulty swallowing: Dissolve the tablets in 2 ounces of non-carbonated water and stir for 10 minutes. Take it immediately. Rinse the residue with 4 ounces of water before taking it.
1. QT interval prolongation : Suspend administration when QTcF>500ms, restore to <450ms and then reduce the dose to 200mg or 100mg.
2. Renal insufficiency : The starting dose for moderate to severe patients (creatinine clearance <50mL/min) is adjusted to 200mg.
3. Toxic reaction : Suspension of administration for grade ≥3 toxicity, and reduce the dose after recovery to grade ≤1.
1. Electrocardiogram monitoring : Monitor the QT interval at baseline, 2-4 weeks, 8-12 weeks and every 3 months to correct hypokalemia/hypocalcium/hypomagnesemia.
2. Skin reaction : Avoid sun exposure and use sun protection measures; severe rashes (such as Stevens-Johnson syndrome) require permanent discontinuation of the drug.
3. Diarrhea :Use antidiarrheal drugs regularly. In severe cases, suspend administration and monitor electrolytes.
4. Hypertension : Monitor regularly and reduce dosage or discontinue medication if control is not good.
1. Pregnant women : Contraindicated during pregnancy (teratogenic risk), effective contraception is required during medication and within 4 months of discontinuation.
2. During lactation : Discontinue medication or stop breastfeeding.
3. Children : Safety has not been established.
4. U200c: Moderate to severe liver damage (Child-PughB/C) is not recommended.
1. Common (>20%): Diarrhea (57%), rash (53%), acne (33%), nausea (33%), high blood pressure (26%).
2. Serious risks: QT prolongation (7%>500ms), interstitial lung disease (can be fatal), bleeding, heart failure.
It is contraindicated in patients with congenital long QT syndrome.
1. Avoid combined use of strong CYP3A4 inducers (such as rifampicin, St. John's wort) and QT prolonging drugs (such as amiodarone, moxifloxacin).
2. CYP3A4 inhibitors (such as itraconazole) have no significant effect.
Save at room temperature 15-30°C and avoid contact with crushed tablets (need to wear protective equipment when handling).