<p>Vismodegib is a hedgehog inhibitor used in the treatment of basal cell carcinomas and basal cell nevus syndrome. However, treatment is associated with significant side effects that can impact compliance, including fatigue, muscle cramps, hair loss, and taste disturbance. Multiple strategies to change dosing frequency have been implemented to improve the tolerability. Vismodegib may be administered with non-daily dosing or with drug holidays to improve the side effects associated with administration. Intermittent dosing of vismodegib may be more appropriate for patients with locally advanced BCC and drug holidays may be more suited for patients with basal cell nevus syndrome. The most appropriate strategy in each case though will ultimately depend on patient preference.</p>