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Zelboraf (vemurafenib) is a medication used for certain types of cancer treatments, but it carries several important safety warnings. Patients and healthcare providers should be aware of these risks and take necessary precautions.

• Risk of New Cancers: Patients taking Zelboraf may develop new cancers, including skin and non-skin types. Regular monitoring by a healthcare provider is essential, especially for those over 65, with a history of skin cancer, or with extensive sun exposure. Report any new skin changes or sores to your provider immediately.

• Use in BRAF Mutation-Positive Cancers Only: Zelboraf is not suitable for cancers without a BRAF mutation, as it can promote cancer cell growth in such cases. Your healthcare provider will ensure the presence of a BRAF mutation before starting treatment.

• Allergic Reactions: Serious allergic reactions, including anaphylaxis, can occur. Symptoms such as rash, fever, swollen lymph nodes, or breathing difficulties require immediate medical attention.

• Heart Rhythm Changes: Zelboraf may cause QT prolongation, affecting heart rhythm. Inform your provider about any heart conditions or medications you are taking. Those with long QT syndrome or other heart rhythm issues may need alternative treatments.

• Liver Damage: Liver problems may arise, potentially affecting blood clotting. Regular liver function tests are advised during treatment.

• Sun Sensitivity and Skin Reactions: The medication can increase sun sensitivity, leading to sunburn. Avoid direct sunlight, wear protective clothing, and use sunscreen with SPF 30 or higher. Report any skin rashes after sun exposure to your provider.

• Eye Problems: Vision changes such as blurriness and light sensitivity have been reported. Consult your provider if you experience these symptoms, as you may need to pause treatment for an eye examination.

• Potential Harm to Unborn Babies: While the risk is uncertain, there is a potential for harm to unborn babies. Use effective birth control during treatment and for two weeks after the last dose. Notify your provider immediately if you become pregnant.

• Radiation Reaction: Zelboraf may cause radiation recall reactions in patients who have received radiation therapy. These can range from mild skin rashes to severe tissue damage. Discuss any history of radiation therapy with your provider.

• Kidney Function Concerns: Elevated creatinine levels, indicating possible kidney damage, can occur. Regular kidney function testing is recommended.

• Hand and Foot Conditions: Some patients may experience conditions affecting the hands and feet, like Dupuytren’s contracture or plantar fibromatosis, leading to pain and mobility issues. Report any such symptoms to your provider.

It is important to maintain open communication with your healthcare provider throughout your treatment with Zelboraf to manage these risks effectively.

When taking this medication, some common side effects may occur but are generally mild. These include joint pain, tiredness, rash, sensitivity to sunlight, hair loss, nausea, itching, skin papilloma, diarrhea, thickened skin, headache, and vomiting. If these symptoms persist or worsen, it is advisable to consult your healthcare provider for guidance.

Other side effects reported by some users include muscle or back pain, pain in the arms or legs, swelling in these areas, low appetite, constipation, fever, dry skin, sunburn, and changes in taste. Some individuals may also experience new skin cancers, a cough, weakness, or changes in liver enzyme levels in the blood. While these effects may be concerning, they are not typically severe but should still be discussed with your healthcare provider if they arise.

There are rare yet serious side effects that require immediate medical attention. These include severe allergic reactions characterized by rash, fever, difficulty breathing, and swelling of the face or mouth. Serious skin reactions may present as painful blisters, skin wounds, or peeling. Liver problems can manifest as upper stomach pain and yellowing of the skin or eyes. Changes in heart rhythm might cause lightheadedness, blurry vision, fainting, or even seizures. Additionally, individuals who have undergone radiation therapy should be aware of potentially serious reactions.

Furthermore, this drug may lead to the development of other types of skin cancer, such as cutaneous squamous cell carcinoma and melanoma, as well as potentially exacerbate other cancers, including those with RAS mutations. Immediate attention is necessary if you notice new skin changes or symptoms like eye pain or liver issues. Always stay vigilant for any unusual changes in your health while on this medication.

Vemurafenib, also known as Zelboraf, can interact with various medications and supplements. It's important to inform your healthcare provider about all the medications, both prescription and over-the-counter, as well as any vitamins, dietary, or herbal supplements you are taking. This will help in managing potential interactions effectively.

Some drugs, such as ipilimumab, can have interactions with vemurafenib. Additionally, vemurafenib may influence heart rhythm (QT prolongation), so caution is advised when taking it with other medications known to affect heart rhythm, like amiodarone, dofetilide, quinidine, procainamide, and sotalol, as well as certain antipsychotics such as pimozide and thioridazine.

Vemurafenib's effectiveness can be altered by medications that modify its removal from the body. These include azole antifungals (ketoconazole, itraconazole), macrolide antibiotics (clarithromycin), nefazodone, HIV protease inhibitors (atazanavir), ritonavir, and herbal supplements like St. John's wort.

Conversely, vemurafenib might slow down the elimination of certain drugs from the body, impacting their effectiveness. Drugs that might be affected include caffeine, fezolinetant, and warfarin.

For some medications, using them together with vemurafenib is generally not advised unless absolutely necessary. If both drugs are prescribed, your doctor may adjust the dosage or frequency. Examples of these medications include afatinib, alfuzosin, amiodarone, and others.

Always discuss your complete medication list with your healthcare provider to ensure safe and effective use of vemurafenib.