By Gary M. White, MD

Note, this is a brief summary only and is meant to emphasize dermatologic aspects. More complete information, including the package insert and recent studies should be consulted before prescribing.

Eviredge (vismodegib) is an oral medication (Hedgehog pathway inhibitor) that has become first line therapy for basal cell carcinoma that can't be resected nor irradiated.


Indicated for basal cell carcinoma which has metastasized to other parts of the body, relapsed after surgery, or cannot be treated with surgery or radiation.

Off Label Indications

Side Effects (selected, not a complete list)

Is there hepatotoxicity? A post marketing report indicated a significant number of cases of hepatotoxicity (J Am Acad Dermatology Aug 2014).

Squamous Cell Carcinoma

Patients have been described who develop squamous cell carcinoma (SCC) within the tumor bed of a responding BCC. Thus, repeat biopsy is indicated when one area does not respond/grows in the tumor bed or when a tumor stops being suppressed by vismodegib [JAMA Derm 2014;150;970].


150 mg once daily.


None required except for pregnancy testing if indicated.

Jaw Cysts

Case report of resolution of keratocysts of the jaw in basal cell nevus syndrome. In one report of 6 patients treated, 4 experienced a size reduction and 2 had no change [JAMA Dermatol. 2014 May;150(5):542-5.].



JAAD 2015;72;1021


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