Vandetanib - Overall Recommendations

Vandetanib CAN be Co-Administered with the Following Agents, IF Administered with Caution1,2

  • CYP3A4 inhibitors, e.g. itraconazole
  • Digoxin
  • Dabigatran

Vandetanib CANNOT be Co-Administered with the Following Agents1,2

  • Cisapride, erythromycine intravenous (IV), toremifen, mizolastine, moxifloxacine, arsenic, Class I A and III antiarrhythmics.
  • Methadone, haloperidol, amisulpride, chlorpromazine, sulpiride, zuclopenthixol, halofantrine, pentamidine and lumefantrine.
  • Potent CYP3A4 inducers (e.g. rifampicin. St John’s wort)

Additional Important Information when Prescribing Vandetanib1-3

If co-administration of odansetron with vandetanib is necessary, close monitoring of serum electrolytes and ECGs are required

If co-administration with digoxin is required, appropriate clinical and/ or laboratory monitoring is recommended, possibly together with lowering the dose of digoxin.

Clinical monitoring is required for the p-glycoprotein substrate, dabigtran, in combination with vandetanib.

Clinical and laboratory monitoring is required for metformin in combination with vandetanib.

If no appropriate alternative therapy is available, the non-recommended combinations noted above may be given in combination with vandetanib with additional ECG monitoring of the QTc interval, electrolyte monitoring and further control at onset or worsening of diarrhoea.

Monitoring of the INR is recommended if vitamin K antagonists are co-administered with vandetanib.

References

  1. Food and Drug Administration. Vandetanib (CAPRELSA) Prescribing information. 2015.
  2. European Medicines Agency. Vandetanib (CAPRELSA). Summary of Product Characteristics. 2015.
  3. Teo YL, Ho HK, Chan A. Metabolism-related pharmacokinetic drug-drug interactions with tyrosine kinase inhibitors: current understanding, challenges and recommendations. Br J Clin Pharmacol 2015; 79: 241-253.
Last update: 21 July 2015