Enasinib

Indications

Enasidenib is an oral cancer medicine used to treat adults with acute myeloid leukaemia (AML, a fast-growing blood cancer) that has come back or has not responded to treatment, when the leukaemia cells carry a mutation in the IDH2 gene confirmed by a test.

How It Works

The faulty IDH2 enzyme in these leukaemia cells makes a substance that stops blood cells from maturing normally. Enasidenib blocks the faulty enzyme, which allows the abnormal cells to mature into normal working blood cells and reduces the number of immature leukaemia cells (blasts).

Dosage and Administration

Enasidenib is a specialist cancer medicine and is taken exactly as prescribed by the haematologist, usually once a day at about the same time, with or without food. Swallow the tablet whole with a glass of water; do not split, crush or chew it. Treatment usually continues for at least several months to see a response. Do not stop or change the dose without advice.

Interactions

• It may reduce the effect of hormonal contraceptives; use an additional barrier method
• It may raise levels of some medicines carried by body transporters, such as Rosuvastatin
• Tell the doctor about all other medicines, herbal products and supplements

Contraindications

• Allergy to Enasidenib or any ingredient

Side Effects

Common effects include nausea, vomiting, diarrhoea, loss of appetite, raised bilirubin (which can cause yellowing of the skin or eyes), taste changes and low blood calcium or potassium. A serious reaction called differentiation syndrome can occur, usually in the first months: signs include fever, cough, shortness of breath, swelling of the arms or legs, rapid weight gain, bone pain, dizziness and passing less urine. Tumour lysis syndrome (rapid break-down of cancer cells) can also occur.

Get urgent medical help at once for any signs of differentiation syndrome, difficulty breathing, chest pain, fainting or very little urine.

Pregnancy and Lactation

Enasidenib can harm an unborn baby. Women and men should use effective contraception during treatment and for at least 2 months after the last dose (hormonal methods may not be reliable). Do not breastfeed during treatment and for at least 2 months after the last dose.

Precautions and Warnings

Blood counts, liver tests, kidney function and blood salts are checked regularly. Drink plenty of fluids unless told otherwise. Report fever, breathlessness or swelling immediately; treatment with steroids may be needed. Tell the doctor about any liver or kidney disease.

Overdose

Overdose may increase side effects. Contact a doctor or hospital at once; treatment is supportive with monitoring.

Therapeutic Class

Antineoplastic; IDH2 (isocitrate dehydrogenase 2) inhibitor.

Storage

Store below 30°C in a dry place, away from light, in the original pack with the desiccant, and out of the reach of children.