Vemurafenib is used to treat melanoma that has spread to other parts of the body or that cannot be eliminating through surgery.
WHAT IS VEMURAFENIB?
Vemurafenib is a type of treatment called a kinase inhibitor (also known as a cancer growth blocker). Kinase inhibitors interfere with the production of important proteins for the body called kinases, which regulate how cells grow and divide.
HOW DOES VEMURAFENIB WORK?
Vemurafenib only works in melanomas that have a change (mutation) in a gene called BRAF. The change in the BRAF gene leads to the production of a changed (mutated) BRAF protein. This protein helps melanoma tumors to grow. Vemurafenib acts by blocking the changed BRAF protein. This can stop the melanoma cells from growing and dividing.
Doctors can determine whether your melanoma has a mutation in the BRAF gene. They do this by testing a piece of melanoma that has already been eliminated during the tests performed to diagnose it or during surgery.
WHEN IS VEMURAFENIB USED?
Vemurafenib can be used when a melanoma tumor has a mutated BRAF gene or when the tumor has spread to other parts of the body or that cannot be eliminated surgically.
WHAT DOES VEMURAFENIB LOOK LIKE?
Vemurafenib comes in 240-gram oval-shaped pills that are pink or light orange in color.
HOW IS VEMURAFENIB TAKEN?
You will be told to take four pills in the morning and then another four 12 hours later. Each time you have the pills, you will be taking a 960-mg dose.
Do as follows:
- Take the pills at the same time of the morning and night each day
- Don't make a habit of taking the pills on an empty stomach
- Swallow the tablets whole, taking them with a full glass of water.
You usually have vemurafenib for as long as it is controlling the melanoma. Rarely, the treatment may be suspended if it is causing severe side effects.
POSSIBLE SIDE EFFECTS OF VEMURAFENIB
Each person's reaction to cancer treatment is different: while some people develop very few side effects, others may experience more. The side effects described below will not affect everyone who is treated with the drug. We have outlined only the most common.
If you notice you develop any side effects that are not listed here, talk to your doctor or specialist nurse.
MILD SKIN CHANGES
Some mild changes to the skin are common with vemurafenib. These include rash, itchiness, dry or scaly skin, or warts. You should let your nurse or doctor know if you develop any of these changes, as they will be able to prescribe creams and ointments to help.
EFFECTS ON THE HANDS AND/OR FEET
You may notice reddening on the palms of your hands of the soles of your feet. At times, the hands and feet hurt and become inflamed. You may also have changes in sensation, such as numbness or tingling. If you notice that this happens, tell your nurse or doctor.
Sometimes, if the pain does not go away or if blistering occurs, your doctor may lower the dose of vemurafenib or temporarily interrupt the treatment. Occasionally, people may need to stop the treatment permanently.
SENSITIVITY TO LIGHT
During treatment with vemurafenib, your skin will be more sensitive to daylight (even on cloudy days) and sunlight. When outdoors, you should always wear sunscreen with an SPF of at least 30. Some doctors and specialist nurses recommend SPF-50 sunblock. They also advise people to apply sunblock on their lips and cover themselves with clothing and a hat.
TYPES OF SKIN CANCER
Some people may develop other types of skin cancer (squamous cell or, less commonly, basal cell skin cancer) while taking vemurafenib. Normally, these types of skin cancer can be easily removed surgically. You will be asked to check your skin regularly for signs of these types of cancer; these signs may include a small bump or an area that looks scaly, bleeds, or has a hard layer on top. If you notice anything unusual , tell your nurse or doctor.
LOSS OF APPETITE
Some people lose their appetite while taking vemurafenib. This can be mild and last for a few days. If it doesn't get better, request to see a dietitian or specialist nurse at your hospital. They can give you advice on how to improve your appetite and maintain a healthy weight.
CHANGES IN TASTE
You may notice that food tastes different. A dietitian or specialist nurse can give you advice on ways to cope with this.
You may experience more frequent or liquid bowel movements. Normally, this can be easily controlled with drugs, though you should tell your doctor if your diarrhea is severe or long-lasting. It's important to drink lots of fluids if you have diarrhea.
In general, it helps to drink lots of fluids, eat more fiber, and get some light exercise. You may need to take drugs (laxatives) to help. Your doctor can prescribe these or you can buy them at the pharmacy.
NAUSEA AND VOMITING
Your doctor can prescribe antiemetic drugs to prevent or greatly reduce your nausea or vomiting. If your nausea remains uncontrolled or continues, tell your nurse or doctor. They can prescribe other, more effective drugs.
If people taking vemurafenib become fatigued, it is normally mild. It is important that you try to pace yourself and rest as much as you need to. Try to balance this with light exercise, such as taking short walks.
EFFECTS ON THE HAIR
Your hair may thin out while you are taking vemurafenib. This includes hair that is on other parts of your body, including eyelashes and eyebrows. Changes to your hair are normally temporary and get better before during the treatment or after it has concluded. However, some changes may be permanent. Some people may find that their hair changes texture when it grows back.
MUSCLE AND JOINT PAIN
This can happen during treatment. Your doctor can prescribe painkillers and/or anti-inflammatory medication to help.
BUILD-UP OF FLUID
This usually causes swelling in the ankle. Fluid build-up often goes away without treatment, though if it doesn't, diuretics can help you get rid of some of the liquid.
Vemurafenib can sometimes cause coughing. Tell your doctor if this happens, as they may be able to give you medication to help.
FEVER AND CHILLS
You may experience fever and chills when you start your treatment, though they do not usually last very long. Your doctor can prescribe medicines to help with this. Some people continue to have occasional fever during treatment.
Rarely, vemurafenib can cause headaches. Let your doctor or nurse know if this is the case, as they can give you painkillers to help with this.
WEAKNESS IN THE MUSCLES OF THE FACE
Vemurafenib can sometimes cause weakness or paralysis on one side of the face. This may cause mouth to sag, and it may be difficult to close the eye on this side of the face. Paralysis is temporary and goes away once you stop taking the medication.
In a small number of people, vemurafenib can cause an irregular or rapid heartbeat (sometimes known as palpitations). If you have palpitations or feel weak, tell your doctor immediately. You will have a test to see how well your heart functions before starting to take vemurafenib. These test can be done again while you are having treatment.
You may have eye soreness, swelling, or redness. Though less common, some people experience changes in their vision such as blurriness. Tell your nurse or doctor immediately if you have any of these problems.
INFREQUENT ADVERSE EFFECTS
Vemurafenib can sometimes cause severe allergic reactions. However, this is uncommon. Signs of allergic reactions include swelling in the face, lips, or tongue, rash, dizziness, or feeling breathless. It is important that you notify your doctor or nurse as soon as possible if you have any of these symptoms and that you stop taking the tablets. Do not try to treat the symptoms along with other drugs.
EFFECTS ON THE LIVER
Rarely, vemurafenib can cause temporary changes in the way the liver functions. Your doctor will keep a close watch on your liver and have you take periodic blood tests to check that your liver is functioning properly.
ADDITIONAL INFORMATION ON VEMURAFENIB
Some drugs, including those bought over the counter in a store or pharmacy, may be harmful to you while you are taking vemurafenib. Tell your doctor if you are taking any medicines, including over-the-counter medications, complementary therapies, and herbal medicines.
This treatment may affect your ability to conceive. It is important that you talk to your doctor before beginning treatment.
Little is known about the effects of vemurafenib on developing babies. Therefore, it is not recommendable to become pregnant while taking this drug.
It is unknown whether vemurafenib is present in semen or vaginal fluid. In order to protect your partner, it is safest to avoid having sex or use a barrier contraceptive device for about 48 hours after the chemotherapy.
There is a potential risk that vemurafenib may be present in breast milk, and therefore women are recommended not to breast feed during the treatment and for a few months afterward.
If you are admitted to the hospital for any reason not related to cancer, it is important that you tell your doctors and nurses caring for you that you are receiving treatment with vemurafenib.