Enasidenib (Idhifa®)

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About This Drug

Enasidenib is used to treat cancer. It is given orally (by mouth).

Possible Side Effects

  • Nausea and vomiting (throwing up)
  • Loose bowel movements (diarrhea)
  • Increased total bilirubin in your blood. This may mean that you have changes in your liver function.
  • Decreased appetite (decreased hunger)

Note: Each of the side effects above was reported in 20% or greater of patients treated with enasidenib. Not all possible side effects are included above.

Warnings and Precautions

  • A serious syndrome may happen with the use of this drug which is known as differentiation syndrome, which can be life-threatening. It can cause a fever, weight gain, and breathing problems.
  • Tumor lysis syndrome: This drug may act on the cancer cells very quickly. This may affect how your kidneys work.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

How to Take Your Mediation

  • Swallow the medicine whole with or without food. Do not split or crush the tablet.
  • Take this medicine at the same time each day.
  • Missed dose: If you miss or vomit a dose, take it as soon as you think about it on the same day and take your next dose at the regular time on the next day. Do not take 2 doses at the same time to make up for a missed dose.
  • Handling: Wash your hands after handling your medicine. Your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature. Keep the lid tightly closed with desiccant inside to protect from moisture.
  • Disposal of unused medicine: Do not flush any expired and/or unused medicine down the toilet or drain unless you are specifically instructed to do so on the medication label. Some facilities have take-back programs and/or other options. If you do not have a take-back program in your area, then please discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with decreased appetite eat foods high in calories and protein, such as meat, poultry, fish, dry beans, tofu, eggs, nuts, milk, yogurt, cheese, ice cream, pudding, and nutritional supplements.
  • Consider using sauces and spices to increase taste.
  • Daily exercise, with your doctor’s approval, may increase your appetite.

Food and Drug Interactions

  • There are no known interactions of enasidenib with food.
  • This drug may interact with other medicines. Tell your doctor and pharmacist about all the prescription and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
  • This drug may interact with hormonal birth control (i.e., birth control pills, skin patches, vaginal rings, injections) and affect how they work. Discuss with your doctor and/or nurse what method of birth control may be right for you during your treatment.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Tiredness that interferes with your daily activities
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Signs of tumor lysis: confusion or agitation, decreased urine, nausea/vomiting, diarrhea, muscle cramping, numbness and/or tingling, seizures
  • Signs of differentiation syndrome: fever, weight gain, swelling, bone pain, or trouble breathing
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 1 month after treatment. Men with female partners of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 1 month after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner. Birth control pills (oral contraceptives) may not be effective with this medication.
  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should not breastfeed during treatment and for at least 1 month after treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised October 2018