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Ivosidenib

Generic name: ivosidenib (EYE voe SID e nib)
Brand name: Tibsovo
Dosage forms: oral tablet (250 mg)
Drug class: Miscellaneous antineoplastics

Medically reviewed by Drugs.com on Sep 1, 2021. Written by Cerner Multum.

What is ivosidenib?

Ivosidenib targets a specific gene mutation called IDH1, which can affect your bone marrow. IDH1 mutation prevents young blood cells from developing into healthy adult blood cells, which can result in symptoms of acute myeloid leukemia (AML).

Ivosidenib is for use only in adults with an IDH1 mutation. Your doctor will test you for this gene.

Ivosidenib is used to treat AML after other treatments did not work or stopped working.

Ivosidenib is also used to treat AML in adults 75 years and older who have newly-diagnosed AML and cannot use certain chemotherapy treatments because of other health problems.

Ivosidenib is also used to treat bile duct cancer that has progressed or has spread to other parts of the body (metastatic) after treatment with other medicine.

Ivosidenib may also be used for purposes not listed in this medication guide.

Warnings

Ivosidenib can cause a condition called differentiation syndrome, which affects blood cells and can be fatal if not treated. This condition may occur within 1 days to 3 months after you start taking ivosidenib.

Seek medical help right away if you have symptoms of differentiation syndrome: fever, dizziness, cough, trouble breathing, swelling, rapid weight gain, rash, or decreased urination.

Before taking this medicine

You should not use ivosidenib if you are allergic to it.

Tell your doctor if you have ever had:

  • heart disease;

  • long QT syndrome (in you or a family member);

  • nerve problems;

  • an electrolyte imbalance (such as low levels of potassium, sodium, or magnesium in your blood);

  • cirrhosis or other liver disease; or

  • kidney disease (or if you are on dialysis).

May harm an unborn baby. Use birth control and tell your doctor if you become pregnant.

Ivosidenib can make hormonal birth control less effective, including birth control pills, injections, implants, skin patches, and vaginal rings. Use barrier birth control to prevent pregnancy: condom, diaphragm, cervical cap, or contraceptive sponge.

Pregnancy may be less likely to occur while the mother or the father is using ivosidenib. Women should still use birth control to prevent pregnancy because the medicine can harm an unborn baby.

Do not breastfeed while using ivosidenib, and for at least 1 month after your last dose.

How should I take ivosidenib?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Swallow the tablet whole and do not crush, chew, or break it.

Take the medicine at the same time each day, with or without food.

Do not change your dose or stop taking ivosidenib without your doctor's advice.

Drink plenty of liquids while you are taking ivosidenib.

Do not take ivosidenib with foods that are high in fat, such as butter, bacon, cheese, or whole milk.

If you vomit shortly after taking ivosidenib, do not take another dose. Take your next dose as scheduled.

You may need medical tests to check your heart function.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if your next dose is due in less than 12 hours. Do not take two doses within 12 hours.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking ivosidenib?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Ivosidenib side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Ivosidenib can cause a condition called differentiation syndrome, which affects blood cells and can be fatal if not treated. This condition may occur within 1 days to 3 months after you start taking ivosidenib.

Seek medical help right away if you have symptoms of differentiation syndrome:

  • fever, cough, trouble breathing;

  • dizziness;

  • rash;

  • decreased urination;

  • rapid weight gain; or

  • swelling in your arms or legs.

Call your doctor at once if you have:

  • fast or pounding heartbeats, fluttering in your chest, shortness of breath, sudden dizziness (like you might pass out);

  • jaundice (yellowing of the skin or eyes);

  • fluid build-up around the stomach--rapid weight gain, stomach pain and bloating, trouble breathing while lying down;

  • low red blood cells (anemia)--pale skin, tiredness, feeling light-headed or short of breath, cold hands and feet;

  • high white blood cell counts--fever, weakness, not feeling well, bleeding or bruising, nausea, loss of appetite, weight loss; or

  • nervous system problems--numbness, pain, tingling, weakness, burning or prickly feeling, vision or hearing problems, trouble breathing.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common side effects may include:

  • irregular heartbeats;

  • stomach pain or swelling, nausea, vomiting, loss of appetite;

  • diarrhea, constipation;

  • fever, tiredness;

  • low red blood cell or high white blood cell counts;

  • cough, shortness of breath;

  • sores in your mouth or throat;

  • rash;

  • abnormal liver function tests;

  • muscle or joint pain; or

  • swelling in your arms or legs.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Ivosidenib dosing information

Usual Adult Dose for Acute Myeloid Leukemia:

500 mg orally once daily until disease progression or unacceptable toxicity; for patients without disease progression or unacceptable toxicity, treat for a minimum of 6 months to allow time for clinical response

Comments:
-NOTE: Select patients for the treatment of AML based on the presence of IDH1 mutations in the blood or bone marrow. Patients without IDH1 mutations at diagnosis should be retested at relapse because a mutation in IDH1 may emerge during therapy and at relapse.

Use: For the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with a susceptible isocitrate dehydrogenase-1 (IDH1) mutation as detected by an FDA-approved test

Usual Geriatric Dose for Acute Myeloid Leukemia:

75 years or older:
500 mg orally once daily until disease progression or unacceptable toxicity; for patients without disease progression or unacceptable toxicity, treat for a minimum of 6 months to allow time for clinical response

Comments:
-NOTE: Select patients for the treatment of AML based on the presence of IDH1 mutations in the blood or bone marrow. Patients without IDH1 mutations at diagnosis should be retested at relapse because a mutation in IDH1 may emerge during therapy and at relapse.

Use: For the treatment of adult patients with newly-diagnosed AML with a susceptible IDH1 mutation as detected by an FDA-approved test who are 75 years older or who have comorbidities that preclude use of intensive induction chemotherapy.

What other drugs will affect ivosidenib?

Ivosidenib can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.

Other drugs may affect ivosidenib, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

Does Ivosidenib interact with my other drugs?

Enter other medications to view a detailed report.

Frequently asked questions

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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