Vandetanib (Caprelsa®)

Store your medication in the original container with the label. If you want to use a pillbox, talk to your pharmacist. Keep it in a dry place at room temperature unless your provider or pharmacist tells you otherwise. Keep containers out of reach of children and pets.

If a caregiver prepares your dose for you, they should consider wearing gloves or pour the pills directly from their container into the cap, a small cup, or directly into your hand. They should avoid touching the pills. They should always wash their hands before and after giving you the medication. Pregnant or nursing people should not prepare the dose for you. Ask your provider where to return any unused medication for disposal. Do not flush down the toilet or throw in the trash. 

Some cancer medications are only available through specialty pharmacies. Your provider or pharmacist will start this process. Your insurance plan may also affect where you can get your medication.  Call your prescription plan provider to find out which specialty pharmacies are in-network.

This medication may be covered by your prescription plan. If you qualify, you may be able to get financial help through patient assistance programs (PAP). Co-pay cards may also be available to lower your out-of-pocket cost if you have commercial (not Medicare/Medicaid/Tricare) insurance. Your pharmacist, social worker, or navigator can help find resources for financial support.

These are some of the most common or most serious side effects of this medication. Talk with your provider about the side effects you are having and how they can be managed.

QT prolongation is when your heart is not working how it should, causing abnormal heartbeats or an abnormal heart rhythm. QT prolongation happens when the electrical signal to the lower chambers of your heart (ventricles) takes too long (prolonged), causing a period of time where these chambers don’t know what to do. During this time, the lower chambers can beat too fast and out of control while waiting for the correct signal.

Torsades de pointes (TdP) happens when the lower chambers start to beat out of control or dangerously fast. This stops your heart from being able to pump enough blood to your body and brain, which can cause fainting or seizures. If not treated right away, TdP can cause your heart to stop beating correctly and can make your heart stop. Call 911 right away if you feel abnormal heartbeats, if your heart is beating fast, or if you feel dizzy or faint. 

Diarrhea can be a serious side effect that can lead to dehydration (when you do not have enough fluid in your body). Tell your healthcare provider if you have diarrhea.

Diarrhea is when you pass three or more stools in a day. Your providers can suggest medications to relieve diarrhea. Do not take any medications to manage your diarrhea without talking to your provider first because your stool may need to be tested. To manage it, try eating foods that are low in fiber and bland, like white rice and boiled or baked chicken. Try not to eat raw fruits, vegetables, whole grain breads, cereals, and seeds. Soluble fiber is a type of fiber found in some foods that helps absorb (soak up) fluid. Foods high in soluble fiber are applesauce, bananas (ripe), canned fruit, oranges, boiled potatoes, white rice, foods made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Stay hydrated by drinking 8 to 10 glasses of non-alcoholic, non-caffeinated fluid each day.

This medication can cause high blood pressure (hypertension). You should have your blood pressure checked often during therapy, so that if you have high blood pressure, it can be treated. If your blood pressure cannot be controlled, your provider may want you to stop taking the medication. Tell your providers about any headaches, vision changes, or dizziness. 

Talk to your providers if you have nausea and/or vomiting. They can prescribe medications to help you. Making changes to your diet can also help. Avoid things that make your symptoms worse, like heavy or greasy/fatty foods and spicy or acidic foods, like tomatoes, lemons, and oranges. Try saltines or ginger ale to help your symptoms.  

Call your providers if you cannot keep fluids down for more than 12 hours or if you feel lightheaded or dizzy.

Fatigue can cause exhaustion, feeling worn out and that your body is "heavy" and hard to move, or being unable to focus. It is common when you have cancer, and it is not the same as feeling tired. You may need to adjust your schedule to manage fatigue. Plan times to rest during the day and save your energy for more important activities. Exercise can help lessen fatigue. Talk to your providers about ways to deal with this side effect.

This medication can make your skin more sensitive to the sun, which can result in a severe sunburn or rash. Sun sensitivity can last even after you are done with chemotherapy. Avoid the sun between 10 am and 4 pm, when it is strongest. Wear sunscreen every day and reapply when you are in the sun. The best sunscreen is SPF 30 or higher and protects against both types of sunlight, UVA and UVB. Wear sunglasses, a hat, and long sleeves/pants to protect your skin, a lip balm with SPF greater than 30, and seek out shade whenever possible.

Tell your providers if you develop red, painful, or itchy skin, sunburn, skin irritation, bumps, or thick, dry skin.

This medication can cause inflammation (swelling and irritation) of your lungs, called pneumonitis. It can also cause scarring of your lungs, called interstitial lung disease. If you have any new or worsening symptoms, like shortness of breath, cough (with or without mucous), fever, or chest pain, call your provider right away. If you are finding it hard to breathe, call 911 right away.

If you notice you are bleeding more easily or for no reason, especially new bleeding from your gums or nose, call your provider right away. You may also bruise more easily.

If you have bright red or dark, tarry stool, blood in your vomit, vomit that looks like coffee grounds, or have any signs of stroke (severe headache, trouble talking, weakness on one side, confusion), call 911 right away. 

This medication can cause a neurological (brain) disorder called posterior reversible encephalopathy syndrome (PRES or reversible posterior leukoencephalopathy (RPLS). Symptoms of PRES/RPLS are:

• Headache.
• Seizure.
• Lethargy (feeling tired, drowsy, sluggish).
• Confusion.
• Blindness and other vision changes.
• Neurological problems.

Tell your provider about any of these symptoms right away.

If you have a wound, this medication can affect how it heals. It can make your wound heal very slowly or not heal completely (like a surgical wound not healing or not staying closed). If you are having a procedure or surgery:

• Tell your provider that you have a surgical procedure planned.
• Tell the surgeon that you are taking this medication.
• This medication will likely be stopped before you have any surgery. 
• Any surgical incision should be fully healed before starting or restarting this medication. 

If you have a surgical wound that has not healed or starts to have signs of infection (redness, swelling, warmth), tell your provider.

This medication can cause kidney problems, like an increased creatinine level. Your provider may monitor for kidney problems with blood tests. Symptoms may be:

• Less urine output than normal.
• Blood in the urine.
• Swelling in the ankles.
• Loss of appetite.

Tell your provider if you have any of these symptoms.