Pemigatinib

Pemigatinib is used to treat a certain type of cholangiocarcinoma (bile duct cancer) and to treat a certain type of myeloid/lymphoid neoplasms (MLN; a type of blood cancer). Pemigatinib is in a class of medications called kinase inhibitors. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This helps stop or slow the spread of cancer cells.

Pemigatinib comes as a tablet to take by mouth. It is taken with or without food once a day. The schedule and length of treatment depends on your condition and how you respond to treatment. Take pemigatinib at around the same time every day. 

Take pemigatinib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the tablets whole; do not split, chew, dissolve, or crush them.

If you vomit after taking pemigatinib, do not take another dose. Continue your regular dosing schedule.

Your doctor may decrease your dose or temporarily or permanently stop your treatment if you experience certain side effects. This depends on how well the medication works for you and the side effects you experience. Be sure to tell your doctor how you are feeling during your treatment with pemigatinib.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking pemigatinib,

• tell your doctor or pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• the following nonprescription or herbal product may interact with pemigatinib: St. John's Wort. Be sure to let your doctor and pharmacist know that you are taking this medication before you start taking pemigatinib. Do not start this medication while taking pemigatinib without discussing with your healthcare provider.
• tell your doctor if you have trouble swallowing tablets or if you have or have ever had vision or eye problems, high blood levels of phosphate, or kidney or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or if you plan on fathering a child. You may need to take a pregnancy test before you start treatment and should not become pregnant while you are taking pemigatinib. If you or your partner can become pregnant, use effective birth control to prevent pregnancy during your treatment and for 1 week after your final dose.  Talk to your doctor about birth control methods that you can use during your treatment. If you or your partner become pregnant while taking pemigatinib, call your doctor immediately. Pemigatinib may harm the fetus.
• tell your doctor if you are breastfeeding. You should not breastfeed while you are taking pemigatinib and for 1 week after your final dose.
• you should know that this medication may cause dry eyes. Your doctor may tell you to use artificial tears or lubricant eye drops during your treatment with pemigatinib.

Do not eat grapefruit or drink grapefruit juice while taking this medication.

If you miss a dose of pemigatinib by less than 4 hours, take the missed dose as soon as you remember it and then take the next dose at the scheduled time. However, if you miss a dose by 4 or more hours, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Pemigatinib may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• diarrhea
• nausea
• changes in taste
• vomiting
• loss of appetite
• weight loss
• constipation
• stomach pain
• indigestion
• sores on the lips, mouth, or throat
• dry mouth and/or skin
• nail disorders
• hair loss
• headache
• fatigue
• joint or back pain
• burning or painful urination
• pain or swelling of hands, feet, legs or ankles
• rash
• nose bleed

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• blurred vision, floaters in the eye, seeing flashes of light, or other changes in vision
• muscle cramps, numbness, or tingling around the mouth
• pale skin, shortness of breath, dizziness, weakness
• redness, swelling, and blistering of the hands and feet

Pemigatinib may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor, eye doctor, and the laboratory. Your doctor will order a lab test before you begin your treatment to see whether your cancer can be treated with pemigatinib. Your doctor will also order certain lab and eye tests before and during your treatment to check your body's response to pemigatinib.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

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