Warning: Differentiation SyndromePatients treated with ivosidenib have experienced symptoms of differentiation syndrome, which can be fatal if not treated. Symptoms may include fever, dyspnea, hypoxia, pulmonary infiltrates, pleural or pericardial effusions, rapid weight gain or peripheral edema, hypotension, and hepatic, renal, or multi-organ dysfunction. If differentiation syndrome is suspected, initiate corticosteroid therapy and hemodynamic monitoring until symptom resolution .Early recognition and aggressive management of differentiation syndrome is required to lessen the likelihood of serious illness and death. Symptoms of differentiation syndrome should be described to patients when starting therapy and at follow-up visits. Differentiation syndrome has occurred as early as 10 days and up to 5 months after initiating therapy with another isocitrate dehydrogenase 2 inhibitor .
Medically reviewed by Drugs.com. Last updated on Aug 19, 2019.
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antineoplastic Agent
Uses for ivosidenib
Ivosidenib is used to treat newly-diagnosed acute myeloid leukemia (AML) in patients who are 75 years of age or older or who have health problems that prevent the use of certain cancer treatments (chemotherapy). It is also used to treat AML that has come back or has not improved after a previous treatment. Ivosidenib is used only in patients who have an isocitrate dehydrogenase-1 (IDH1) mutation in their AML. Your doctor will test for the presence of this mutation.
Ivosidenib is available only with your doctor's prescription.
Before using ivosidenib
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ivosidenib, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to ivosidenib or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of ivosidenib in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ivosidenib in the elderly.
Interactions with medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking ivosidenib, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using ivosidenib with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using ivosidenib with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Ethinyl Estradiol
- Inotuzumab Ozogamicin
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- St John's Wort
Interactions with food/tobacco/alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Other medical problems
The presence of other medical problems may affect the use of ivosidenib. Make sure you tell your doctor if you have any other medical problems, especially:
- Electrolyte imbalance or
- Guillain-Barré syndrome (autoimmune disease) or
- Heart failure or
- Heart rhythm problems (eg, long QT syndrome) or—Use with caution. May make these conditions worse.
- Kidney disease, severe or
- Liver disease, severe—Use has not been studied in patients with these conditions.
Proper use of ivosidenib
Medicines used to treat cancer are very strong and can have many side effects. Before using ivosidenib, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
Take ivosidenib only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.
Ivosidenib comes with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.
You may take ivosidenib with or without food. However, do not take ivosidenib with a high fat meal.
Swallow the tablet whole. Do not crush, break, or chew it.
Drink plenty of fluids to help prevent other unwanted effects.
The dose of ivosidenib will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ivosidenib. If your dose is different, do not change it unless your doctor tells you to do so.
- For oral dosage form (tablets):
- For relapsed or refractory acute myeloid leukemia:
- Adults—500 milligrams (mg) taken once a day.
- Children—Use and dose must be determined by your doctor.
- For relapsed or refractory acute myeloid leukemia:
If you miss a dose of ivosidenib, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
If you miss a dose and it is less than 12 hours until your next regular dose, skip the missed dose and take your next dose at the regular time. If you miss a dose and it is 12 hours or more until your next regular dose, take the missed dose as soon as possible, and then go back to your regular schedule. Do not administer 2 doses within 12 hours.
If you vomit after taking a dose of ivosidenib, do not take an additional dose. Take your next dose at your usual time.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions while using ivosidenib
It is very important that your doctor check your progress at regular visits to make sure ivosidenib is working properly. Blood and urine tests may be needed to check for unwanted effects.
Using ivosidenib may increase your risk of having a condition called differentiation syndrome, which may be life-threatening. It may occur within 1 day and up to 3 months after treatment with ivosidenib. Check with your doctor right away if you start to have a fever, cough, troubled breathing, swelling of the arms or legs or around the neck, groin, or underarms, rapid weight gain, or bone pain.
Ivosidenib may also cause a serious reaction called tumor lysis syndrome (TLS). Call your doctor right away if you have a change in how much or how often you urinate, rapid weight gain, muscle or joint pain, swelling of the feet or lower legs, or unusual tiredness or weakness.
Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you had a heart rhythm problem, such as QT prolongation.
Contact your doctor immediately if fever, rash, joint pain, sudden numbness and weakness in the arms and legs, or inability to move the arms and legs occurs. These could be symptoms of an autoimmune syndrome where the body attacks itself.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Ivosidenib side effects
Check with your doctor immediately if any of the following side effects occur:
- Blurred vision
- burning, tingling, numbness or pain in the hands, arms, feet, or legs
- chest pain
- decreased urination
- difficult or labored breathing
- difficulty in moving
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- eye pain
- general feeling of illness
- irregular heartbeat, recurrent
- joint pain, stiffness, or swelling
- lower back, side, or stomach pain
- muscle ache, cramps, pain, or stiffness
- rapid weight gain
- sensation of pins and needles
- sore throat
- stabbing pain
- swelling of your arms, feet, or lower legs
- tightness in the chest
- unusual tiredness or weakness
- Inability to move the arms and legs
- sudden numbness and weakness in the arms and legs
- Cracked lips
- decreased appetite
- difficulty in swallowing
- sores, ulcers, or white spots on the lips, tongue, or inside the mouth
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More about ivosidenib
- Side Effects
- During Pregnancy
- Dosage Information
- Drug Interactions
- En Español
- Drug class: miscellaneous antineoplastics
Other brands: Tibsovo