Vepdegestrant (Veppanu™)

Author: Christina Bach, MBE, LCSW, OSW-C
Content Contributor: Kristin Melathe, PharmD
Last Reviewed: May 26, 2026

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Pronounce: vep-deh-JES-trant

Classification: Proteolysis-targeting chimera (PROTAC) estrogen receptor degrader

About Vepdegestrant (Veppanu™)

This medication is a protein degrader. Some cancers grow in the body because of a protein called estrogen receptor. This medication attaches to the estrogen receptor, letting the body know to break it down. Then the cell’s normal processes break down the proteins they no longer need. Unlike other hormonal treatments, this medication reduces estrogen receptor protein levels, rather than just blocking them.  This medication targets ER+, HER2-negative, ESR1-mutated tumors. Your tumor will be tested for this mutation.

How to Take this Medication

This medication comes in tablet form and is taken by mouth. You should take it with food. Do not chew, crush, dissolve, or split the medication. If you miss a dose or throw it up, take the next dose at your regular time.

It is important to take the correct amount of medication. Before each dose, check that the medication and the amount match what your provider prescribed.

The blood levels of this medication can be affected by certain foods and medications, so they should be avoided. These include: St John’s wort, grapefruit, and grapefruit juice. Be sure to tell your healthcare provider about all medications and supplements you take.

Storage and Handling

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. 

Where Do I Get This Medication?

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.

Insurance Information

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.

Possible Side Effects

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.

Low White Blood Cell Count (Leukopenia or Neutropenia)

White blood cells (WBC) help your body fight infection. While you are having treatment for cancer, your WBC count can drop, putting you at a higher risk of an infection. Tell your provider right away if you have a fever (temperature greater than 100.4°F or 38°C), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn't heal.

Tips for preventing infection:

  • Hand washing: both yours and your visitors is the best way to prevent the spread of infection.
  • Avoid large crowds and people who are sick (those who have a cold, fever, or cough, or live with someone with these symptoms).
  • When working outside, wear clothes that protect you, like long pants and gloves.
  • Do not handle pet waste.
  • Keep all cuts and scratches clean.
  • Shower or bathe daily. 
  • Brush your teeth at least twice a day.
  • Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
  • Ask your providers before scheduling dental appointments or procedures.
  • Ask your providers before you or someone you live with has any vaccines

Liver Toxicity

This medication can cause liver toxicity, or liver problems, which your provider may monitor for with blood tests called liver function tests. Symptoms may be:

  • Yellowing of your skin or eyes.
  • Dark or brown urine.
  • Pain in your abdomen (belly).

Tell your provider if you have any of these symptoms.

Muscle or Joint Pain/Aches and Headache

You may have joint or muscle pain/aches and headaches while taking this medication. Your provider can recommend medications and other ways to help relieve your pain.

Fatigue

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.

Low Red Blood Cell Count (Anemia)

Anemia is when your red blood cell count is lower than normal. Red blood cells carry oxygen to the tissues in your body. When your red cell count is low, you may feel tired or weak. Tell your providers if you have shortness of breath, trouble breathing, or pain in your chest. If your count gets too low, you may receive a blood transfusion.

Fertility

This medication may affect your fertility. It can cause changes to your menstrual cycle or sperm. You may want to consider sperm banking or egg harvesting if you might wish to have a child in the future. Talk about your options with your provider before treatment.

Reproductive Concerns

There is a higher risk of health problems for your baby if you are pregnant, become pregnant, or get someone pregnant while on this medication. To lower the risk of birth defects, you should use birth control (contraception) to avoid pregnancy. Talk with your provider about what kind of birth control is safest for you and your partner.

If you can become pregnant, you will need to use effective birth control during treatment and for 2 weeks after the last dose of this medication, even if your menstrual cycle has stopped or changed. If you can get someone pregnant, you will need to use effective birth control during treatment and for 2 weeks after the last dose of this medication, even if you believe you are not producing sperm. You should not breastfeed during treatment and for 2 weeks after the last dose of this medication.

Important but Less Common Side Effects

QT Prolongation

QT prolongation is when your heart is not working how it should, and it can cause slow or abnormal heartbeats or an abnormal heart rhythm. Tell your provider right away if you feel abnormal heartbeats or if you feel dizzy or faint.