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Vemurafenib: Comprehensive Guide to Treatment and Dosage
Summary of Key Points
Vemurafenib is a prescription medication used to treat certain cancers, such as melanoma, that have a specific genetic mutation known as BRAF. It works by inhibiting the growth of cancer cells. Vemurafenib is taken orally, typically in tablet form. Like all medications, it may cause side effects, so it’s important to follow your doctor’s instructions closely and report any unusual symptoms.
Names of Medication
US Brand Name: Zelboraf
Generic Name: Vemurafenib
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, Vemurafenib is the generic name.
Pharmacologic Category
BRAF Inhibitors
Antineoplastic Agents
Vemurafenib Dosage
Vemurafenib is prescribed to treat various cancers in adults. The dosage may vary depending on the type of cancer being treated. Always follow your doctor’s instructions and never adjust your dose without consulting a healthcare provider. If you need personalized advice, you can schedule a telemedicine appointment with one of our providers.
Melanoma (BRAF V600 Mutation-Positive)
Dosage: 960 mg (four 240 mg tablets) taken orally twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Non-Small Cell Lung Cancer (BRAF V600 Mutation-Positive)
Dosage: 960 mg taken orally twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Thyroid Cancer (BRAF V600 Mutation-Positive)
Dosage: 960 mg taken orally twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Colorectal Cancer (BRAF V600 Mutation-Positive)
Dosage: 960 mg taken orally twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Pancreatic Cancer (BRAF V600 Mutation-Positive)
Dosage: 960 mg taken orally twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
BRAF-Mutant Cancer (Other Types)
Dosage: 960 mg taken orally twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Brain Cancer (BRAF V600 Mutation-Positive)
Dosage: 960 mg taken orally twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Liver Cancer (BRAF V600 Mutation-Positive)
Dosage: 960 mg taken orally twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Ovarian Cancer (BRAF V600 Mutation-Positive)
Dosage: 960 mg taken orally twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Breast Cancer (BRAF V600 Mutation-Positive)
Dosage: 960 mg taken orally twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Dosage Forms and Strengths
Tablet: 240 mg
Administration Instructions for Vemurafenib
Vemurafenib can be taken with or without food, but it’s essential to take it at the same time each day. Swallow the tablet whole—do not crush, chew, or split it. If you miss a dose, take it as soon as you remember unless it’s within 4 hours of your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Contraindications for Vemurafenib Treatment
Contraindications are conditions where a medication should not be used because it may be harmful. Before starting Vemurafenib, ensure you don’t have any of the following conditions that could make the treatment unsafe.
Hypersensitivity to Vemurafenib: If you are allergic to Vemurafenib or any of its ingredients, you should not take this medication. Allergic reactions can range from mild skin rashes to severe, life-threatening conditions like anaphylaxis.
QT Prolongation: Vemurafenib may cause or worsen a heart condition called QT prolongation, which affects the heart’s rhythm. If you have a history of QT prolongation or other heart rhythm disorders, Vemurafenib could increase your risk of serious heart complications.
Severe Liver Impairment: If you have significant liver disease, Vemurafenib may not be safe. The liver plays a key role in processing medications, and impaired liver function could lead to higher drug levels in the body, increasing the risk of side effects.
Severe Kidney Impairment: If you have severe kidney disease, your body may not clear Vemurafenib effectively, which could raise the risk of toxicity.
Drug-to-Drug Interactions with Vemurafenib
Vemurafenib can interact with other medications, potentially affecting its effectiveness or increasing the likelihood of side effects. Be sure to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Vemurafenib:
Warfarin (Coumadin): Vemurafenib may enhance the effects of warfarin, a blood thinner, increasing the risk of bleeding.
Ketoconazole (Nizoral): This antifungal medication can raise Vemurafenib levels in your blood, potentially leading to more side effects.
Rifampin (Rifadin): This antibiotic may reduce Vemurafenib’s effectiveness by lowering its levels in the bloodstream.
Phenytoin (Dilantin): This anti-seizure medication may decrease Vemurafenib’s effectiveness by speeding up its breakdown in the liver.
St. John’s Wort: This herbal supplement can also reduce Vemurafenib’s effectiveness by increasing its breakdown in the liver.
Vemurafenib in Pregnancy
Is it safe to take Vemurafenib when pregnant?
Vemurafenib is not recommended during pregnancy. Animal studies suggest it may harm a developing fetus, and there is limited information on its safety in pregnant women. If you are pregnant or planning to become pregnant, it’s essential to consult your healthcare provider about alternative treatments. Additionally, it’s crucial to use effective contraception while taking Vemurafenib and for at least two weeks after your last dose to prevent pregnancy.
Vemurafenib while Breastfeeding
Is it safe to take Vemurafenib while breastfeeding?
It is unclear whether Vemurafenib passes into breast milk. However, due to the potential risk of serious side effects in nursing infants, breastfeeding is not recommended while taking this medication. If you are currently breastfeeding or plan to breastfeed, discuss your options with your healthcare provider. They may advise you to either stop breastfeeding or consider alternative treatments.
Estimated Cost of Vemurafenib
The cost of a 30-day supply of Vemurafenib can vary depending on the pharmacy and your location. Without insurance, the estimated cost using a GoodRX coupon is approximately $11,000 to $12,000 for a 30-day supply. Be sure to check with your pharmacy for the most accurate pricing, and if you have concerns about the cost, discuss potential financial assistance options with your healthcare provider.
Possible Alternatives to Vemurafenib Treatment
If Vemurafenib is not the right option for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore your options.
Melanoma
Alternatives include immunotherapy (e.g., pembrolizumab or nivolumab) and other targeted therapies like dabrafenib. Depending on the stage of the cancer, surgery and radiation therapy may also be considered.
Non-Small Cell Lung Cancer
Other targeted therapies, such as osimertinib, or immunotherapy agents like atezolizumab, may be used. Chemotherapy and radiation are also common treatment options.
Thyroid Cancer
Treatment options may include radioactive iodine therapy, surgery, and other targeted therapies such as lenvatinib or sorafenib.
Colorectal Cancer
Available treatments include chemotherapy, immunotherapy, and other targeted therapies like cetuximab or panitumumab.
Pancreatic Cancer
Chemotherapy (e.g., gemcitabine or FOLFIRINOX) and radiation therapy are common treatments. In some cases, surgery may also be an option.
BRAF-Mutant Cancer
Other targeted therapies, such as dabrafenib or trametinib, may be used to treat cancers with BRAF mutations.
Brain Cancer
Treatment options include surgery, radiation therapy, and chemotherapy. Targeted therapies like bevacizumab may also be considered.
Liver Cancer
Treatment options include surgery, liver transplantation, and targeted therapies such as sorafenib or lenvatinib.
Ovarian Cancer
Chemotherapy, surgery, and targeted therapies like olaparib or bevacizumab are common treatment options.
Breast Cancer
Depending on the type of breast cancer, treatment may involve hormonal therapies (e.g., tamoxifen), chemotherapy, and targeted therapies like trastuzumab or pertuzumab.
Recent Updates on Vemurafenib Research
Recent studies are exploring the combination of Vemurafenib with other therapies to improve outcomes for patients with BRAF-mutant cancers. For instance, ongoing research is investigating the use of Vemurafenib alongside immunotherapy agents like pembrolizumab to enhance the immune system’s ability to fight cancer. Additionally, clinical trials are examining Vemurafenib’s effectiveness in treating cancers beyond melanoma, such as colorectal and thyroid cancers. While these studies show promising results, further research is needed to confirm the long-term benefits and safety of these combinations.
Staying informed about the latest research is important. Be sure to discuss any new treatment options with your healthcare provider. If you have questions about your current treatment plan or are interested in exploring new therapies, consider scheduling a telemedicine appointment with one of our providers today.
