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Erivedge (vismodegib)

Erivedge® (vismodegib) is used to treat certain aggressive cases of basal cell carcinoma (BCC). Metastatic BCC is cancer that has spread to distant parts of the body. Locally advanced BCC is cancer that still confined to the skin tumor, but it is large, recurrent, or difficult to treat.1

Vismodegib is approved to treat2:

  • Metastatic BCC
  • Locally advanced BCC that has recurred (come back) after surgery or patients that cannot be treated with surgery or radiation

Vismodegib does not come in generic form. Vismodegib is similar to Odomzo® (sonidegib), another drug that is approved to treat certain kinds of advanced basal cell carcinoma.

How does Vismodegib work?

Vismodegib blocks a cell signaling pathway called Hedgehog.2 This pathway has a role in the development of hair follicles and glands. It also helps to control skin growth.

Key players in the Hedgehog pathway are two receptors called PTCH1 (“Patched”) and SMO (“Smoothened”).3 In normal cells, PTCH1 acts like an off-switch for SMO. It prevents SMO from sending signals for cell division and survival.

In about 40% of BCC tumors, PTCH1 is mutated.4 Mutated PTCH1 does not turn SMO off, so SMO starts sending out signals. This leads to uncontrolled cell growth and survival.

Vismodegib works by blocking the SMO receptor.2 It is called a targeted therapy, because it targets one feature that makes cancer cells different from normal cells.

How do I take Vismodegib?

Before taking Vismodegib, read the Medication Guide that comes in the package. Follow your doctor’s instructions for dosing and duration.

In general, you take Vismodegib once a day. Vismodegib comes as a capsule that is taken by mouth. Swallow the capsule whole. You can take it with or without food.2

You will continue taking Vismodegib until the cancer progresses or the side effects are unacceptable.2

Patients should take their medication as prescribed by their doctor. Patients should talk to their doctor if they have any questions, or if they have questions regarding their vismodegib regimen.

What are the side effects of Vismodegib?

Nearly all patients experience at least one side effect.6 Most are mild or moderate. The most common side effects of Vismodegib include:2

  • Muscle spasms
  • Hair loss
  • Taste changes, loss of appetite, weight loss
  • Fatigue
  • Gastrointestinal problems (nausea, vomiting, diarrhea or constipation)

Women may stop having a menstrual period while taking Vismodegib. It is not known whether this change is permanent.

Who should not take Vismodegib?

Vismodegib can cause stillbirth or severe birth defects.2 Pregnant women should not take Vismodegib. Women who could become pregnant should use effective birth control during treatment and for 24 months after the last dose. Do not breastfeed while taking Vismodegib or for 24 months after the last dose.

Vismodegib is present in semen.2 Men should always use a condom during sex with a partner who is or could become pregnant. Use a condom during treatment and for 3 months after the last dose of Vismodegib. Do not donate semen during this time.

What precautions are needed when taking Vismodegib?

During treatment with Vismodegib and for 24 months after the last dose:2

  • Do not donate blood or blood products.
  • Women should use effective birth control.
  • Women should not breastfeed.

During treatment with Vismodegib and for 3 months after the last dose, men whose sexual partners are pregnant or could become pregnant should use a condom.

Written by: Sarah O'Brien | Last reviewed: June 2019.
  1. Sekulic A, Migden MR, Lewis K, et al. Pivotal ERIVANCE basal cell carcinoma (BCC) study: 12-month update of efficacy and safety of vismodegib in advanced BCC. J Am Acad Dermatol. 2015;72:1021-1026.
  2. Erivedge® [prescribing information]. South San Francisco, CA: Genentech USA, Inc; November 2016.
  3. My Cancer Genome. Hedgehog signaling. Accessed January 18, 2016 at:
  4. Rudin C. Molecular profiling of basal cell carcinoma (Updated July 15, 2015). My Cancer Genome. Accessed January 6, 2017 at:
  5. National Cancer Institute. Staging. Accessed February 7, 2017 at:
  6. NCCN Clinical Practice Guidelines in Oncology. Basal cell skin cancer. Version 1.2017. Published October 3, 2016.