Vismodegib – Uses, Dosage, Side Effects, Interaction

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 41 min read
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Vismodegib - Uses, Dosage, Side Effects, Interaction
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Vismodegib is an orally bioavailable, small molecule inhibitor of SMO and the Hedgehog (Hh) pathway, with potential antineoplastic activity. Upon oral administration, vismodegib targets binds to, and inhibits the cell membrane-spanning G-protein coupled receptor SMO, which may result in the suppression of Hh pathway signaling...

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Article Summary

Vismodegib is an orally bioavailable, small molecule inhibitor of SMO and the Hedgehog (Hh) pathway, with potential antineoplastic activity. Upon oral administration, vismodegib targets binds to, and inhibits the cell membrane-spanning G-protein coupled receptor SMO, which may result in the suppression of Hh pathway signaling and a decrease in tumor cell proliferation and survival. SMO is activated upon binding of the Hh ligand to the...

Key Takeaways

  • This article explains Mechanism of Action in simple medical language.
  • This article explains Indications in simple medical language.
  • This article explains Contraindications in simple medical language.
  • This article explains Dosage in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
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Vismodegib is an orally bioavailable, small molecule inhibitor of SMO and the Hedgehog (Hh) pathway, with potential antineoplastic activity. Upon oral administration, vismodegib targets binds to, and inhibits the cell membrane-spanning G-protein coupled receptor SMO, which may result in the suppression of Hh pathway signaling and a decrease in tumor cell proliferation and survival. SMO is activated upon binding of the Hh ligand to the cell surface receptor Patched (PTCH); inappropriate activation of Hh signaling and uncontrolled cellular proliferation may be associated with SMO mutations.

Vismodegib is a kinase inhibitor actively used in the therapy of unresectable or metastatic basal cell carcinoma. Vismodegib therapy is associated with a low rate of transient elevations in serum aminotransferase during therapy and has been linked to rare cases of clinically apparent acute liver injury.

Vismodegib is a benzamide obtained by formal condensation between the carboxy group of 2-chloro-4-(methylsulfonyl)benzoic acid and the aniline group of 4-chloro-3-(pyridine-2-yl)aniline. Used for the treatment of metastatic basal cell carcinoma. It has a role as an antineoplastic agent, an SMO receptor antagonist, a Hedgehog signaling pathway inhibitor, and a teratogenic agent. It is a sulfone, a member of benzamides, a member of pyridines, and a member of monochlorobenzenes.

Mechanism of Action

Mutations of the Hedgehog pathway may results in uncontrolled proliferation of skin basal cells. Vismodegib binds to and inhibits the transmembrane protein Smoothened homologue (SMO) to inhibit the Hedgehog signalling pathway. Vismodegib is an inhibitor of the Hedgehog pathway. Vismodegib binds to and inhibits Smoothened, a transmembrane protein involved in Hedgehog signal transduction.

Recent evidence from in vitro and in vivo studies has demonstrated that aberrant reactivation of the Sonic Hedgehog (SHH) signaling pathway regulates genes that promote cellular proliferation in various human cancer stem cells (CSCs). Therefore, the chemotherapeutic agents that inhibit activation of Gli transcription factors have emerged as promising novel therapeutic drugs for pancreatic cancer. GDC-0449 (Vismodegib), orally administrable molecule belonging to the 2-arylpyridine class, inhibits SHH signaling pathway by blocking the activities of Smoothened. The objectives of this study were to examine the molecular mechanisms by which GDC-0449 regulates human pancreatic CSC characteristics in vitro. GDC-0499 inhibited cell viability and induced apoptosis in three pancreatic cancer cell lines and pancreatic CSCs. This inhibitor also suppressed cell viability, Gli-DNA binding and transcriptional activities, and induced apoptosis through caspase-3 activation and PARP cleavage in pancreatic CSCs. GDC-0449-induced apoptosis in CSCs showed increased Fas expression and decreased expression of PDGFRa. Furthermore, Bcl-2 was down-regulated whereas TRAIL-R1/DR4 and TRAIL-R2/DR5 expression was increased following the treatment of CSCs with GDC-0449. Suppression of both Gli1 plus Gli2 by shRNA mimicked the changes in cell viability, spheroid formation, apoptosis and gene expression observed in GDC-0449-treated pancreatic CSCs. Thus, activated Gli genes repress DRs and Fas expressions, up-regulate the expressions of Bcl-2 and PDGFRa and facilitate cell survival. These data suggest that GDC-0499 can be used for the management of pancreatic cancer by targeting pancreatic CSCs.

or

Hedgehog (Hh) signaling is involved in the pathogenesis of liver chronic injury or inflammation. সহজ বাংলা: অতিরিক্ত দাগের মতো টিস্যু তৈরি হওয়া।" data-rx-term="fibrosis" data-rx-definition="Fibrosis means excess scar-like tissue formation after chronic injury or inflammation. সহজ বাংলা: অতিরিক্ত দাগের মতো টিস্যু তৈরি হওয়া।">fibrosis. It has been previously shown that Hh-inhibitor cyclopamine (CYA) can reduce liver chronic injury or inflammation. সহজ বাংলা: অতিরিক্ত দাগের মতো টিস্যু তৈরি হওয়া।" data-rx-term="fibrosis" data-rx-definition="Fibrosis means excess scar-like tissue formation after chronic injury or inflammation. সহজ বাংলা: অতিরিক্ত দাগের মতো টিস্যু তৈরি হওয়া।">fibrosis in rats. However, CYA is not stable in vivo, which limits its clinical application. This study compares the antifibrotic potential of two known Hh antagonists, vismodegib (GDC-0449, abbreviated to GDC) and CYA. GDC is a synthetic molecule presently in clinical cancer trials and has been reported to be safe and efficacious. These drugs attenuated early liver fibrosis in common bile duct ligated rats, improved liver function, and prevented hepatic stellate cell (HSC) activation, thereby suppressing epithelial to mesenchymal transition (EMT). While both CYA and GDC increased the number of proliferating cell nuclear antigen positive liver cells in vivo, only CYA increased Caspase-3 expression in HSCs in rat livers, suggesting that while GDC and CYA effectively attenuate early liver fibrosis, their hepatoprotective effects may be mediated through different modes of action. Thus, GDC has the potential to serve as a new therapeutic agent for treating early liver fibrosis.

Indications

  • Vismodegib is used for treating locally advanced or metastatic basal cell carcinoma in patients whose carcinoma has recurred after surgery, and in patients who are not candidates for surgery or radiation.
  • Erivedge is indicated for the treatment of adult patients with: symptomatic metastatic basal cell carcinoma locally advanced basal cell carcinoma inappropriate for surgery or radiotherapy
  • Vismodegib is a kinase inhibitor active used in the therapy of unresectable or metastatic basal cell carcinoma.
  • Erivedge capsule is indicated for the treatment of adults with metastatic basal cell carcinoma, or with locally advanced basal cell carcinoma that has recurred following surgery or who are not candidates for surgery, and who are not candidates for radiation.
  • Vismodegib is indicated for patients with basal cell carcinoma (BCC) which has metastasized to other parts of the body, relapsed after surgery, or cannot be treated with surgery or radiation.
  • Vismodegib is a hedgehog pathway inhibitor used to treat patients with locally advanced or metastatic basal cell carcinoma.
  • Vismodegib is used for treating locally advanced or metastatic basal cell carcinoma in patients whose carcinoma has recurred after surgery, and in patients who are not candidates for surgery or radiation.
  • Locally Advanced Basal Cell Carcinoma
  • Metastatic Basal cell carcinoma

Use in Cancer

Vismodegib is approved to treat:

  • Basal cell carcinoma (a type of skin cancer). It is used in adults whose disease has metastasized (spread to other parts of the body). It is also used in adults with locally advanced disease that has recurred (come back) after surgery or who cannot be treated with surgery or radiation.

Vismodegib is also being studied in the treatment of other types of cancer.

Contraindications

Vismodegib is contraindicated in pregnant women or women who may become pregnant.

Boxed Warning of Embryofetal Toxicity

Embryotoxic effects include:

  • Craniofacial abnormalities
  • Anorectal defects
  • Fused or absent digits

Blood Donations – Patients should be advised not to donate blood or blood products during vismodegib treatment and at least 24 months after the last dose.

Important Special Warnings – Counseling of both males and females on vismodegib is necessary.

Women- Following a negative pregnancy test, initiate highly effective contraception before the first dose of vismodegib and continue for seven months after treatment.

Men – During treatment, and for three months following treatment, men should not donate sperm and should use condoms with spermicide (even after vasectomy) as vismodegib may be present in seminal fluid. This precaution is to avoid exposure to patients that may be pregnant.

Dosage

Strengths: 150 mg

Basal Cell Carcinoma

  • 150 mg orally once a day until disease progression or unacceptable toxicity
  • Withhold therapy for up to 8 weeks for intolerable adverse reactions until improvement or resolution.
  • Treatment durations shorter than 8 weeks prior to interruptions have not been studied.

EMBRYOFETAL TOXICITY:

  • This drug can cause embryofetal death or severe birth defects when administered to a pregnant woman.
  • This drug is embryotoxic, fetotoxic, and teratogenic in animals.
  • Teratogenic effects include severe midline defects, missing digits, and other irreversible malformations.
  • Verify the pregnancy status of females of reproductive potential within 7 days prior to initiating therapy.
  • Advise pregnant women of the potential risks to a fetus.
  • Advise females of reproductive potential to use effective contraception during and after therapy.
  • Advise males of the potential risk of drug exposure through semen and to use condoms with a pregnant partner or a female partner of reproductive potential.

Administration advice:

  • This drug may be taken with or without food.
  • Swallow capsules whole; do not open or crush.
  • If a dose of is missed, do not make it up; resume with the next scheduled dose.
  • Verify pregnancy status of females of reproductive potential within 7 days prior to initiating this drug.

Side Effects

The Most Common

  • muscle spasms
  • joint pain
  • tiredness
  • hair loss
  • change in how things taste or loss of taste
  • decreased appetite
  • weight loss
  • nausea
  • vomiting
  • diarrhea
  • constipation
  • missed menstrual periods
  • Absent, missed, or irregular menstrual periods
  • change in taste
  • constipation
  • decreased appetite
  • diarrhea
  • difficulty having a bowel movement
  • difficulty with moving
  • hair loss or thinning
  • loss of taste
  • muscle spasm or stiffness
  • pain in the joints
  • stopping of menstrual bleeding
  • weight loss

More Common

  • Bloody or cloudy urine
  • confusion
  • decreased urine output
  • dizziness
  • dry mouth
  • fast or irregular heartbeat
  • pain in the head or upper neck. সহজ বাংলা: মাথাব্যথা।" data-rx-term="headache" data-rx-definition="Headache means pain in the head or upper neck. সহজ বাংলা: মাথাব্যথা।">headache
  • increased thirst
  • loss of consciousness
  • muscle pain or cramps
  • nausea
  • pain in the lower back or side
  • seizures
  • swelling of the face, ankles, or hands
  • thirst
  • unusual tiredness or weakness
  • vomiting

Rare

  • Black, tarry stools
  • blistering, peeling, loosening of the skin
  • chest pain
  • chills
  • cough
  • diarrhea
  • itching skin
  • joint or muscle pain
  • painful or difficult urination
  • red irritated eyes
  • red skin lesions, often with a purple center
  • sores, ulcers, or white spots in the mouth or on the lips
  • sore throat
  • swollen glands
  • trouble breathing
  • unusual bleeding or bruising
  • yellow eyes or skin

Drug interactions

Pregnancy and Lactation

FDA Pregnancy Category D

Pregnancy

Vismodegib capsule can cause fetal harm when administered to a pregnant female based on its mechanism of action. Vismodegib is teratogenic in rats at doses corresponding to an exposure of 20% of the exposure at the recommended human dose (estimated AUC0-24hr steady-state exposure). In rats, malformations included craniofacial anomalies, open perineum, and absent or fused digits. Fetal retardations and variations were also observed. Vismodegib is embryolethal in rats at exposures within the range achieved at the recommended human dose. If vismodegib is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the  potential hazard to the embryo or fetus. Encourage women who may have been exposed to vismodegib during pregnancy, either directly or through seminal fluid, to participate in the vismodegib pregnancy pharmacovigilance program by contacting the Genentech

Lactation

No information is available on the clinical use of vismodegib during breastfeeding. Because vismodegib is more than 99% bound to plasma proteins, the amount in milk is likely to be low. However, its half-life is 4 days and it might accumulate in the infant. The manufacturer recommends that breastfeeding be discontinued during vismodegib therapy and for 24 months after the final dose.

How should this medicine be used?

Vismodegib comes as a capsule to take by mouth. It is usually taken once a day with or without food. To help you remember to take vismodegib, take it at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take vismodegib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the capsules whole; do not split, chew, or crush them.

What special precautions should I follow?

Before taking vismodegib,

  • tell your doctor and pharmacist if you are allergic to vismodegib, any other medications, or any of the ingredients in vismodegib capsules. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antacids; certain antibiotics such as azithromycin (Z-Pak, Zithromax), clarithromycin (Biaxin, in Prevpac), and erythromycin (E.E.S., Eryc, Ery-Tab, Erythrocin, PCE); a medication for indigestion, heartburn, or ulcers such as cimetidine (Tagamet), famotidine (Pepcid), and ranitidine (Zantac); and proton-pump inhibitors such as dexlansoprazole (Dexilant), lansoprazole (Prevacid, in Prevpac), omeprazole (Prilosec, Zegerid), pantoprazole (Protonix), and rabeprazole (AcipHex). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with vismodegib, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
  • do not breastfeed while you are taking vismodegib and for 7 months after your treatment.

References

Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Emergency care / cardiology / medicine doctor
Tests to discuss with doctor
  • ECG as early as possible when chest pain suggests heart risk
  • Troponin or cardiac blood tests if doctor suspects heart attack
  • Blood pressure, oxygen level, chest examination, and other tests as advised urgently
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
  • Is this heart-related, and do I need emergency observation?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Vismodegib – Uses, Dosage, Side Effects, Interaction

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Mechanism of Action Mutations of the Hedgehog pathway may results in uncontrolled proliferation of skin basal cells. Vismodegib binds to and inhibits the transmembrane protein Smoothened homologue (SMO) to inhibit the Hedgehog signalling pathway. Vismodegib is an inhibitor of the Hedgehog pathway. Vismodegib binds to and inhibits Smoothened, a transmembrane protein involved in Hedgehog signal transduction. Recent evidence from in vitro and in vivo studies has demonstrated that aberrant reactivation of the Sonic Hedgehog (SHH) signaling pathway regulates genes that promote cellular proliferation in various human cancer stem cells (CSCs). Therefore, the chemotherapeutic agents that inhibit activation of Gli transcription factors have emerged as promising novel therapeutic drugs for pancreatic cancer. GDC-0449 (Vismodegib), orally administrable molecule belonging to the 2-arylpyridine class, inhibits SHH signaling pathway by blocking the activities of Smoothened. The objectives of this study were to examine the molecular mechanisms by which GDC-0449 regulates human pancreatic CSC characteristics in vitro. GDC-0499 inhibited cell viability and induced apoptosis in three pancreatic cancer cell lines and pancreatic CSCs. This inhibitor also suppressed cell viability, Gli-DNA binding and transcriptional activities, and induced apoptosis through caspase-3 activation and PARP cleavage in pancreatic CSCs. GDC-0449-induced apoptosis in CSCs showed increased Fas expression and decreased expression of PDGFRa. Furthermore, Bcl-2 was down-regulated whereas TRAIL-R1/DR4 and TRAIL-R2/DR5 expression was increased following the treatment of CSCs with GDC-0449. Suppression of both Gli1 plus Gli2 by shRNA mimicked the changes in cell viability, spheroid formation, apoptosis and gene expression observed in GDC-0449-treated pancreatic CSCs. Thus, activated Gli genes repress DRs and Fas expressions, up-regulate the expressions of Bcl-2 and PDGFRa and facilitate cell survival. These data suggest that GDC-0499 can be used for the management of pancreatic cancer by targeting pancreatic CSCs. or Hedgehog (Hh) signaling is involved in the pathogenesis of liver fibrosis. It has been previously shown that Hh-inhibitor cyclopamine (CYA) can reduce liver fibrosis in rats. However, CYA is not stable in vivo, which limits its clinical application. This study compares the antifibrotic potential of two known Hh antagonists, vismodegib (GDC-0449, abbreviated to GDC) and CYA. GDC is a synthetic molecule presently in clinical cancer trials and has been reported to be safe and efficacious. These drugs attenuated early liver fibrosis in common bile duct ligated rats, improved liver function, and prevented hepatic stellate cell (HSC) activation, thereby suppressing epithelial to mesenchymal transition (EMT). While both CYA and GDC increased the number of proliferating cell nuclear antigen positive liver cells in vivo, only CYA increased Caspase-3 expression in HSCs in rat livers, suggesting that while GDC and CYA effectively attenuate early liver fibrosis, their hepatoprotective effects may be mediated through different modes of action. Thus, GDC has the potential to serve as a new therapeutic agent for treating early liver fibrosis. Indications Vismodegib is used for treating locally advanced or metastatic basal cell carcinoma in patients whose carcinoma has recurred after surgery, and in patients who are not candidates for surgery or radiation. Erivedge is indicated for the treatment of adult patients with: symptomatic metastatic basal cell carcinoma locally advanced basal cell carcinoma inappropriate for surgery or radiotherapy Vismodegib is a kinase inhibitor active used in the therapy of unresectable or metastatic basal cell carcinoma. Erivedge capsule is indicated for the treatment of adults with metastatic basal cell carcinoma, or with locally advanced basal cell carcinoma that has recurred following surgery or who are not candidates for surgery, and who are not candidates for radiation. Vismodegib is indicated for patients with basal cell carcinoma (BCC) which has metastasized to other parts of the body, relapsed after surgery, or cannot be treated with surgery or radiation. Vismodegib is a hedgehog pathway inhibitor used to treat patients with locally advanced or metastatic basal cell carcinoma. Vismodegib is used for treating locally advanced or metastatic basal cell carcinoma in patients whose carcinoma has recurred after surgery, and in patients who are not candidates for surgery or radiation. Locally Advanced Basal Cell Carcinoma Metastatic Basal cell carcinoma Use in Cancer Vismodegib is approved to treat: Basal cell carcinoma (a type of skin cancer). It is used in adults whose disease has metastasized (spread to other parts of the body). It is also used in adults with locally advanced disease that has recurred (come back) after surgery or who cannot be treated with surgery or radiation. Vismodegib is also being studied in the treatment of other types of cancer. Contraindications Vismodegib is contraindicated in pregnant women or women who may become pregnant. Boxed Warning of Embryofetal Toxicity Embryotoxic effects include: Craniofacial abnormalities Anorectal defects Fused or absent digits Blood Donations - Patients should be advised not to donate blood or blood products during vismodegib treatment and at least 24 months after the last dose. Important Special Warnings - Counseling of both males and females on vismodegib is necessary. Women- Following a negative pregnancy test, initiate highly effective contraception before the first dose of vismodegib and continue for seven months after treatment. Men - During treatment, and for three months following treatment, men should not donate sperm and should use condoms with spermicide (even after vasectomy) as vismodegib may be present in seminal fluid. This precaution is to avoid exposure to patients that may be pregnant. Dosage Strengths: 150 mg Basal Cell Carcinoma 150 mg orally once a day until disease progression or unacceptable toxicity Withhold therapy for up to 8 weeks for intolerable adverse reactions until improvement or resolution. Treatment durations shorter than 8 weeks prior to interruptions have not been studied. EMBRYOFETAL TOXICITY: This drug can cause embryofetal death or severe birth defects when administered to a pregnant woman. This drug is embryotoxic, fetotoxic, and teratogenic in animals. Teratogenic effects include severe midline defects, missing digits, and other irreversible malformations. Verify the pregnancy status of females of reproductive potential within 7 days prior to initiating therapy. Advise pregnant women of the potential risks to a fetus. Advise females of reproductive potential to use effective contraception during and after therapy. Advise males of the potential risk of drug exposure through semen and to use condoms with a pregnant partner or a female partner of reproductive potential. Administration advice: This drug may be taken with or without food. Swallow capsules whole; do not open or crush. If a dose of is missed, do not make it up; resume with the next scheduled dose. Verify pregnancy status of females of reproductive potential within 7 days prior to initiating this drug. Side Effects The Most Common muscle spasms joint pain tiredness hair loss change in how things taste or loss of taste decreased appetite weight loss nausea vomiting diarrhea constipation missed menstrual periods Absent, missed, or irregular menstrual periods change in taste constipation decreased appetite diarrhea difficulty having a bowel movement difficulty with moving hair loss or thinning loss of taste muscle spasm or stiffness pain in the joints stopping of menstrual bleeding weight loss More Common Bloody or cloudy urine confusion decreased urine output dizziness dry mouth fast or irregular heartbeat headache increased thirst loss of consciousness muscle pain or cramps nausea pain in the lower back or side seizures swelling of the face, ankles, or hands thirst unusual tiredness or weakness vomiting Rare Black, tarry stools blistering, peeling, loosening of the skin chest pain chills cough diarrhea itching skin joint or muscle pain painful or difficult urination red irritated eyes red skin lesions, often with a purple center sores, ulcers, or white spots in the mouth or on the lips sore throat swollen glands trouble breathing unusual bleeding or bruising yellow eyes or skin Drug interactions DRUG INTERACTION Abametapir The serum concentration of Vismodegib can be increased when it is combined with Abametapir. Abatacept The metabolism of Vismodegib can be increased when combined with Abatacept. Abemaciclib Vismodegib may decrease the excretion rate of Abemaciclib which could result in a higher serum level. Abrocitinib The metabolism of Abrocitinib can be decreased when combined with Vismodegib. Acenocoumarol The metabolism of Vismodegib can be decreased when combined with Acenocoumarol. Acetohexamide The metabolism of Vismodegib can be decreased when combined with Acetohexamide. Acetyl sulfisoxazole The metabolism of Vismodegib can be decreased when combined with Acetyl sulfisoxazole. Acetylsalicylic acid The metabolism of Vismodegib can be decreased when combined with Acetylsalicylic acid. Adalimumab The metabolism of Vismodegib can be increased when combined with Adalimumab. Afatinib Vismodegib may decrease the excretion rate of Afatinib which could result in a higher serum level. Agomelatine The metabolism of Vismodegib can be decreased when combined with Agomelatine. Allopurinol Vismodegib may decrease the excretion rate of Allopurinol which could result in a higher serum level. Alosetron The metabolism of Vismodegib can be decreased when combined with Alosetron. Alpelisib The serum concentration of Alpelisib can be increased when it is combined with Vismodegib. Aminophenazone The metabolism of Vismodegib can be decreased when combined with Aminophenazone. Amiodarone The metabolism of Vismodegib can be decreased when combined with Amiodarone. Amitriptyline The metabolism of Vismodegib can be decreased when combined with Amitriptyline. Amodiaquine The metabolism of Vismodegib can be decreased when combined with Amodiaquine. Amprenavir The metabolism of Vismodegib can be decreased when combined with Amprenavir. Anakinra The metabolism of Vismodegib can be increased when combined with Anakinra. Antipyrine The metabolism of Vismodegib can be decreased when combined with Antipyrine. Apalutamide The metabolism of Vismodegib can be increased when combined with Apalutamide. Apixaban Vismodegib may decrease the excretion rate of Apixaban which could result in a higher serum level. Apremilast The metabolism of Vismodegib can be increased when combined with Apremilast. Aprepitant The metabolism of Vismodegib can be decreased when combined with Aprepitant. Arformoterol The metabolism of Vismodegib can be decreased when combined with Arformoterol. Armodafinil The metabolism of Vismodegib can be decreased when combined with Armodafinil. Artemether The metabolism of Vismodegib can be decreased when combined with Artemether. Articaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Articaine. Asciminib The metabolism of Vismodegib can be decreased when combined with Asciminib. Asunaprevir The metabolism of Asunaprevir can be decreased when combined with Vismodegib. Atazanavir The metabolism of Vismodegib can be decreased when combined with Atazanavir. Atovaquone The metabolism of Vismodegib can be decreased when combined with Atovaquone. Avanafil The serum concentration of Avanafil can be increased when it is combined with Vismodegib. Avapritinib The metabolism of Vismodegib can be decreased when combined with Avapritinib. Avatrombopag The metabolism of Vismodegib can be increased when combined with Avatrombopag. Azelastine The metabolism of Vismodegib can be decreased when combined with Azelastine. Belzutifan The serum concentration of Belzutifan can be increased when it is combined with Vismodegib. Benzocaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Benzocaine. Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Benzyl alcohol. Berotralstat The serum concentration of Berotralstat can be increased when it is combined with Vismodegib. Bexarotene The metabolism of Vismodegib can be decreased when combined with Bexarotene. Bimekizumab The metabolism of Vismodegib can be increased when combined with Bimekizumab. Boceprevir The metabolism of Vismodegib can be decreased when combined with Boceprevir. Bortezomib The metabolism of Vismodegib can be decreased when combined with Bortezomib. Bosentan The metabolism of Vismodegib can be increased when combined with Bosentan. Brigatinib Vismodegib may decrease the excretion rate of Brigatinib which could result in a higher serum level. Brivaracetam The metabolism of Vismodegib can be decreased when combined with Brivaracetam. Bupivacaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Bupivacaine. Buprenorphine The metabolism of Vismodegib can be decreased when combined with Buprenorphine. Bupropion The metabolism of Vismodegib can be decreased when combined with Bupropion. Butacaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Butacaine. Butamben The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Butamben. Cabozantinib The metabolism of Cabozantinib can be decreased when combined with Vismodegib. Canakinumab The metabolism of Vismodegib can be increased when combined with Canakinumab. Candesartan The metabolism of Vismodegib can be decreased when combined with Candesartan cilexetil. Cannabidiol The metabolism of Vismodegib can be decreased when combined with Cannabidiol. Capecitabine The metabolism of Vismodegib can be decreased when combined with Capecitabine. Capsaicin The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Capsaicin. Carbamazepine The metabolism of Vismodegib can be increased when combined with Carbamazepine. Carvedilol The metabolism of Vismodegib can be decreased when combined with Carvedilol. Celecoxib Vismodegib may decrease the excretion rate of Celecoxib which could result in a higher serum level. Cenobamate The serum concentration of Vismodegib can be decreased when it is combined with Cenobamate. Ceritinib The metabolism of Vismodegib can be decreased when combined with Ceritinib. Cerivastatin Vismodegib may decrease the excretion rate of Cerivastatin which could result in a higher serum level. Certolizumab pegol The metabolism of Vismodegib can be increased when combined with Certolizumab pegol. Chloroprocaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Chloroprocaine. Chlorpropamide The metabolism of Vismodegib can be decreased when combined with Chlorpropamide. Cilostazol The serum concentration of Cilostazol can be increased when it is combined with Vismodegib. Cimetidine The metabolism of Vismodegib can be decreased when combined with Cimetidine. Cinchocaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Cinchocaine. Cinnarizine The metabolism of Vismodegib can be decreased when combined with Cinnarizine. Ciprofloxacin The metabolism of Vismodegib can be decreased when combined with Ciprofloxacin. Cladribine Vismodegib may decrease the excretion rate of Cladribine which could result in a higher serum level. Clarithromycin The metabolism of Vismodegib can be decreased when combined with Clarithromycin. Clevidipine The metabolism of Vismodegib can be decreased when combined with Clevidipine. Clofarabine Vismodegib may decrease the excretion rate of Clofarabine which could result in a higher serum level. Clopidogrel The metabolism of Vismodegib can be decreased when combined with Clopidogrel. Clozapine The metabolism of Vismodegib can be decreased when combined with Clozapine. Cobicistat The metabolism of Vismodegib can be decreased when combined with Cobicistat. Cocaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Cocaine. Conivaptan The metabolism of Vismodegib can be decreased when combined with Conivaptan. Conjugated Vismodegib may decrease the excretion rate of Conjugated estrogens which could result in a higher serum level. Copanlisib Vismodegib may decrease the excretion rate of Copanlisib which could result in a higher serum level. Crizotinib The metabolism of Vismodegib can be decreased when combined with Crizotinib. Curcumin The metabolism of Vismodegib can be decreased when combined with Curcumin. Cyclizine The metabolism of Vismodegib can be decreased when combined with Cyclizine. Cyclophosphamide The metabolism of Vismodegib can be decreased when combined with Cyclophosphamide. Cyclosporine The metabolism of Vismodegib can be decreased when combined with Cyclosporine. Dabrafenib The serum concentration of Vismodegib can be decreased when it is combined with Dabrafenib. Dacomitinib Vismodegib may decrease the excretion rate of Dacomitinib which could result in a higher serum level. Dactinomycin Vismodegib may decrease the excretion rate of Dactinomycin which could result in a higher serum level. Danazol The metabolism of Vismodegib can be decreased when combined with Danazol. Dapagliflozin The metabolism of Vismodegib can be decreased when combined with Dapagliflozin. Dapsone The metabolism of Vismodegib can be decreased when combined with Dapsone. Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Vismodegib. Darolutamide Vismodegib may decrease the excretion rate of Darolutamide which could result in a higher serum level. Darunavir The metabolism of Vismodegib can be decreased when combined with Darunavir. Dasatinib Vismodegib may decrease the excretion rate of Dasatinib which could result in a higher serum level. Daunorubicin Vismodegib may decrease the excretion rate of Daunorubicin which could result in a higher serum level Delafloxacin Vismodegib may decrease the excretion rate of Delafloxacin which could result in a higher serum level. Delavirdine The metabolism of Vismodegib can be decreased when combined with Delavirdine. Desogestrel The metabolism of Vismodegib can be decreased when combined with Desogestrel. Desvenlafaxine The metabolism of Vismodegib can be decreased when combined with Desvenlafaxine. Dexamethasone The metabolism of Vismodegib can be increased when combined with Dexamethasone. Dexibuprofen The metabolism of Dexibuprofen can be decreased when combined with Vismodegib. Dextromethorphan The metabolism of Vismodegib can be decreased when combined with Dextromethorphan. Diacerein The metabolism of Vismodegib can be decreased when combined with Diacerein. Diazepam The metabolism of Vismodegib can be decreased when combined with Diazepam. Diclofenac The metabolism of Vismodegib can be decreased when combined with Diclofenac. Dicoumarol The metabolism of Vismodegib can be decreased when combined with Dicoumarol. Diethylstilbestrol The metabolism of Vismodegib can be decreased when combined with Diethylstilbestrol. Diltiazem The metabolism of Vismodegib can be decreased when combined with Diltiazem. Diosmin The metabolism of Vismodegib can be decreased when combined with Diosmin. Diphenhydramine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Diphenhydramine. Doconexent The metabolism of Vismodegib can be decreased when combined with Doconexent. Dolutegravir Vismodegib may decrease the excretion rate of Dolutegravir which could result in a higher serum level. Donepezil Vismodegib may decrease the excretion rate of Donepezil which could result in a higher serum level. Doxazosin The metabolism of Vismodegib can be decreased when combined with Doxazosin. Doxepin The metabolism of Vismodegib can be decreased when combined with Doxepin. Doxorubicin Vismodegib may decrease the excretion rate of Doxorubicin which could result in a higher serum level. Dronabinol The metabolism of Vismodegib can be decreased when combined with Dronabinol. Dronedarone The metabolism of Vismodegib can be decreased when combined with Dronedarone. Duloxetine The metabolism of Vismodegib can be decreased when combined with Duloxetine. Duvelisib Vismodegib may decrease the excretion rate of Duvelisib which could result in a higher serum level. Dyclonine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Dyclonine. Efavirenz The metabolism of Vismodegib can be decreased when combined with Efavirenz. Eletriptan The metabolism of Vismodegib can be decreased when combined with Eletriptan. Elvitegravir The metabolism of Vismodegib can be decreased when combined with Elvitegravir. Emapalumab The metabolism of Vismodegib can be increased when combined with Emapalumab. Enasidenib Vismodegib may decrease the excretion rate of Enasidenib which could result in a higher serum level. Enzalutamide The serum concentration of Vismodegib can be decreased when it is combined with Enzalutamide. Epinephrine The metabolism of Vismodegib can be decreased when combined with Epinephrine. Erdafitinib The metabolism of Erdafitinib can be decreased when combined with Vismodegib. Ergotamine The metabolism of Vismodegib can be decreased when combined with Ergotamine. Ertugliflozin Vismodegib may decrease the excretion rate of Ertugliflozin which could result in a higher serum level. Erythromycin The metabolism of Vismodegib can be decreased when combined with Erythromycin. Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Vismodegib. Esketamine The metabolism of Esketamine can be decreased when combined with Vismodegib. Estradiol The metabolism of Vismodegib can be decreased when combined with Estradiol. Estradiol acetate The metabolism of Estradiol acetate can be decreased when combined with Vismodegib. Estradiol benzoate The metabolism of Estradiol benzoate can be decreased when combined with Vismodegib. Estradiol cypionate The metabolism of Estradiol cypionate can be decreased when combined with Vismodegib. Estradiol dienant The metabolism of Estradiol dienanthate can be decreased when combined with Vismodegib. Estradiol valerate The metabolism of Estradiol valerate can be decreased when combined with Vismodegib. Estrone sulfate The metabolism of Vismodegib can be decreased when combined with Estrone sulfate. Etanercept The metabolism of Vismodegib can be increased when combined with Etanercept. Ethambutol The metabolism of Vismodegib can be decreased when combined with Ethambutol. Ethanol The metabolism of Vismodegib can be decreased when combined with Ethanol. Ethinylestradiol The metabolism of Vismodegib can be decreased when combined with Ethinylestradiol. Ethyl chloride The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Ethyl chloride. Etidocaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Etidocaine. Etodolac The metabolism of Vismodegib can be decreased when combined with Etodolac. Etoposide Vismodegib may decrease the excretion rate of Etoposide which could result in a higher serum level. Etoricoxib The metabolism of Vismodegib can be decreased when combined with Etoricoxib. Etravirine The metabolism of Vismodegib can be decreased when combined with Etravirine. Ezetimibe Vismodegib may decrease the excretion rate of Ezetimibe which could result in a higher serum level. Felbamate The metabolism of Vismodegib can be decreased when combined with Felbamate. Felodipine The metabolism of Vismodegib can be decreased when combined with Felodipine. Fenofibrate The metabolism of Vismodegib can be decreased when combined with Fenofibrate. Flecainide The metabolism of Vismodegib can be decreased when combined with Flecainide. Floxuridine The metabolism of Vismodegib can be decreased when combined with Floxuridine. Fluconazole The metabolism of Vismodegib can be decreased when combined with Fluconazole. Fluindione The metabolism of Fluindione can be decreased when combined with Vismodegib. Flunarizine The metabolism of Vismodegib can be decreased when combined with Flunarizine. Flunitrazepam The metabolism of Vismodegib can be decreased when combined with Flunitrazepam. Fluorouracil Vismodegib may decrease the excretion rate of Fluorouracil which could result in a higher serum level. Fluoxetine The metabolism of Vismodegib can be decreased when combined with Fluoxetine. Flurbiprofen The metabolism of Vismodegib can be decreased when combined with Flurbiprofen. Fluvastatin The metabolism of Vismodegib can be decreased when combined with Fluvastatin. Fluvoxamine The metabolism of Vismodegib can be decreased when combined with Fluvoxamine. Folic acid Vismodegib may decrease the excretion rate of Folic acid which could result in a higher serum level. Formoterol The metabolism of Vismodegib can be decreased when combined with Formoterol. Fosnetupitant The metabolism of Vismodegib can be decreased when combined with Fosnetupitant. Fosphenytoin The metabolism of Vismodegib can be increased when combined with Fosphenytoin. Fostemsavir Vismodegib may decrease the excretion rate of Fostemsavir which could result in a higher serum level. Fusidic acid The metabolism of Vismodegib can be decreased when combined with Fusidic acid. Gefitinib Vismodegib may decrease the excretion rate of Gefitinib which could result in a higher serum level. Gemfibrozil The metabolism of Vismodegib can be decreased when combined with Gemfibrozil. Ginkgo biloba The metabolism of Vismodegib can be decreased when combined with Ginkgo biloba. Glasdegib Vismodegib may decrease the excretion rate of Glasdegib which could result in a higher serum level. Glecaprevir Vismodegib may decrease the excretion rate of Glecaprevir which could result in a higher serum level. Gliclazide The metabolism of Vismodegib can be decreased when combined with Gliclazide. Glimepiride The metabolism of Vismodegib can be decreased when combined with Glimepiride. Glipizide The metabolism of Vismodegib can be decreased when combined with Glipizide. Gliquidone The metabolism of Vismodegib can be decreased when combined with Gliquidone. Glyburide Vismodegib may decrease the excretion rate of Glyburide which could result in a higher serum level. Golimumab The metabolism of Vismodegib can be increased when combined with Golimumab. Haloperidol The serum concentration of Haloperidol can be increased when it is combined with Vismodegib. Halothane The metabolism of Vismodegib can be decreased when combined with Halothane. Hydromorphone The metabolism of Vismodegib can be decreased when combined with Hydromorphone. Ibuprofen The metabolism of Vismodegib can be decreased when combined with Ibuprofen. Idarubicin The metabolism of Vismodegib can be decreased when combined with Idarubicin. Idelalisib Vismodegib may decrease the excretion rate of Idelalisib which could result in a higher serum level. Ifosfamide The metabolism of Vismodegib can be decreased when combined with Ifosfamide. Imatinib The metabolism of Vismodegib can be decreased when combined with Imatinib. Indinavir The metabolism of Vismodegib can be decreased when combined with Indinavir. Indomethacin The metabolism of Vismodegib can be decreased when combined with Indomethacin. Infliximab The metabolism of Vismodegib can be increased when combined with Infliximab. Irbesartan The metabolism of Vismodegib can be decreased when combined with Irbesartan. Irinotecan Vismodegib may decrease the excretion rate of Irinotecan which could result in a higher serum level. Isavuconazole The metabolism of Vismodegib can be decreased when combined with Isavuconazole. Isavuconazonium The metabolism of Vismodegib can be decreased when combined with Isavuconazonium. Isoniazid The metabolism of Vismodegib can be decreased when combined with Isoniazid. Isradipine The metabolism of Vismodegib can be decreased when combined with Isradipine. Istradefylline The metabolism of Istradefylline can be decreased when combined with Vismodegib. Itraconazole The metabolism of Vismodegib can be decreased when combined with Itraconazole. Ivermectin Vismodegib may decrease the excretion rate of Ivermectin which could result in a higher serum level. Ivosidenib The metabolism of Vismodegib can be increased when combined with Ivosidenib. Ketamine The metabolism of Vismodegib can be decreased when combined with Ketamine. Ketoconazole The metabolism of Vismodegib can be decreased when combined with Ketoconazole. Ketorolac The metabolism of Vismodegib can be decreased when combined with Ketorolac. Lacosamide The metabolism of Vismodegib can be decreased when combined with Lacosamide. Lamivudine Vismodegib may decrease the excretion rate of Lamivudine which could result in a higher serum level. Lansoprazole The metabolism of Vismodegib can be decreased when combined with Lansoprazole. Leflunomide Vismodegib may decrease the excretion rate of Leflunomide which could result in a higher serum level. Lenvatinib Vismodegib may decrease the excretion rate of Lenvatinib which could result in a higher serum level. Lesinurad The metabolism of Lesinurad can be decreased when combined with Vismodegib. Levobupivacaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Levobupivacaine. Levoketoconazole The metabolism of Vismodegib can be decreased when combined with Levoketoconazole. Lidocaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Lidocaine. Linagliptin The metabolism of Vismodegib can be decreased when combined with Linagliptin. Lonafarnib The metabolism of Vismodegib can be decreased when combined with Lonafarnib. Lopinavir The metabolism of Vismodegib can be decreased when combined with Lopinavir. Lornoxicam The metabolism of Vismodegib can be decreased when combined with Lornoxicam. Losartan The metabolism of Vismodegib can be decreased when combined with Losartan. Lovastatin The metabolism of Vismodegib can be decreased when combined with Lovastatin. Lumacaftor The metabolism of Vismodegib can be increased when combined with Lumacaftor. Lumiracoxib The metabolism of Vismodegib can be decreased when combined with Lumiracoxib. Lusutrombopag Vismodegib may decrease the excretion rate of Lusutrombopag which could result in a higher serum level. Lynestrenol The metabolism of Lynestrenol can be decreased when combined with Vismodegib. Manidipine The metabolism of Vismodegib can be decreased when combined with Manidipine. Mavacamten The serum concentration of Vismodegib can be decreased when it is combined with Mavacamten. Medroxyprogester The metabolism of Vismodegib can be decreased when combined with Medroxyprogesterone acetate. Mefenamic acid The metabolism of Vismodegib can be decreased when combined with Mefenamic acid. Meloxicam The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Meloxicam. Mephenytoin The metabolism of Vismodegib can be decreased when combined with Mephenytoin. Mepivacaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Mepivacaine. Mestranol The metabolism of Vismodegib can be decreased when combined with Mestranol. Methadone The metabolism of Vismodegib can be decreased when combined with Methadone. Methimazole The metabolism of Vismodegib can be decreased when combined with Methimazole. Methotrexate Vismodegib may decrease the excretion rate of Methotrexate which could result in a higher serum level. Methoxy The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Vismodegib. Methoxyflurane The metabolism of Vismodegib can be decreased when combined with Methoxyflurane. Methylene blue The metabolism of Vismodegib can be decreased when combined with Methylene blue. Metreleptin The metabolism of Vismodegib can be increased when combined with Metreleptin. Metronidazole The metabolism of Vismodegib can be decreased when combined with Metronidazole. Miconazole The metabolism of Vismodegib can be decreased when combined with Miconazole. Midostaurin The metabolism of Vismodegib can be decreased when combined with Midostaurin. Mifepristone The metabolism of Vismodegib can be decreased when combined with Mifepristone. Milnacipran The metabolism of Vismodegib can be decreased when combined with Milnacipran. Mitotane The metabolism of Vismodegib can be increased when combined with Mitotane. Mitoxantrone Vismodegib may decrease the excretion rate of Mitoxantrone which could result in a higher serum level. Modafinil The metabolism of Vismodegib can be decreased when combined with Modafinil. Montelukast The metabolism of Vismodegib can be decreased when combined with Montelukast. Mycophenolate Vismodegib may decrease the excretion rate of Mycophenolate mofetil which could result in a higher serum level. Nabilone The metabolism of Vismodegib can be decreased when combined with Nabilone. Nabumetone The metabolism of Vismodegib can be decreased when combined with Nabumetone. Naloxone The metabolism of Vismodegib can be decreased when combined with Naloxone. Naproxen The metabolism of Vismodegib can be decreased when combined with Naproxen. Nateglinide The metabolism of Vismodegib can be decreased when combined with Nateglinide. Nefazodone The metabolism of Vismodegib can be decreased when combined with Nefazodone. Nelfinavir The metabolism of Vismodegib can be decreased when combined with Nelfinavir. Netupitant The metabolism of Vismodegib can be decreased when combined with Netupitant. Nevirapine The metabolism of Vismodegib can be decreased when combined with Nevirapine. Nicardipine The metabolism of Vismodegib can be decreased when combined with Nicardipine. Niclosamide The metabolism of Vismodegib can be decreased when combined with Niclosamide. Nilotinib The metabolism of Vismodegib can be decreased when combined with Nilotinib. Nilutamide The metabolism of Vismodegib can be decreased when combined with Nilutamide. Nilvadipine The metabolism of Vismodegib can be decreased when combined with Nilvadipine. Nitrofurantoin Vismodegib may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level. Norgestimate The metabolism of Vismodegib can be decreased when combined with Norgestimate. Noscapine The metabolism of Vismodegib can be decreased when combined with Noscapine. Olanzapine The metabolism of Vismodegib can be decreased when combined with Olanzapine. Olodaterol The metabolism of Olodaterol can be decreased when combined with Vismodegib. Ombitasvir Vismodegib may decrease the excretion rate of Ombitasvir which could result in a higher serum level. Omeprazole The metabolism of Vismodegib can be decreased when combined with Omeprazole. Ondansetron The metabolism of Vismodegib can be decreased when combined with Ondansetron. Oritavancin The metabolism of Vismodegib can be decreased when combined with Oritavancin. Osimertinib Vismodegib may decrease the excretion rate of Osimertinib which could result in a higher serum level. Ospemifene The metabolism of Vismodegib can be decreased when combined with Ospemifene. Oxaliplatin Vismodegib may decrease the excretion rate of Oxaliplatin which could result in a higher serum level. Oxandrolone The metabolism of Vismodegib can be decreased when combined with Oxandrolone. Oxetacaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Oxetacaine. Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Oxybuprocaine. Ozanimod Vismodegib may decrease the excretion rate of Ozanimod which could result in a higher serum level. Palbociclib Vismodegib may decrease the excretion rate of Palbociclib which could result in a higher serum level. Paramethadione The metabolism of Vismodegib can be decreased when combined with Paramethadione. Parecoxib The metabolism of Vismodegib can be decreased when combined with Parecoxib. Paroxetine The metabolism of Vismodegib can be decreased when combined with Paroxetine. Pazopanib Vismodegib may decrease the excretion rate of Pazopanib which could result in a higher serum level. Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Vismodegib. Peginterferon The metabolism of Vismodegib can be increased when combined with Peginterferon alfa-2b. Pentobarbital The metabolism of Vismodegib can be increased when combined with Pentobarbital. Phenobarbital The metabolism of Vismodegib can be increased when combined with Phenobarbital. Phenol The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Phenol. Phenprocoumon The metabolism of Vismodegib can be decreased when combined with Phenprocoumon. Phenylbutazone The metabolism of Vismodegib can be decreased when combined with Phenylbutazone. Phenytoin The metabolism of Vismodegib can be increased when combined with Phenytoin. Pibrentasvir Vismodegib may decrease the excretion rate of Pibrentasvir which could result in a higher serum level. Piperaquine The metabolism of Piperaquine can be decreased when combined with Vismodegib. Pirfenidone The metabolism of Vismodegib can be decreased when combined with Pirfenidone. Piroxicam The metabolism of Vismodegib can be decreased when combined with Piroxicam. Pitavastatin Vismodegib may decrease the excretion rate of Pitavastatin which could result in a higher serum level. Pitolisant The serum concentration of Vismodegib can be decreased when it is combined with Pitolisant. Ponatinib Vismodegib may decrease the excretion rate of Ponatinib which could result in a higher serum level. Posaconazole The metabolism of Vismodegib can be decreased when combined with Posaconazole. Pralatrexate Vismodegib may decrease the excretion rate of Pralatrexate which could result in a higher serum level. Pralsetinib Vismodegib may decrease the excretion rate of Pralsetinib which could result in a higher serum level. Pramocaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Pramocaine. Prasugrel The metabolism of Vismodegib can be decreased when combined with Prasugrel. Pravastatin Vismodegib may decrease the excretion rate of Pravastatin which could result in a higher serum level. Prazosin Vismodegib may decrease the excretion rate of Prazosin which could result in a higher serum level. Prilocaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Prilocaine. Primaquine The metabolism of Vismodegib can be decreased when combined with Primaquine. Primidone The metabolism of Vismodegib can be increased when combined with Primidone. Probenecid The metabolism of Vismodegib can be decreased when combined with Probenecid. Procaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Procaine. Progesterone The metabolism of Vismodegib can be decreased when combined with Progesterone. Proguanil The metabolism of Vismodegib can be decreased when combined with Proguanil. Promazine The metabolism of Vismodegib can be decreased when combined with Promazine. Promethazine The metabolism of Vismodegib can be decreased when combined with Promethazine. Proparacaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Proparacaine. Propofol The metabolism of Vismodegib can be decreased when combined with Propofol. Propoxycaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Propoxycaine. Propranolol The serum concentration of Propranolol can be increased when it is combined with Vismodegib. Quazepam The metabolism of Vismodegib can be decreased when combined with Quazepam. Quinidine The metabolism of Vismodegib can be decreased when combined with Quinidine. Quinine The metabolism of Vismodegib can be decreased when combined with Quinine. Raloxifene Vismodegib may decrease the excretion rate of Raloxifene which could result in a higher serum level. Ramelteon The metabolism of Vismodegib can be decreased when combined with Ramelteon. Regorafenib The metabolism of Vismodegib can be decreased when combined with Regorafenib. Revefenacin Vismodegib may decrease the excretion rate of Revefenacin which could result in a higher serum level. Ribociclib The metabolism of Vismodegib can be decreased when combined with Ribociclib. Rifampicin The metabolism of Vismodegib can be increased when combined with Rifampicin. Rifamycin The metabolism of Vismodegib can be increased when combined with Rifamycin. Rifapentine The metabolism of Vismodegib can be increased when combined with Rifapentine. Rilonacept The metabolism of Vismodegib can be increased when combined with Rilonacept. Rilpivirine The metabolism of Vismodegib can be decreased when combined with Rilpivirine. Riluzole Vismodegib may decrease the excretion rate of Riluzole which could result in a higher serum level. Rimegepant The serum concentration of Rimegepant can be increased when it is combined with Vismodegib. Riociguat Vismodegib may decrease the excretion rate of Riociguat which could result in a higher serum level. Ripretinib Vismodegib may decrease the excretion rate of Ripretinib which could result in a higher serum level. Ritonavir The serum concentration of Vismodegib can be increased when it is combined with Ritonavir. Rivaroxaban Vismodegib may decrease the excretion rate of Rivaroxaban which could result in a higher serum level. Rofecoxib The metabolism of Vismodegib can be decreased when combined with Rofecoxib. Ropivacaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Ropivacaine. Rosiglitazone The metabolism of Vismodegib can be decreased when combined with Rosiglitazone. Rosuvastatin Vismodegib may decrease the excretion rate of Rosuvastatin which could result in a higher serum level. Rucaparib Vismodegib may decrease the excretion rate of Rucaparib which could result in a higher serum level. Rupatadine The metabolism of Rupatadine can be decreased when combined with Vismodegib. Ruxolitinib The metabolism of Ruxolitinib can be decreased when combined with Vismodegib. Salicylic acid The metabolism of Vismodegib can be decreased when combined with Salicylic acid. Saquinavir The metabolism of Vismodegib can be decreased when combined with Saquinavir. Satralizumab The serum concentration of Vismodegib can be decreased when it is combined with Satralizumab. Secukinumab The metabolism of Vismodegib can be increased when combined with Secukinumab. Selegiline The metabolism of Vismodegib can be decreased when combined with Selegiline. Selumetinib Vismodegib may decrease the excretion rate of Selumetinib which could result in a higher serum level. Sertraline The metabolism of Vismodegib can be decreased when combined with Sertraline. Sildenafil The metabolism of Vismodegib can be decreased when combined with Sildenafil. Siltuximab The metabolism of Vismodegib can be increased when combined with Siltuximab. Simeprevir The metabolism of Vismodegib can be decreased when combined with Simeprevir. Simvastatin The metabolism of Vismodegib can be decreased when combined with Simvastatin. Siponimod The metabolism of Siponimod can be decreased when combined with Vismodegib. Sitaxentan The metabolism of Vismodegib can be decreased when combined with Sitaxentan. Sofosbuvir Vismodegib may decrease the excretion rate of Sofosbuvir which could result in a higher serum level. Somatrogon The metabolism of Vismodegib can be increased when combined with Somatrogon. Sorafenib The metabolism of Vismodegib can be decreased when combined with Sorafenib. Sotorasib The serum concentration of Vismodegib can be decreased when it is combined with Sotorasib. St. John's Wort The metabolism of Vismodegib can be increased when combined with St. John's Wort. Stiripentol The metabolism of Vismodegib can be decreased when combined with Stiripentol. Sulfadiazine The metabolism of Vismodegib can be decreased when combined with Sulfadiazine. Sulfamethizole The metabolism of Vismodegib can be decreased when combined with Sulfamethizole. Sulfamethoxazole The metabolism of Vismodegib can be decreased when combined with Sulfamethoxazole. Sulfaphenazole The metabolism of Vismodegib can be decreased when combined with Sulfaphenazole. Sulfapyridine The metabolism of Vismodegib can be decreased when combined with Sulfapyridine. Sulfasalazine Vismodegib may decrease the excretion rate of Sulfasalazine which could result in a higher serum level. Sulfinpyrazone The metabolism of Vismodegib can be decreased when combined with Sulfinpyrazone. Sulfisoxazole The metabolism of Vismodegib can be decreased when combined with Sulfisoxazole. Sumatriptan Vismodegib may decrease the excretion rate of Sumatriptan which could result in a higher serum level. Talazoparib Vismodegib may decrease the excretion rate of Talazoparib which could result in a higher serum level. Tamoxifen Vismodegib may decrease the excretion rate of Tamoxifen which could result in a higher serum level. Tazemetostat Vismodegib may decrease the excretion rate of Tazemetostat which could result in a higher serum level. Tegaserod Vismodegib may decrease the excretion rate of Tegaserod which could result in a higher serum level. Telaprevir The metabolism of Vismodegib can be decreased when combined with Telaprevir. Telithromycin The metabolism of Vismodegib can be decreased when combined with Telithromycin. Telotristat ethyl The serum concentration of Vismodegib can be decreased when it is combined with Telotristat ethyl. Teniposide Vismodegib may decrease the excretion rate of Teniposide which could result in a higher serum level. Tenofovir The serum concentration of Tenofovir alafenamide can be increased when it is combined with Vismodegib. Tenoxicam The metabolism of Vismodegib can be decreased when combined with Tenoxicam. Tepotinib The metabolism of Vismodegib can be decreased when combined with Tepotinib. Terbinafine The metabolism of Vismodegib can be decreased when combined with Terbinafine. Terfenadine The metabolism of Vismodegib can be decreased when combined with Terfenadine. Teriflunomide Vismodegib may decrease the excretion rate of Teriflunomide which could result in a higher serum level. Testosterone Vismodegib may decrease the excretion rate of Testosterone which could result in a higher serum level. Testosterone Vismodegib may decrease the excretion rate of Testosterone cypionate which could result in a higher serum level. Testosterone Vismodegib may decrease the excretion rate of Testosterone enanthate which could result in a higher serum level. Tetracaine The risk or severity of methemoglobinemia can be increased when Vismodegib is combined with Tetracaine. Thalidomide The metabolism of Vismodegib can be decreased when combined with Thalidomide. Thiamylal The metabolism of Vismodegib can be decreased when combined with Thiamylal. Ticagrelor The metabolism of Vismodegib can be decreased when combined with Ticagrelor. Ticlopidine The metabolism of Vismodegib can be decreased when combined with Ticlopidine. Tipranavir The metabolism of Vismodegib can be decreased when combined with Tipranavir. Tocilizumab The metabolism of Vismodegib can be increased when combined with Tocilizumab. Tolazamide The metabolism of Vismodegib can be decreased when combined with Tolazamide. Tolbutamide The metabolism of Vismodegib can be decreased when combined with Tolbutamide. Tolterodine The metabolism of Vismodegib can be decreased when combined with Tolterodine. Topotecan Vismodegib may decrease the excretion rate of Topotecan which could result in a higher serum level. Torasemide The metabolism of Vismodegib can be decreased when combined with Torasemide. Trabectedin The metabolism of Vismodegib can be decreased when combined with Trabectedin. Tranylcypromine The metabolism of Vismodegib can be decreased when combined with Tranylcypromine. Treprostinil The metabolism of Vismodegib can be decreased when combined with Treprostinil. Tretinoin The metabolism of Vismodegib can be decreased when combined with Tretinoin. Triclabendazole The metabolism of Vismodegib can be decreased when combined with Triclabendazole. Trilaciclib Vismodegib may decrease the excretion rate of Trilaciclib which could result in a higher serum level. Trimethadione The metabolism of Vismodegib can be decreased when combined with Trimethadione. Trimethoprim The metabolism of Vismodegib can be decreased when combined with Trimethoprim. Trimipramine The metabolism of Vismodegib can be decreased when combined with Trimipramine. Troglitazone The metabolism of Vismodegib can be decreased when combined with Troglitazone. Troleandomycin The metabolism of Vismodegib can be decreased when combined with Troleandomycin. Tucatinib The metabolism of Tucatinib can be decreased when combined with Vismodegib. Ubrogepant The serum concentration of Ubrogepant can be increased when it is combined with Vismodegib. Valdecoxib The metabolism of Vismodegib can be decreased when combined with Valdecoxib. Valproic acid The metabolism of Vismodegib can be decreased when combined with Valproic acid. Valsartan The metabolism of Vismodegib can be decreased when combined with Valsartan. Velpatasvir Vismodegib may decrease the excretion rate of Velpatasvir which could result in a higher serum level. Vemurafenib Vismodegib may decrease the excretion rate of Vemurafenib which could result in a higher serum level. Venetoclax The metabolism of Vismodegib can be decreased when combined with Venetoclax. Verapamil The metabolism of Vismodegib can be decreased when combined with Verapamil. Viloxazine The metabolism of Vismodegib can be decreased when combined with Viloxazine. Vincristine Vismodegib may decrease the excretion rate of Vincristine which could result in a higher serum level. Voriconazole The metabolism of Vismodegib can be decreased when combined with Voriconazole. Vortioxetine The metabolism of Vortioxetine can be decreased when combined with Vismodegib. Voxelotor The metabolism of Voxelotor can be decreased when combined with Vismodegib. Voxilaprevir Vismodegib may decrease the excretion rate of Voxilaprevir which could result in a higher serum level. Warfarin The metabolism of Vismodegib can be increased when combined with Warfarin. Ximelagatran The metabolism of Vismodegib can be decreased when combined with Ximelagatran. Zafirlukast The metabolism of Vismodegib can be decreased when combined with Zafirlukast. Zidovudine Vismodegib may decrease the excretion rate of Zidovudine which could result in a higher serum level. Zileuton The metabolism of Vismodegib can be decreased when combined with Zileuton. Zimelidine The metabolism of Vismodegib can be decreased when combined with Zimelidine. Ziprasidone The metabolism of Vismodegib can be decreased when combined with Ziprasidone. Zolpidem The metabolism of Vismodegib can be decreased when combined with Zolpidem. Zopiclone The metabolism of Vismodegib can be decreased when combined with Zopiclone. Pregnancy and Lactation FDA Pregnancy Category D Pregnancy Vismodegib capsule can cause fetal harm when administered to a pregnant female based on its mechanism of action. Vismodegib is teratogenic in rats at doses corresponding to an exposure of 20% of the exposure at the recommended human dose (estimated AUC0-24hr steady-state exposure). In rats, malformations included craniofacial anomalies, open perineum, and absent or fused digits. Fetal retardations and variations were also observed. Vismodegib is embryolethal in rats at exposures within the range achieved at the recommended human dose. If vismodegib is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the  potential hazard to the embryo or fetus. Encourage women who may have been exposed to vismodegib during pregnancy, either directly or through seminal fluid, to participate in the vismodegib pregnancy pharmacovigilance program by contacting the Genentech Lactation No information is available on the clinical use of vismodegib during breastfeeding. Because vismodegib is more than 99% bound to plasma proteins, the amount in milk is likely to be low. However, its half-life is 4 days and it might accumulate in the infant. The manufacturer recommends that breastfeeding be discontinued during vismodegib therapy and for 24 months after the final dose. How should this medicine be used?

Vismodegib comes as a capsule to take by mouth. It is usually taken once a day with or without food. To help you remember to take vismodegib, take it at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take vismodegib exactly as directed. Do not take more or less of it or take it more often than prescribed by your…

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