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Overview: Caprelsa is used to treat thyroid cancer. Common side effects include diarrhea, rash, and high blood pressure. Call your health care provider right away if you get a fever, changes in heart rhythm, shortness of breath, or chest pain. Caprelsa is a tablet that you will swallow.

Uses

What is Caprelsa used for?

Caprelsa (vandetanib) is commonly used to treat certain types of thyroid cancer. 

Caprelsa may also be used for other conditions as determined by your health care provider.

How does Caprelsa work (mechanism of action)?

Caprelsa is a type of medicine known as a tyrosine kinase inhibitor (TKI). It works by targeting specific proteins on cancer cells. By blocking the action of these proteins, Caprelsa can cause cancer cells to die and prevent them from growing or spreading.

How is Caprelsa supplied (dosage forms)?

Brands and other names

  • Caprelsa

Dosage forms and strengths

  • 100 mg oral tablets
  • 300 mg oral tablets

How should I store Caprelsa?

Caprelsa should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of Caprelsa?

The most common side effects of Caprelsa are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Diarrhea (see below)
  • Rash
  • Acne
  • High blood pressure (see below)
  • Nausea
  • Headache
  • Infection in the nose or throat, sore throat, or common cold symptoms
  • Loss of appetite
  • Stomach pain

There may be other side effects of Caprelsa that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345

What are the serious side effects of Caprelsa?

While less common, the most serious side effects of Caprelsa are described below, along with what to do if they happen.

Severe Allergic Reactions. Caprelsa may cause allergic reactions, which can be serious. Stop taking Caprelsa and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Heart Rhythm Changes. Caprelsa may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or take medicines that can prolong the QT interval. Tell your health care provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Severe Skin Reactions. Caprelsa can cause severe skin reactions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop Caprelsa and call your health care provider right away. Get emergency help if you have any of the following symptoms of SJS or TEN.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Flu-like symptoms, including fever, chills, and muscle aches

Lung Inflammation. Caprelsa can cause inflammation in your lungs, also called interstitial lung disease or pneumonitis. This can be serious or even life-threatening. Get emergency help if you have trouble breathing. You may also have a cough, fever, or chest pain. 

Stroke. Caprelsa can increase your risk of a stroke that can lead to death. Get emergency help if you have any of the following symptoms of a stroke.

  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech
  • Trouble seeing in one or both of your eyes
  • Trouble walking, dizziness, or lack of balance or coordination

Severe Bleeding. Caprelsa can increase your risk of severe bleeding that can lead to death. Some people with serious bleeding may need a blood transfusion or surgery. Call your health care provider right away if you have any of the following signs of severe bleeding while taking Caprelsa.

  • Pink, red, or brown urine (pee)
  • Vomit with blood that looks like coffee grounds
  • Red or black stools (which look like tar)
  • Coughing up blood or blood clots

Heart Failure. Caprelsa may increase your risk of heart failure. Tell your health care provider right away if you have any of the following symptoms of heart failure.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs
  • Unusually fast weight gain
  • Unusual tiredness

Diarrhea. Diarrhea is common with Caprelsa. Call your health care provider right away if you develop diarrhea or if you have more than two bowel movements in one day. If you are given medicine to prevent or treat diarrhea, take it exactly as your health care provider tells you. Call your health care provider right away if you have any of the following.

  • Severe diarrhea
  • Diarrhea that does not go away
  • Diarrhea with weakness, dizziness, or fever

Low Thyroid Hormones (Hypothyroidism). Caprelsa can cause the function of your thyroid gland to change, which can lead to low thyroid levels. Keep all appointments to have your blood checked. Tell your health care provider if you have any of the following signs of low thyroid hormone levels.

  • Weight gain
  • Feeling cold
  • Tiredness that does not go away or continues to worsen
  • Constipation

Increased Blood Pressure (Hypertension). Caprelsa may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your health care provider if your blood pressure increases while taking this medicine.

If you measure your blood pressure and the top number (systolic) is 180 or higher or the bottom number (diastolic) is 120 or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your health care provider right away if you have any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea or vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Posterior Reversible Encephalopathy Syndrome (PRES). Caprelsa may cause a rare but serious brain condition called PRES. PRES involves swelling and narrowing of blood vessels in your brain. If PRES is not treated, it can lead to a stroke. Call your health care provider right away if you have the following symptoms of PRES.

  • Changes in thinking or behavior
  • Confusion or hallucinations
  • Sudden decrease or change in vision
  • Sudden severe headache
  • Seizures

Kidney Damage. Kidney damage can happen when taking Caprelsa. Call your health care provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

Wound Healing Issues. Caprelsa can make it difficult for your body to heal wounds. Tell your health care provider if you have any planned or emergency surgeries or if you have any injuries that occur while taking Caprelsa.

Warnings & Precautions

Who should not use Caprelsa?

Allergies to Ingredients. People who are allergic to any of the following should not take Caprelsa.

  • Caprelsa
  • Vandetanib
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Caprelsa.

Heart Rhythm Problems. If you have a condition called QT prolongation or long QT syndrome, you should not take Caprelsa. Talk to your health care provider about any problems you have had with your heart.

What should I know about Caprelsa before using it?

Do not take Caprelsa unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share Caprelsa with other people, even if they have the same condition as you. It may harm them.

Keep Caprelsa out of the reach of children.

Take Caprelsa whole with water. Do not crush the tablets. If you accidentally crush Caprelsa, make sure it does not touch your skin. If you cannot swallow Caprelsa, talk to your health care provider or pharmacist about options to take the medicine. 

Your health care provider will test your blood pressure while you take Caprelsa. 

Caprelsa can make your skin more sensitive to light from the sun, sunlamps, and tanning beds. This is called photosensitivity. Exposure to this light can cause severe sunburns, blisters, and swelling. If you need to be in sunlight while taking Caprelsa and for four months after your last dose, wear sunscreen, a hat, and clothing that covers your skin.

Caprelsa can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how Caprelsa affects you.

Caprelsa is only available through a special program, from certain pharmacies, and to certain people. It is important that you keep all of your appointments, including labs or other testing, while taking Caprelsa. If you have any questions about this program you can go to www.caprelsarems.com or call 800-817-2722.

Call your health care provider right away if you feel lightheaded, close to fainting, or feel your heart beating differently while taking Caprelsa. 

Caprelsa may make it difficult for you to get pregnant or get your partner pregnant. If you have concerns, talk to your health care provider.

What should I tell my health care provider before using Caprelsa?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Caprelsa is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Heart problems, including cardiomyopathy, an abnormal heartbeat, heart failure, and QT prolongation
  • Any family members who have heart problems like QT prolongation
  • Low blood levels of potassium, calcium, magnesium
  • Thyroid problems or high levels of thyroid-stimulating hormone (TSH)
  • High blood pressure
  • Skin problems
  • Breathing problems
  • History of coughing up blood
  • Bleeding problems
  • Diarrhea or digestion problems
  • Liver problems
  • Kidney problems
  • Seizures
  • Recent or planned surgery

Other Medicines and Supplements. Caprelsa may interact with other medicines and supplements. Before taking Caprelsa, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Caprelsa may cause harm to a fetus. Your health care provider will give you a test to make sure you are not pregnant before you start taking Caprelsa. If you can get pregnant, you should use birth control while taking Caprelsa and for four months after your last dose. If you are able to get a partner pregnant, you should use condoms while taking Caprelsa and for four months after your last dose. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if Caprelsa passes into breast milk. Do not breastfeed while taking Caprelsa and for four months after your last dose. Tell your health care provider if you are breastfeeding or plan to breastfeed.

How can I get more information about Caprelsa?

For more information about Caprelsa, you can visit the drugmaker’s website at www.caprelsa.com or call them at 800-817-2722.

Interactions

Does Caprelsa interact with foods or drinks?

Grapefruit, star fruit, pomegranate, and Seville oranges interact with Caprelsa. It is important to avoid eating grapefruit, star fruit, pomegranate, and Seville oranges or drinking the juice of these fruits while taking Caprelsa. This is because these fruits can interfere with your body’s ability to break down Caprelsa, which can lead to high levels of the medicine and an increased risk of side effects. 

It is unknown if drinking alcohol will affect Caprelsa, but heavy drinking can slow your immune response and make it harder for your body to fight cancer.

Does Caprelsa interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking Caprelsa.

  • St. John’s wort, which is a supplement that may be used for depression
  • A medicine used to control your heart rate or rhythm (antiarrhythmic), such as amiodarone, disopyramide, dofetilide, procainamide, and sotalol
  • Any medicine that can cause QT prolongation, which is a potentially dangerous heart rhythm problem, such as chloroquine, clarithromycin, dolasetron, granisetron, haloperidol, methadone, moxifloxacin, and pimozide
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • Metformin, a medicine used to treat diabetes
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis

Some other medicines may alter the blood levels of Caprelsa and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Caprelsa. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Caprelsa?

If you or someone else has used too much Caprelsa, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Caprelsa?

If you miss a dose, take it as soon as you remember. If it is less than 12 hours until your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.