Vandetanib effectively controls tumor growth and spread by inhibiting signaling pathways such as EGFR, VEGFR, and RET in tumor cells.

1、 Drug name

1. Common name: Vandetanib

2. Product Name: Caprelsa

2、 Indications

Used for the treatment of unresectable locally advanced or metastatic symptomatic or progressive medullary thyroid carcinoma (MTC). For patients who are asymptomatic or have slow disease progression, the risks and benefits of treatment should be carefully evaluated.

3、 Specifications and characteristics

1. Tablets: 100mg, 300mg

2. Main ingredients: vandetanib hemihydrate, excipients include calcium hydrogen phosphate dihydrate, microcrystalline cellulose, etc.

4、 Usage and dosage

1. Standard dose: 300mg once daily, oral, can be taken with food or on an empty stomach.

2. Omission treatment: If the missed dose is at least 12 hours away from the next administration, it can be supplemented, otherwise it will be skipped.

3. For those with swallowing difficulties: Dissolve the pill in 2 ounces of non carbonated water and stir for 10 minutes before taking immediately. Rinse the residue with 4 ounces of water before taking.

5、 Dose adjustment

1. QT interval prolongation: Discontinue administration when QTcF>500ms, reduce to 200mg or 100mg after recovery to<450ms.

2. Renal insufficiency: For moderate to severe patients (creatinine clearance rate<50mL/min), the initial dose is adjusted to 200mg.

3. Toxic reactions: Discontinue administration of drugs with a toxicity level of ≥ 3, and reduce dosage after recovery to ≤ 1.

6、 Medication precautions

1. Electrocardiogram monitoring: Monitor QT interval at baseline, 2-4 weeks, 8-12 weeks, and every 3 months to correct hypokalemia/hypocalcemia/hypomagnesemia.

2. Skin reactions: Avoid sun exposure and use sunscreen measures; Severe rash (such as Stevens Johnson syndrome) requires permanent discontinuation of medication.

3. Diarrhea: Conventional use of antidiarrheal drugs, with suspension of administration and monitoring of electrolytes in severe cases.

4. Hypertension: Regular monitoring, reduce or discontinue medication if not well controlled.

7、 Medication for special populations

1. Pregnant women: Prohibited during pregnancy (teratogenic risk), effective contraception should be used during medication and within 4 months of discontinuation.

2. Breastfeeding period: Stop taking medication or breastfeeding.

3. Children: Safety has not been established.

4. Liver injury: Not recommended for moderate to severe (Child Pugh B/C).

8、 Adverse reactions

1. Common (>20%): Diarrhea (57%), rash (53%), acne (33%), nausea (33%), hypertension (26%).

2. Serious risks: QT prolongation (7%>500ms), interstitial lung disease (fatal), bleeding, heart failure.

9、 Contraindications

Patients with congenital long QT syndrome are contraindicated.

10、 Drug interactions

1. Avoid using strong CYP3A4 inducers (such as rifampicin, St. John's wort) and QT prolonging drugs (such as amiodarone, moxifloxacin) in combination.

2. CYP3A4 inhibitors (such as itraconazole) have no significant effect.

11、 Storage method

Store at room temperature of 15-30 ° C and avoid contact with crushed tablets (protective equipment should be worn for handling).

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