Vizimpro (Dacomitinib) - Oral

What Is Vizimpro?

Vizimpro (dacomitinib) is a medication used to treat a type of lung cancer called non-small cell lung cancer (NSCLC). It is known as a kinase inhibitor.

Vizimpro tablets are only used when the NSCLC is metastatic, which means it has spread to areas outside where it originally started. It must also have an epidermal growth factor (EGFR) mutation, an abnormal protein in the tumor tissue.

This treatment works by affecting the EGFR pathway. In NSCLC, EGFR mutations signal abnormal growth of lung cancer cells. By interfering with this pathway, Vizimpro inhibits the growth of cancer cells.

Vizimpro is available in tablet form to be taken by mouth.

What Is Vizimpro Used For?

Vizimpro is approved for use in metastatic NSCLC with a mutation in EGFR exon 19 or exon 21 L858R. These mutations can be found using special testing called next-generation sequencing. This type of testing looks for genetic mutations in the DNA of the cancer cells. With this mutation, the EGFR pathways are abnormal and signal the cancer cells to grow uncontrollably.

If an EGFR exon 19 or exon 21 L858R mutation is found, Vizimpro can be used in first-line treatment. This would be the first medication used to treat that cancer. Vizimpro is not chemotherapy; it targets the EGFR pathway and interferes with one of the pathways that cancer cells use to grow.

How to Take Vizimpro 

Vizimpro is taken by mouth daily and can be taken with or without food. It should also be taken around the same time each day.

Since proton pump inhibitors interact with Vizimpro, people may take antacids or H2 blockers, also called H2 receptor agonists, as alternatives. Make sure to take your dose of Vizimpro at least six hours before or 10 hours after any antacids or H2 blockers to avoid interactions.

Storage

This medication should be stored in its original container. Do not store it in the bathroom.The pill bottle should be kept at room temperature (between 68 F and 77 F) and out of the reach of children and pets.

What Are the Side Effects of Vizimpro?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider or a pharmacist. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects 

The most common side effects of Vimprizo include:

• Diarrhea
• Rash on the skin
• Irritation to the nail beds
• Sores or irritation inside the mouth
• Decreased appetite and weight loss
• Dry skin
• Cough
• Hair loss
• Itching

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Diarrhea: This is a common side effect but has the potential of being severe, leading to dehydration, electrolyte imbalances, and hospitalization. 
• Interstitial lung disease: This is a condition that can lead to breathing problems. The symptoms can include shortness of breath, cough, and fever. 
• Severe skin reactions: Skin rash is a common side effect. However, sometimes severe skin lesions can develop. These lesions, especially when exposed to the sun, can lead to severe peeling, blistering, and pain. 

Dosage: How Much Vizimpro Should I Take?

Missed Dose 

If a dose of Vizimpro is missed, the missed dose should be skipped. It should not be doubled up on. The next dose should be taken at the next scheduled time.

Overdose: What Happens If I Take Too Much Vizimpro? 

If you take more than the prescribed dose of Vizimpro, notify your oncology team immediately. They may have specific instructions for you if you’ve taken too much. 

Precautions

What Are Reasons I Shouldn’t Take Vizimpro?

Vizimpro should not be taken if you are allergic to it or any of its ingredients. It should also not be taken by anyone who is pregnant or breastfeeding.

What Other Medications Interact With Vizimpro?

Some medications should not be used along with Vizimpro. For example, using proton pump inhibitors (PPIs) may reduce how well Vizimpro works. Additionally, Vizimpro can increase the effects of drugs that are CYP2D6 substrates, which can lead to toxicity risks for certain medications.

Examples of medications that interact with Vizimpro include:

• PPIs include Prilosec (omeprazole) and Nexium (esomeprazole), among others. Avoid taking these medications with Vizimpro. Some people may use antacids or H2 blockers as an alternative, although be sure to take your Vizimpro dose at least six hours before or 10 hours after taking these.
• Thioridazine is a CYP2D6 substrate used to treat schizophrenia and psychosis. Vizimpro can increase the effects of this medication when taken together.
• Ingrezza (valbenazine) is a CYP2D6 substrate used to treat tardive dyskinesia. You may need a lower dose of valbenazine if taking it with Vizimpro.

This is not a complete list of drugs that can interact with Vizimpro. Talk to your healthcare provider about your prescription and over-the-counter (OTC) medicines, vitamins, and herbal supplements to avoid potential interactions.

What Medications Are Similar?

Multiple EGFR medications have been approved to treat lung cancer. These work in a similar way to Vizimpro, but should not be taken together:

• Tarceva (erlotinib)
• Gilotrif (afatinib)
• Iressa (gefitinib)
• Tagrisso (osimertinib)

How Can I Stay Healthy While Taking Vizimpro?

Thanks to advances in medicine, newer and better treatments have provided additional options to people diagnosed with lung cancer. Still, a cancer diagnosis can be scary and overwhelming, especially when managing the symptoms and effects of treatment.

When taking Vizimpro, it's important to take it exactly as your oncology team prescribes. It is also important to communicate regularly with them to discuss any side effects. They can be an excellent resource for learning how to manage side effects. Your healthcare provider may prescribe additional medications or adjust the dosages of current ones if side effects become intolerable.