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The use of Vismodegib, also known as Erivedge, requires careful adherence to safety guidelines due to potential risks. It is crucial for both patients and healthcare providers to understand these risks and the necessary precautions.

• Risk of Harm to Unborn Babies: Vismodegib can cause severe harm or death to an unborn child. Women who are pregnant or might become pregnant must not use this medication. Women of childbearing potential must have a negative pregnancy test within 7 days before beginning treatment and must continue using effective birth control while taking Vismodegib and for 2 years following the last dose. Men must use condoms with spermicide during sexual intercourse with women who are pregnant or may become pregnant, and continue this practice for 3 months after the last dose. Men should also refrain from donating sperm during this period. Immediate consultation with a doctor is necessary if pregnancy occurs or is suspected.

• Serious Skin Reactions: Rare but severe skin reactions, such as Stevens-Johnson syndrome (SJS) or Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), may occur. Symptoms like painful blisters, skin wounds, peeling skin, or fever require urgent medical attention.

• Muscle Issues: Muscle spasms are a common side effect, typically mild, but can be severe and indicative of tissue damage. Regular monitoring of creatine phosphokinase (CPK) levels is advised before and during treatment. Severe muscle spasms or elevated CPK levels may necessitate pausing or discontinuing the medication.

• Bone Changes in Children: Exposure to Vismodegib can lead to abnormal bone development in children. Ensure this medication is stored safely out of children's reach to prevent accidental exposure.

Patients are strongly advised to discuss any concerns with their healthcare provider to ensure safe and effective use of Vismodegib.

When taking Erivedge (vismodegib), it's important to be aware of potential interactions with other medications and substances:

• Medications Affecting Stomach Acid: Drugs that alter stomach acidity, such as proton pump inhibitors (e.g., Omeprazole), H2-receptor antagonists (e.g., ranitidine), and antacids, may reduce the absorption of Erivedge, potentially decreasing its effectiveness.

• Certain Antibiotics: Antibiotics like Clarithromycin, Erythromycin, and Azithromycin can increase Erivedge levels in the body, raising the risk of side effects.

• Cholesterol-Lowering Medications: Statins, including Atorvastatin, Fluvastatin, Pravastatin, Rosuvastatin, and Simvastatin, may interact with Erivedge.

• Herbal Supplements: St. John's wort, commonly used for depression, can decrease Erivedge's effectiveness and should be avoided during treatment.

• Other Medications: Drugs such as bosentan (for high blood pressure), glibenclamide (for diabetes), Valsartan and Olmesartan (for high blood pressure and heart problems), and topotecan (for certain cancers) may interact with Erivedge.

Additionally, Erivedge can cause severe birth defects. Women who can become pregnant should use two forms of contraception during treatment and for 24 months after the final dose. Men should use condoms during treatment and for 3 months after the final dose to prevent exposing partners to the drug.

Always inform your healthcare provider about all medications, supplements, and herbal products you are taking before starting Erivedge to ensure safe and effective treatment.