Vemurafenib (Generic Name)

Other Names:  Zelboraf ®

About This Drug

Vemurafenib is a drug used to treat patients with metastatic melanoma. This drug is administered orally (by mouth).

Possible Side Effects (More Common)

  • Skin
    • Rash, which may be severe. Drugs are available to lessen this side effect.
    • Photosensitivity reaction. Exposure to the sun should be avoided while taking this medication.
    • Dry skin with significant itching.
    • New malignant lesions on your skin. These will need to be removed, but you can continue receiving this drug.
  • Joint and muscle pain
  • Fatigue
  • Nausea, vomiting, diarrhea. Drugs are available to lessen these side effects.
  • Hair loss. This is usually temporary while taking this drug.

Possible Side Effects (Less Common)

  • Fever. Drugs are available to lessen this side effect.
  • Decrease in appetite
  • Cough
  • Changes in liver function.  Lab work will be done to monitor for this side effect.
  • Allergic reactions to this drug occur in some patients.  Signs of an allergic reaction are rash, itching, dizziness, lightheadedness, palpitations (feeing like your heart is beating rapidly), swelling of your face, lips or tongue, and/or wheezing or difficulty breathing

Sexual Problems and Reproduction Concerns

Sexual problems and reproduction concerns may occur. In both men and women, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations. In women, menstrual bleeding may become irregular or stop while you are receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Speak with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Pregnancy Warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment. Ask your doctor or nurse about effective methods of birth control.

Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.

Breast Feeding Warning: It is not known if this drug passes into breast milk. For this reason, women are advised to discuss with their doctor the risks and benefits of breast feeding during treatment with this drug, because this drug may enter the breast milk and seriously harm a breast-feeding infant.

Women may experience signs of menopause such as vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Treating Side Effects

  • Drink 6 to 8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
  • Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash is bothersome.
  • Speak with your nurse about obtaining a wig before you lose your hair. Also, call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good ... Feel Better” program close to where you live. It is a free program for women undergoing chemotherapy to learn about wigs, turbans, and scarves, as well as makeup techniques and skin and nail care.
  • Use sunscreen with SPF 30 or higher when you are outdoors even for a short time. Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.

Food and Drug Interactions

There are no known interactions of vemurafenib with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs, and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's advice.

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Unusual bleeding or bruising
  • Signs of an allergic reaction: Wheezing or difficulty breathing, rash or itching,swelling of your face, lips or tongue, and/or feeling your heart beat rapidly (palpitations). 
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than 3 times a day
  • Diarrhea of several stools a day or diarrhea with dizziness or weakness
  • Blisters or peeling of the skin
  • Redness or swelling of your face, hands, or soles (bottoms) of the feet

Call your doctor or nurse as soon as possible if any of the following symptoms occur:

  • Yellowing of skin or eyes
  • Urine turns dark or brown (tea color)
  • Severe loss of appetite
  • Appearance of a new skin growth or other abnormality on your skin

New September 2011

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