Caprelsa and Cardioquin

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using vandetanib together with quiNIDine. Combining these medications can increase the risk of an irregular heart rhythm that may be serious. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or special monitoring by your doctor to safely use both medications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Vandetanib can cause concentration-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death. In a phase 3 clinical trial where 231 medullary thyroid cancer patients were randomized to receive vandetanib 300 mg once daily, mean change in QTcF (Fridericia-corrected QT interval) from baseline based on the exposure-response relationship was 35 ms for the 300 mg dose. The QTcF increase remained above 30 ms for the duration of the trial (up to 2 years). In addition, 36% of patients experienced greater than 60 ms QTcF increases from baseline and 4.3% had QTcF greater than 500 ms. Vandetanib treatment alone has been associated with reported cases of torsade de pointes, ventricular tachycardia, and sudden death. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia, hypocalcemia). Moreover, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s).

MANAGEMENT: The use of vandetanib in combination with other medications that can prolong the QT interval should generally be avoided. Should treatment with other QT-prolonging drugs be required, the manufacturer recommends more frequent monitoring of the ECG as well as serum potassium, magnesium, and calcium levels. Given vandetanib's half-life of 19 days, ECGs and serum electrolytes should typically be obtained at baseline, at 2 to 4 weeks and 8 to 12 weeks after starting treatment, and every 3 months thereafter. Vandetanib should not be started if baseline QTcF is greater than 450 ms, and treatment should be interrupted if QTcF is greater than 500 ms. Treatment may resume when QTcF returns to less than 450 ms, but at a reduced dosage. In addition, hypokalemia, hypomagnesemia, and/or hypocalcemia must be corrected prior to vandetanib administration. Since diarrhea is a common side effect of vandetanib and may cause electrolyte imbalances, ECG and electrolyte levels should also be monitored more frequently when diarrhea develops. Vandetanib treatment should be stopped in the presence of severe diarrhea. Treatment may resume when diarrhea improves, but at a reduced dosage. Following any dosage reduction, or any interruption of treatment greater than 2 weeks, QT assessment and serum electrolytes should be conducted as described previously. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitations, irregular heartbeat, shortness of breath, or syncope. Because of the drug's long half-life, adverse reactions including a prolonged QT interval may not resolve quickly, thus appropriate monitoring is necessary.

Caprelsa

Generic Name: vandetanib

Brand name: Caprelsa

Synonyms: n.a.

What is Caprelsa?

Cardioquin

Generic Name: quinidine

Brand name: Quin-G, Cardioquin, Quinora, Quinidex Extentabs, Quinaglute Dura-Tabs, Quin-Release

Synonyms: n.a.

What is Cardioquin?