The Basics
What is Vandetanib?
Used to treat thyroid cancer (medullary type).
Brand names for Vandetanib
Caprelsa
How Vandetanib is classified
Antineoplastic Agents, Enzyme Inhibitors, Protein Kinase Inhibitors, Signal Transduction Inhibitors, Tyrosine Kinase Inhibitors
Vandetanib During Pregnancy
Vandetanib pregnancy category
Category DNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Vandetanib while pregnant
Based on its mechanism of action, CAPRELSA can cause fetal harm when administered to a pregnant woman.Vandetanib is embryotoxic, fetotoxic, and teratogenic in rats, at exposures less than or equal to those expected at therecommended human dose of 300 mg/day. If CAPRELSA is used during pregnancy, or if the patient becomes pregnantwhile taking this drug, the patient should be apprised of the potential hazard to a fetus.Animal dataWhen vandetanib was administered to female rats prior to mating and through the first week of pregnancy at a dose of 25mg/kg/day (approximately equal to the human exposure at the recommended dose based on Cmax), there were increases inpre-implantation loss and post-implantation loss resulting in a reduction in the number of live embryos.During organogenesis, a vandetanib dose of 25 mg/kg administered to rats caused an increase in post-implantation loss,including occasional total litter loss. At doses greater than 10 mg/kg (approximately 0.4 times the human exposure at therecommended dose by Cmax) treatment with vandetanib resulted in increases in late embryofetal death and decreases infetal birth weight. A no effect level for malformations was not identified in this study. Administration of vandetanib atdoses greater than or equal to 1 mg/kg/day (approximately 0.03 times, the Cmax in patients with cancer at therecommended dose) resulted in dose dependent increases in both malformations of the heart vessels and skeletalvariations including delayed ossification of the skull, vertebrae, and sternum, indicating delayed fetal development.In a rat pre- and post-natal development study, at doses producing mild maternal toxicity (1 and 10 mg/kg/day) duringgestation and/or lactation, vandetanib decreased pup survival and/or reduced post-natal pup growth. Reduced post-natalpup growth was associated with a delay in physical development.
Taking Vandetanib While Breastfeeding
What are recommendations for lactation if you're taking Vandetanib?
No information is available on the clinical use of vandetanib during breastfeeding. Because vandetanib is 90% bound to plasma proteins, the amount in milk is likely to be low. However, its half-life is 19 days and it might accumulate in the infant. The manufacturer recommends that breastfeeding be discontinued during vandetanib therapy and for 4 months after the last dose.
Maternal / infant drug levels
No information is available on the clinical use of vandetanib during breastfeeding. Because vandetanib is 90% bound to plasma proteins, the amount in milk is likely to be low. However, its half-life is 19 days and it might accumulate in the infant. The manufacturer recommends that breastfeeding be discontinued during vandetanib therapy and for 4 months after the last dose.
Possible effects of Vandetanib on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Vandetanib
None listed
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/None listed
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.