Quizartinib (Oral)

Generic name: quizartinib [ kwiz-AR-ti-nib ]
Brand name: Vanflyta
Drug class: Multikinase inhibitors

Medically reviewed by Drugs.com. Last updated on Aug 13, 2024.

Oral route(Tablet)

Warning: QT Prolongation, Torsades de Pointes, and Cardiac Arrest

Quizartinib prolongs the QT interval in a dose- and concentration-related manner. Prior to quizartinib administration and periodically, monitor for hypokalemia or hypomagnesemia, and correct deficiencies. Perform ECG to monitor the QTc at baseline, weekly during induction and consolidation therapy, weekly for at least the first month of maintenance, and periodically thereafter.

Torsades de pointes and cardiac arrest have occurred in patients receiving quizartinib. Do not administer quizartinib to patients with severe hypokalemia, severe hypomagnesemia, or long QT syndrome.

Do not initiate treatment with quizartinib or escalate the quizartinib dose if the QT interval corrected by Fridericia's formula (QTcF) is greater than 450 ms.

Monitor ECGs more frequently if concomitant use of drugs known to prolong the QT interval is required.

Reduce the quizartinib dose when used concomitantly with strong CYP3A inhibitors, as they may increase quizartinib exposure.

Because of the risk of QT prolongation, quizartinib is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the VANFLYTA REMS .

Uses for quizartinib

Quizartinib is used in combination with other medicines (eg, cytarabine, anthracycline) and alone as maintenance therapy to treat acute myeloid leukemia in patients with a FLT3-ITD mutation. Your doctor will test for the presence of this mutation.

This medicine is available only under a restricted distribution program called Vanflyta® REMS (Risk Evaluation and Mitigation Strategy) Program.

Before using quizartinib

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 this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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 quizartinib 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 quizartinib 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 this medicine, 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 this medicine 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.

Adagrasib
Alfuzosin
Amiodarone
Amisulpride
Amitriptyline
Anagrelide
Apalutamide
Apomorphine
Aripiprazole
Aripiprazole Lauroxil
Arsenic Trioxide
Asenapine
Astemizole
Atazanavir
Atovaquone
Azithromycin
Bedaquiline
Bepridil
Boceprevir
Bosentan
Buprenorphine
Buserelin
Carbamazepine
Cenobamate
Ceritinib
Chloroquine
Chlorpromazine
Ciprofloxacin
Cisapride
Citalopram
Clarithromycin
Clofazimine
Clomipramine
Clozapine
Cobicistat
Conivaptan
Crizotinib
Cyclobenzaprine
Dabrafenib
Dasatinib
Degarelix
Delamanid
Desipramine
Deslorelin
Deutetrabenazine
Dipyrone
Disopyramide
Dofetilide
Dolasetron
Domperidone
Donepezil
Doxepin
Doxycycline
Dronedarone
Droperidol
Ebastine
Efavirenz
Elagolix
Encorafenib
Entrectinib
Enzalutamide
Eribulin
Erythromycin
Escitalopram
Etravirine
Famotidine
Felbamate
Fexinidazole
Fingolimod
Flecainide
Fluconazole
Fluoxetine
Formoterol
Foscarnet
Fosphenytoin
Galantamine
Gatifloxacin
Gemifloxacin
Glasdegib
Gonadorelin
Goserelin
Granisetron
Halofantrine
Haloperidol
Histrelin
Hydroquinidine
Hydroxychloroquine
Hydroxyzine
Ibutilide
Idelalisib
Iloperidone
Imipramine
Indinavir
Inotuzumab Ozogamicin
Itraconazole
Ivabradine
Ivosidenib
Josamycin
Ketoconazole
Lapatinib
Lefamulin
Lenvatinib
Lesinurad
Leuprolide
Levofloxacin
Lofexidine
Lonafarnib
Lopinavir
Lorlatinib
Lumacaftor
Lumefantrine
Macimorelin
Mefloquine
Mesoridazine
Methadone
Methotrimeprazine
Metronidazole
Mibefradil
Mifepristone
Mitotane
Mizolastine
Mobocertinib
Modafinil
Moricizine
Moxifloxacin
Nafarelin
Nafcillin
Nefazodone
Nelfinavir
Nilotinib
Norfloxacin
Octreotide
Ofloxacin
Olanzapine
Ondansetron
Osilodrostat
Osimertinib
Oxaliplatin
Paliperidone
Panobinostat
Papaverine
Paroxetine
Pasireotide
Pazopanib
Pentamidine
Perphenazine
Phenobarbital
Phenytoin
Pimavanserin
Pimozide
Pipamperone
Piperaquine
Pitolisant
Ponesimod
Posaconazole
Primidone
Probucol
Procainamide
Prochlorperazine
Promethazine
Propafenone
Protriptyline
Quetiapine
Quinidine
Quinine
Ranolazine
Ribociclib
Rifabutin
Rifampin
Rifapentine
Risperidone
Ritonavir
Saquinavir
Selpercatinib
Sertindole
Sertraline
Sevoflurane
Siponimod
Sodium Phosphate
Sodium Phosphate, Dibasic
Sodium Phosphate, Monobasic
Solifenacin
Sorafenib
Sotalol
Sparfloxacin
St John's Wort
Sulpiride
Sultopride
Sunitinib
Tacrolimus
Tamoxifen
Telaprevir
Telavancin
Telithromycin
Telotristat Ethyl
Terfenadine
Tetrabenazine
Thioridazine
Tolterodine
Toremifene
Trazodone
Triclabendazole
Trimipramine
Triptorelin
Troleandomycin
Tucatinib
Vandetanib
Vardenafil
Vemurafenib
Venlafaxine
Vilanterol
Vinflunine
Voclosporin
Voriconazole
Vorinostat
Ziprasidone
Zotepine
Zuclopenthixol

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.

Proper use of quizartinib

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

Take this medicine 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.

It is very important that you understand the requirements of the Vanflyta® REMS program and Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions. Ask your pharmacist for the medication guide if you do not have one.

You may take this medicine with or without food. Take this medicine at the same time each day.

Swallow the tablet whole. Do not cut, crush, or chew it.

Dosing

The dose of this medicine 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 this medicine. 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 (tablets):
- For acute myeloid leukemia:
  - Adults—At first, 35.4 milligrams (mg) once a day. Your doctor may adjust your dose as needed and tolerated.
  - Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, 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 vomit after taking a dose of this medicine, do not take an additional dose. Take the next dose at the regular time.

Storage

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

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 quizartinib

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

Using this medicine while you are pregnant can harm your unborn baby. It may also cause birth defects if the father is using it when his sexual partner becomes pregnant. Your doctor will give you a pregnancy test within 7 days before you use this medicine to make sure you are not pregnant. Female patients should use effective birth control during treatment with this medicine and for at least 7 months after the last dose. Male patients who have female partners should use effective birth control during treatment with this medicine and for at least 4 months after the last dose. If you think you have become pregnant while using this medicine, tell your doctor right away.

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 (eg, QT prolongation, torsade de pointes).

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.

Side Effects of quizartinib

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
bleeding gums
blood in the urine or stools
body aches or pain
burning or stinging of the skin
chills
confusion
cough
dizziness
ear congestion
fainting
fast heartbeat
fever
headache
lightheadedness
loss of voice
lower back or side pain
painful cold sores or blisters on lips, nose, eyes, or genitals
painful or difficult urination
pale skin
pinpoint red spots on the skin
stuffy or runny nose
trouble breathing
ulcers, sores, or white spots in the mouth
unusual bleeding or bruising
unusual tiredness or weakness

Incidence not known

Chest pain or discomfort
irregular or slow heart rate
no blood pressure
stopping of the heart
unconsciousness

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