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Use of an Over-the-Counter Supplement to Decrease Muscle Cramps Caused by a Popular Skin Cancer Medication

SKIN: The Journal of Cutaneous Medicine(TM), L-Carnitine Reduces Muscle Cramps in Patients Taking Vismodegib

These cases illustrate a promising treatment option for the most common side effect associated with hedgehog pathway inhibitor treatment for Basal Cell Carcinoma.”
— Matthew S. Dinehart, BA, M.Ed
NEW YORK, NY, UNITED STATES, March 12, 2018 / -- A popular new class of oral medications, called hedgehog pathway inhibitors, is commonly used to treat patients with locally advanced or metastatic basal cell carcinoma of the skin. These medications have been shown to be very effective in in shrinking tumors prior to surgery and in treating non-operable tumors.

Unfortunately, one of the major barriers to treatment with this class of medications is resultant severe muscle cramps, which occur in 60-70% of patients. The muscle cramps associated with hedgehog pathway inhibitors can be so severe that they adversely affect quality of life or even lead to discontinuation of the drug due to intolerance.

A new article published today in SKIN: The Journal of Cutaneous MedicineTM examines the use of an over-the-counter supplement, L-carnitine, to alleviate the muscle cramps associated with vismodegib—a medication in this class.

Matthew Dinehart, BA, M.Ed, and coauthors report three cases where treatment with L-carnitine drastically reduced muscle cramps to a tolerable level, allowing all three patients to continue their anti-tumor therapy without issue. Moreover, the supplement appears to be extremely safe.

“These cases illustrate a promising treatment option for the most common side effect associated with hedgehog pathway inhibitor treatment for Basal Cell Carcinoma,” says Dinehart. Although he and his coauthors acknowledge that larger studies are needed, they continue to see good effects with this treatment regimen and are now routinely placing all of their advanced basal cell carcinoma patients on L-carnitine before they begin vismodegib therapy, in an attempt to prevent the development of muscle cramps.

SKIN: The Journal of Cutaneous Medicine(TM) is a peer-reviewed online medical journal that is the official journal of The National Society for Cutaneous Medicine. The mission of SKIN is to provide an enhanced and accelerated route to disseminate new dermatologic knowledge for all aspects of cutaneous disease.

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Link to article

(DOI: 10.25251/skin.2.2.1)

Editors’ Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Matthew S. Dinehart, BA, M.Ed
University of Arkansas for Medical Sciences
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