Drug Formulary information is intended for use by healthcare professionals. It is not intended to be medical advice. Some of the information, including information about funding for cancer drugs, does not apply to all patients. Cancer treatment plans are unique to each patient. If you are a patient, please speak with your healthcare team to understand how this information applies to you.

drug-infosheet

vanDETanib

Cancer Type
Endocrine, Thyroid
Other Names

Caprelsa®

Appearance

white tablet in various strengths and shapes

vanDETanib

Pronunciation:

van-DET-a-nib

Other Name(s):

Caprelsa®

Appearance:

white tablet in various strengths and shapes

This handout gives general information about this cancer medication.

You will learn:

  • who to contact for help

  • what the medication is

  • how it is given

  • what to expect while on medication

People Talking

This handout was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.

This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.

 

Who do I contact if I have questions or need help?

 

My cancer health care provider is: _____________________________________________

During the day I should contact: _______________________________________________

Evenings, weekends and holidays: _____________________________________________

 

This page gives general information about this cancer medication.

You will learn:

  • who to contact for help

  • what the medication is

  • how it is given

  • what to expect while on this medication

People Talking

This information was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.

This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.

What is this treatment for?

Vandetanib is used to treat a certain type of thyroid cancer.

What should I do before I start this treatment?

Tell your health care team if you have or had significant medical condition(s), especially if you have / had:

  • liver, kidney, or lung problems,

  • high blood pressure,

  • bleeding problems,

  • heart problems (including abnormal heartbeat),

  • any recent or upcoming surgery (including dental surgery), or

  • any allergies.

Important Icon

Remember To:

 
  • Tell your health care team about all of the other medications you are taking.

  • Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.

You will have a blood test to check for hepatitis B before starting treatment. See the Hepatitis B and Cancer Medications pamphlet for more information.

How is this treatment given?
  • This medication is usually taken once a day by mouth.

  • Swallow whole with a glass of water, with or without food.

  • If you have difficulty swallowing the tablet(s), you may mix it with water as follows:

    • Put the whole tablet into half a glass (50 mL) of non-carbonated water. Do not use other liquids.

    • Stir the water until the tablet breaks apart in the water. This may take about 10 minutes.

    • Drink the mixture right away. 

    • Rinse the empty glass well with another half a glass of water and drink it.

  • Do not eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while taking this drug. They may increase the amount of drug in your blood and increase side effects.

  • If you vomit (throw up) after taking your medication, talk to your health care team about what to do.

  • If you forget to take a dose of your vandetanib:

    • If it has been less than 12 hours from the missed dose, take the dose as usual. Then take your next dose at the normal scheduled time. 

    • If it has been longer than 12 hours, do not take the dose. Take your next dose at the normal scheduled time. Do not take extra (double up) to make up for the missed dose.
       

Warning: If you take too much of this medication by accident, or if you think a child or a pet may have swallowed your medication, you must call the Ontario Poison Control Center right away at: 1-800-268-9017.

Other important things for you to know about this treatment

While taking vandetanib, wounds may take longer to heal than normal or may not fully heal. Tell your health care team if you plan to have any surgery (including dental surgery). Your health care team may ask you to stop vandetanib treatment before any scheduled surgery.

DO this while on treatment DO NOT do this while on treatment

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  • DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.  

  • DO protect your skin from the sun during treatment and for 4 months after treatment ends. Wear a long sleeved shirt, long pants and a hat. Apply sunscreen with UVA and UVB protection and an SPF of at least 30. Your skin may be more sensitive to the sun and you could develop a bad sunburn or rash more easily.

  • DO rinse your mouth and/or brush your teeth often to keep your teeth, gums and mouth clean at all times. Have regular check-ups with your dentist. Tell your dentist that you are taking vandetanib as this treatment may rarely cause jaw problems. Taking care of your mouth can help prevent jaw problems.

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  • DO NOT eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. These may increase the amount of the medication in your blood and increase the side effects.

  • DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs or substances, or natural health products without checking with your health care team.

  • DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic products, without checking with your health care team.

  • DO NOT use tobacco products (such as smoking cigarettes or vaping) or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.

  • DO NOT drive, operate machinery or do any tasks that need you to be alert if your vision is blurry.

DO this while on treatment

Check Mark Icon

  • DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.  

  • DO protect your skin from the sun during treatment and for 4 months after treatment ends. Wear a long sleeved shirt, long pants and a hat. Apply sunscreen with UVA and UVB protection and an SPF of at least 30. Your skin may be more sensitive to the sun and you could develop a bad sunburn or rash more easily.

  • DO rinse your mouth and/or brush your teeth often to keep your teeth, gums and mouth clean at all times. Have regular check-ups with your dentist. Tell your dentist that you are taking vandetanib as this treatment may rarely cause jaw problems. Taking care of your mouth can help prevent jaw problems.
DO NOT do this while on treatment

Stop Icon

  • DO NOT eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. These may increase the amount of the medication in your blood and increase the side effects.

  • DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs or substances, or natural health products without checking with your health care team.

  • DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic products, without checking with your health care team.

  • DO NOT use tobacco products (such as smoking cigarettes or vaping) or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.

  • DO NOT drive, operate machinery or do any tasks that need you to be alert if your vision is blurry.

Will this treatment interact with other medications or natural health products?

Yes, this medication can interact with other medications, vitamins, foods, traditional medicines and natural health products. Interactions can make this medication not work as well or cause severe side effects.

Tell your health care team about all of your:

  • prescription and over-the-counter (non-prescription) medications
  • other drugs and substances, such as cannabis/marijuana (medical or recreational)
  • natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements, or traditional medicines

Check with your health care team before starting or stopping any of them.
 

Medication Icon
Talk to your health care team BEFORE taking or using these :
  • Anti-inflammatory medications such as ibuprofen (Advil® or Motrin®), naproxen (Aleve®) or Aspirin®
  • Over-the-counter products such as dimenhydrinate (Gravol®
  • Natural health products such as St. John’s Wort
  • Traditional medicines
  • Supplements such as vitamin C
  • Grapefruit juice
  • Alcoholic drinks 
  • Tobacco 
  • All other drugs or substances, such as marijuana or cannabis (medical or recreational)
What to do if you feel unwell, have pain, a headache or a fever
  • Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).

    • Fever can be a sign of infection that may need treatment right away.

    • If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.

How to check for fever:

Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain). 

  • You have a fever if your temperature taken in your mouth (oral temperature) is:

    • 38.3°C (100.9°F) or higher at any time

  •       OR

    • 38.0°C (100.4°F) or higher for at least one hour.

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If you do have a fever: 

  • Try to contact your health care team.  If you are not able to talk to them for advice, you MUST get emergency medical help right away.

  • Ask your health care team for the Fever pamphlet for more information.

 

 

 

 

 

If you do not have a fever but have mild symptoms such as headache or mild pain:

  • Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
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Talk to your health care team before you start taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.

Important Icon

Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.

How will this treatment affect sex, pregnancy and breastfeeding?

Talk to your health care team about:

  • How this treatment may affect your sexual health

  • How this treatment may affect your ability to have a baby, if this applies to you


This treatment may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.

  • If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time until at least 4 months after your last treatment dose. Talk to your health care team about which birth control options are best for you.
     
  • Do not breastfeed while on this treatment.

How to safely store and handle this medication
  • Keep vandetanib tablets in the original packaging at room temperature in a dry place, away from heat and light.

  • Keep out of sight and reach of children and pets.

  • Do not throw out any unused tablets at home. Bring them to your pharmacy to be thrown away safely.
     

How to safely touch oral anti-cancer medication


If you are a patient:

  • Wash your hands before and after touching your oral anti-cancer medication.

  • Swallow each pill whole. Do not crush or chew your pills.

If you are a caregiver:

  • Wear nitrile or latex gloves when touching tablets, capsules or liquids.
     

  • Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
     

  • Throw out your gloves after each use. Do not re-use gloves. 
     

  • Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.

 

What to do if anti-cancer medication gets on your skin or in your eyes 


If medication gets on your skin:

  • Wash your skin with a lot of soap and water.

  • If your skin gets red or irritated, talk to your health care team.

If medication gets in your eyes:

  • Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.

What are the side effects of this treatment?

The following table lists side effects that you may have when getting vandetanib treatment. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.

Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on vandetanib treatment.


Very Common Side Effects (50 or more out of 100 people)
Side effects and what to do When to contact health care team

Diarrhea

(May be severe)

What to look for?

  • Loose, watery, unformed stool (poo) that may happen days to weeks after you get your treatment.
     

What to do?

If you have diarrhea:

  • Take anti-diarrhea medication if your health care team prescribed it or told you to take it.
  • Do not eat foods or drinks with artificial sweetener (like chewing gum or ‘diet’ drinks), coffee and alcohol, until your diarrhea has stopped.
  • Eat many small meals and snacks instead of 2 or 3 large meals.
  • Drink at least 6 to 8 cups of liquids each day, unless your health care team has told you to drink more or less.
  • Talk to your health care team if you can’t drink 6 to 8 cups of liquids each day when you have diarrhea. You may need to drink special liquids with salt and sugar, called Oral Rehydration Therapy.
  • Talk to your health care team if your diarrhea does not improve after 24 hours of taking diarrhea medication or if you have diarrhea more than 7 times in one day.


Ask your health care team for the Diarrhea pamphlet for more information.

 

 

Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day).

Liver problems

(May be severe)

Your health care team may check your liver function with a blood test. Liver changes do not usually cause any symptoms.

What to look for?

  • Rarely, you may develop yellowish skin or eyes, unusually dark pee or pain on the right side of your belly. This may be severe.

What to do?

If you have any symptoms of liver problems, get emergency medical help right away.

Get emergency medical help right away.

 

 
Common Side Effects (25 to 49 out of 100 people)
Side effects and what to do When to contact health care team

Rash; dry, itchy skin

(May be severe)

What to look for?

  • You may have cracked, rough, flaking or peeling areas of the skin.
  • Your skin may look red and feel warm, like a sunburn.
  • Your skin may itch, burn, sting or feel very tender when touched.

What to do?

To prevent and treat dry skin:

  • Use fragrance-free skin moisturizer.
  • Protect your skin from the sun and the cold.
  • Use sunscreen with UVA and UVB protection and a SPF of at least 30.
  • Avoid perfumed products and lotions that contain alcohol.
  • Drink 6 to 8 cups of non-alcoholic, non-caffeinated liquids each day, unless your health care team has told you to drink more or less.

Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away.

Talk to your health care team if it does not improve or if it is severe.

Nausea and vomiting

(Generally mild)

What to look for?

  • Nausea is feeling like you need to throw up. You may also feel light-headed.
  • You may feel nausea within hours to days after your treatment.

What to do?

To help prevent nausea:

  • It is easier to prevent nausea than to treat it once it happens.
  • If you were given anti-nausea medication(s), take them as prescribed, even if you do not feel like throwing up.
  • Drink clear liquids and have small meals. Get fresh air and rest.
  • Do not eat spicy, fried foods or foods with a strong smell.
  • Limit caffeine (like coffee, tea) and avoid alcohol.


If you have nausea or vomiting:

  • Take your rescue (as-needed) anti-nausea medication(s) as prescribed.
  • Ask your health care team for the Nausea & Vomiting pamphlet for more information.
  • Talk to your health care team if:
    • nausea lasts more than 48 hours
    • vomiting lasts more than 24 hours or if it is severe
Contact your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours.

High blood pressure

(May be severe)

What to look for?

  • There are usually no signs of high blood pressure.
  • Rarely, you may have headaches, shortness of breath or nosebleeds.

What to do?

  • Check your blood pressure regularly.
  • Your doctor may prescribe medication to treat high blood pressure.

If you have a severe headache, get emergency help right away as it may be a sign your blood pressure is too high.

Talk to your health care team if it does not improve or if it is severe.

Mild Headache

What to do?

  • Take pain medication (such as acetaminophen) as needed.
  • Read the above section: "What to do if you feel unwell, have pain, a headache or a fever" before taking acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or Aspirin. These medications may hide an infection that needs treatment or they may increase your risk of bleeding.

Ask your health care team for the Pain pamphlet for more information.

If you have a sudden, severe headache get emergency medical help right away.

Talk to your health care team if it does not improve or if it is severe.

 

Less Common Side Effects (10 to 24 out of 100 people)
Side effects and what to do When to contact health care team

Fatigue 

What to look for?

  • Feeling of tiredness or low energy that lasts a long time and does not go away with rest or sleep.
     

What to do?

  • Be active. Aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days.
  • Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Ask family or friends to help you with things like housework, shopping, and child or pet care.
  • Eat well and drink at least 6 to 8 glasses of water or other liquids every day (unless your health care team has told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired.

Ask your health care team for the Fatigue pamphlet for more information. 

 

Talk to your health care team if it does not improve or if it is severe.

Low appetite

What to look for?

  • Loss of interest in food or not feeling hungry.
  • Weight loss.


What to do?

  • Try to eat your favourite foods.
  • Eat small meals throughout the day.
  • You may need to take meal supplements to help keep your weight up.
  • Talk to your health care team if you have no appetite.

Ask your health care team for the Loss of Appetite pamphlet for more information.

 

Talk to your health care team if it does not improve or if it is severe.

Changes in heart rhythm

(May be severe)

This is usually mild with no symptoms. Your health care team may monitor your heart rate for you.

What to look for?

  • It is rare to have symptoms; however, symptoms may include:
    • an irregular heartbeat
    • shortness of breath
    • chest pain
    • fainting spells (passing out)

What to do?

Talk to your health care team right away if you have any of these symptoms. If you are unable to talk to the team for advice, you must get emergency medical help right away.

Talk to your health care team right away if you have any of these symptoms. If you are unable to talk to the team for advice, you must get emergency medical help right away.

Trouble Sleeping

Your medications may cause trouble sleeping. It may get better once your body gets used to the medication or when your treatment ends.

What to look for?

  • You may find it hard to fall asleep or stay asleep.
  • How well you sleep may change over your treatment. For example, you may have several nights of poor sleep followed by a night of better sleep.
  • You may wake up too early or not feel well-rested after a night's sleep.
  • You may feel tired or sleepy during the day.

What to do?

Talk to your health care team if it does not improve or if it is severe

Talk to your health care team if it does not improve or if it is severe.

Skin sensitivity to sunlight

What to look for?

  • When your skin is exposed to the sun you may get an itchy, red rash that looks like a sunburn or other skin reactions.

What to do?

To prevent and treat dry skin:

  • Use fragrance-free skin moisturizer every day.
  • Protect your skin from the sun and the cold. When you are in the sun, wear long sleeved shirts, long pants and a hat.
  • Use sunscreen with UVA and UVB protection and a SPF of at least 30.
  • Use a lip balm with sunscreen on your lips.
  • Drink 6 to 8 cups of non-alcoholic, non-caffeinated liquids each day, unless your health care team has told you to drink more or less.

In rare cases, the rash may be severe and cause your skin to blister or peel. If this happens, get emergency medical help right away.

Talk to your health care team if it does not improve or if it is severe.

Too much or too little salts in your body

What to look for?

  • Muscle spasms, cramping, weakness, twitching, or convulsions.
  • Irregular heartbeat, confusion or blood pressure changes.
     

What to do?

Get emergency medical help right away for severe symptoms.

Get emergency medical help right away for severe symptoms.

Heartburn; stomach upset; bloating

What to look for?

  • Pain or burning in the middle or top part of your chest. It may get worse when you are lying down or bending over or when you swallow.
  • A bitter or acidic taste in your mouth.
     

What to do?

  • Drink clear liquids and eat small meals.
  • Do not eat acidic, fatty or spicy foods.
  • Limit caffeine (like coffee, tea) and avoid alcohol.
  • Avoid smoking or being around tobacco.
  • Sit up or stand after eating. Do not lie down.
  • Raise the head of your bed six to eight inches. You may need to use extra pillows to do this.
Talk to your health care team if it does not improve or if it is severe.
 

Cough and feeling short of breath

(May be severe)

What to look for?

  • You may have a cough and feel short of breath.
  • Symptoms that commonly occur with a cough are:
    • wheezing or a whistling breathing
    • runny nose
    • sore throat
    • heartburn
    • weight loss
    • fever and chills
  • Rarely this may be severe with chest pain, trouble breathing or coughing up blood.

What to do?

  • Check your temperature to see if you have a fever. Read the above section "What to do if you feel unwell, have pain, a headache or a fever".
  • If you have a fever, try to talk to your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
  • If you have a severe cough with chest pain, trouble breathing or you are coughing up blood, get medical help right away.
 

Talk to your health care team. If you are not able to talk to your health care team for advice, and you have a fever or severe symptoms, you MUST get emergency medical help right away.

Other rare, but serious side effects are possible with this treatment.

If you have any of the following, talk to your cancer health care team or get emergency medical help right away:

  • Sudden loss of vision or trouble speaking or using your arms or legs, confusion

  • Chest pain (that may extend to your arm), shortness of breath

  • Sudden severe pain in your upper back, that moves up your neck or down your back, when you didn't hurt yourself

  • Weakness on one side of your body

  • Pain, swelling and hardening in an arm or leg

  • Unusual weight gain, a lack of energy or feeling tired, getting cold easily, or dry skin, nails or hair that breaks easily

  • Unusual bleeding from your gums, nosebleeds, bruising easily or more than normal, or blood in your urine (pee) or stools (poo). If you have bleeding that doesn’t stop or is very heavy, you must get emergency help.

  • Unusual pulsating or throbbing feeling in your chest or belly

  • New swelling in your hands, ankles, feet or other areas of your body

  • Changes in urination (peeing) such as less urine than usual

  • Sudden, severe pain in your belly or stomach area, trouble swallowing

  • Blurry vision or loss of vision

  • Confusion, seizures

  • Wounds that take longer to heal or not fully heal

  • Pain and swelling, poor healing of mouth sores, unusual discharge from gums, loosening of teeth, and the feeling of numbness or heaviness in the jaw

  • Severe bone pain, especially if new for you


 

For more information on how to manage your symptoms ask your health care provider, or visit: https://www.cancercareontario.ca/symptoms.

Notes

July 2026 MIS eng- retrieve 0707

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.

Last Updated: July 21, 2026