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Midostaurin (Oral)

mye-doe-STAW-rin

Medically reviewed on June 7, 2018

Commonly used brand name(s)

In the U.S.

  • Rydapt

Available Dosage Forms:

  • Capsule, Liquid Filled

Therapeutic Class: Antineoplastic Agent

Uses For This Medicine

Midostaurin is used in combination with standard cytarabine and daunorubicin induction and cytarabine consolidation chemotherapy to treat adults with newly diagnosed acute myeloid leukemia (AML) that is FLT3 mutation-positive.

Midostaurin is also used to treat aggressive systemic mastocytosis (ASM), systemic mastocytosis with associated hematological neoplasm (SM-AHN), or mast cell leukemia (MCL).

Midostaurin is available only with your doctor's prescription.

Before Using This Medicine

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 midostaurin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to midostaurin 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.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of midostaurin in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of midostaurin in the elderly.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

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 midostaurin, 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 midostaurin 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.

  • Boceprevir
  • Carbamazepine
  • Clarithromycin
  • Cobicistat
  • Conivaptan
  • Enzalutamide
  • Fosphenytoin
  • Idelalisib
  • Indinavir
  • Itraconazole
  • Ketoconazole
  • Lopinavir
  • Lumacaftor
  • Mitotane
  • Nefazodone
  • Nelfinavir
  • Phenytoin
  • Posaconazole
  • Rifampin
  • Ritonavir
  • Saquinavir
  • St John's Wort
  • Telaprevir
  • Telithromycin
  • Voriconazole

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. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of midostaurin. Make sure you tell your doctor if you have any other medical problems, especially:

  • Lung disease (eg, interstitial lung disease, pneumonitis)—Use with caution. May make these conditions worse.

Proper Use of This Medicine

Medicines used to treat cancer are very strong and can have many side effects. Before receiving midostaurin, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.

Take midostaurin only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

Midostaurin should come with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Swallow the capsule whole. Do not crush, break, chew, or open it. Take midostaurin with food.

You may also receive medicines to help prevent nausea and vomiting.

If you missed a dose or vomit after taking your medicine, do not take an extra dose. Take your next dose at your scheduled dose.

Do not eat grapefruit or drink grapefruit juice while you are using midostaurin.

Dosing

The dose of midostaurin 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 midostaurin. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For treatment of acute myeloid leukemia:
      • Adults—50 milligrams (mg) two times a day on Days 8 to 21 of each cycle of induction with cytarabine and daunorubicin, and on Days 8 to 21 of each cycle of consolidation with high-dose cytarabine.
      • Children—Use and dose must be determined by your doctor.
    • For treatment of ASM, SM-AHN, and MCL:
      • Adults—100 milligrams (mg) two times a day (about every 12 hours apart).
      • Children—Use and dose must be determined by your doctor.

Missed Dose

Midostaurin needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

Storage

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.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Store the medicine in the original package to protect from moisture.

Precautions While Using This Medicine

It is very important that your doctor check your progress at regular visits to make sure midostaurin is working properly and to check for unwanted effects. Blood and urine tests may be needed to check for unwanted effects.

Using midostaurin while you are pregnant can harm your unborn baby. Men and women should use an effective form of birth control to keep from getting pregnant during therapy and for at least 4 months after the last dose of midostaurin. If you think you or your partner have become pregnant while using the medicine, tell the doctor right away.

You must have a negative pregnancy test within 7 days before starting midostaurin. If you miss a period while you are using midostaurin, tell your doctor right away.

Tell your doctor if you have chest pain, chills, cough, fever, or troubled breathing. These may be symptoms of a serious lung problem.

Talk with your doctor before using midostaurin if you plan to have children. Some men and women who use midostaurin have become infertile (unable to have children).

Cancer medicines can cause nausea or vomiting in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these side effects.

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 (eg, St. John's wort) or vitamin supplements.

This Medicine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  • Black, tarry stools
  • bloody urine
  • body aches or pain
  • chest pain
  • cough
  • decreased frequency or amount of urine
  • dizziness
  • ear congestion
  • fever or chills
  • headache
  • increased thirst
  • loss of appetite
  • loss of voice
  • lower back or side pain
  • nasal congestion
  • nausea
  • painful or difficult urination
  • pale skin
  • runny nose
  • sneezing
  • sore throat
  • swelling of the face, fingers, or lower legs
  • tightness in the chest
  • troubled breathing
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting
  • weight gain

Incidence not known

  • Chills
  • general feeling of discomfort or illness
  • thickening of bronchial secretions

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Abdominal or stomach pain
  • bloody nose
  • blurred vision
  • cracked lips
  • diarrhea
  • difficulty having a bowel movement (stool)
  • difficulty with moving
  • difficulty with swallowing
  • dry mouth
  • flushed, dry skin
  • fruit-like breath odor
  • headache
  • increased hunger
  • increased sweating
  • increased thirst
  • increased urination
  • joint or muscle pain
  • muscle stiffness
  • small red or purple spots on the skin
  • sores, ulcers, or white spots on the lips, tongue, or inside the mouth
  • sweating
  • trouble sleeping
  • unexplained weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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