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Overview: Pemazyre is a tablet that you swallow and is used to treat certain types of cancers. Common side effects may include skin, hair, and nail changes, diarrhea, nausea, vomiting, or changes in your appetite or how things taste. Serious side effects are less common, but they may include eye problems or high levels of phosphate in your blood. Tell your health care provider right away if you have numbness or tingling around your mouth or any vision changes.

Uses

What is Pemazyre used for?

Pemazyre (pemigatinib) is commonly used to treat certain people with the following types of cancer. Your health care provider can do tests to see if your cancer is likely to respond to Pemazyre. 

Pemazyre may also be used for other conditions as determined by your health care provider.

How does Pemazyre work (mechanism of action)?

Some cancers have a change or abnormality in a gene called fibroblast growth factor receptor (FGFR). This gene normally helps cells grow and repair, but when it is changed, the cancer cells can grow out of control. Pemazyre is a kinase inhibitor that blocks certain FGFR types. Pemazyre blocks that signal, helping slow down or stop the cancer from growing. Your health care provider can test your cancer to see if it has one of the changes that Pemazyre is likely to work on.

How is Pemazyre supplied (dosage forms)?

Brands and other names

  • Pemazyre

Dosage forms and strengths

  • 4.5 mg oral tablets
  • 9 mg oral tablets
  • 13.5 mg oral tablets

How should I store Pemazyre?

Pemazyre should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of Pemazyre?

The most common side effects of Pemazyre are listed below. These side effects may vary depending on the condition that is being treated. Tell your health care provider if you have any of these side effects that bother you.

  • High phosphate levels (see below)
  • Low phosphate levels
  • Hair loss
  • Diarrhea, nausea, vomiting, constipation, or stomach pain
  • Mouth sores
  • Nail problems, including discoloration, infections, or texture changes 
  • Tiredness
  • Change in how things taste 
  • Dry eyes, skin, or mouth
  • Reduced appetite
  • Back pain, joint pain, or pain in your arms and legs
  • Rash
  • Blood disorders
  • Nose bleeds
  • Eye problems (see below)
  • Fluid retention in your arms, legs, hands, or feet
  • Dizziness

There may be other side effects of Pemazyre that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Pemazyre?

While less common, the most serious side effects of Pemazyre are described below, along with what to do if they happen.

Severe Allergic Reactions. Pemazyre may cause allergic reactions, which can be serious. Stop taking Pemazyre and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Eye Problems. Pemazyre may cause eye problems ranging from dry eyes, inflammation of your eye, or more serious problems, including retinal pigment epithelial detachment (RPED). RPED is when the thin layer of tissue at the back of your eye that supports your retina separates from the layer of tissue underneath it. When this happens, it can affect your vision. Your health care provider will likely recommend an eye exam before you start taking Pemazyre and while you are taking it. Follow any instructions about using a lubricating eye drop while you are taking this medicine. Keep all of your appointments, including those for eye exams. Tell your health care provider right away if you notice any vision changes while you are taking this medicine, such as the following. 

  • Blurry vision
  • Seeing flashes of light
  • Seeing black spots

High Phosphate Levels. Pemazyre may cause your phosphate levels to get too high (hyperphosphatemia). This can sometimes lead to other problems, including calciphylaxis, where you have calcium buildup in your blood vessels. It can also cause calcium to build up in other parts of your body. Your health care provider may recommend a medicine to lower your phosphate levels to keep them from getting too high. They may also suggest that you follow a low-phosphate diet. Follow any dietary and medicine instructions to help manage your phosphate levels. Keep all appointments, including those for lab work, while you are taking this medicine so your health care provider can check your phosphate levels. Tell your health care provider if you have any of the following symptoms of hyperphosphatemia.

  • Muscle cramping
  • Numbness or a tingly feeling around your mouth
  • Pain in your bones or joints
  • Rash

Warnings & Precautions

Who should not use Pemazyre?

Allergies to Ingredients. People who are allergic to any of the following should not take Pemazyre.

  • Pemazyre
  • Pemigatinib
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Pemazyre.

What should I know about Pemazyre before using it?

Do not take Pemazyre unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share Pemazyre with other people, even if they have the same condition as you. It may harm them.

Keep Pemazyre out of the reach of children.

Try to take Pemazyre around the same time each day. Do not crush, chew, break, or dissolve Pemazyre tablets. They should be swallowed whole.

Taking Pemazyre can make your eyes feel dry. You should use a lubricating eye drop, such as carboxymethylcellulose or a similar product, to help. Ask your pharmacist or another health care provider if you are not sure which product to use or how to use it. 

If you can get pregnant or get your partner pregnant, you should use effective birth control while you are taking Pemazyre and for one week after your last dose. Pemazyre may cause harm to a fetus or increase your risk for a miscarriage. See the Pregnancy section for more details.

What should I tell my health care provider before using Pemazyre?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Pemazyre is right for you.

In particular, make sure that you discuss any of the following.

Kidney Problems. You may need to take a different dose of Pemazyre if your kidneys are not working as well as they should be. If there is a concern about the health of your kidneys, your health care provider may do tests to see what dose of Pemazyre is best for you.

Liver Problems. You may need to take a different dose of Pemazyre if your liver is not working as well as it should be. If there is a concern about the health of your liver, your health care provider may do tests to see what dose of Pemazyre is best for you.

Vision or Eye Problems. Tell your health care provider if you have any vision or eye problems before taking Pemazyre. You may be at a higher risk for some eye-related side effects if you already have certain vision or eye problems. 

Pregnancy. Pemazyre may cause harm to a fetus or increase your risk for a miscarriage. Your health care provider may need you to have a negative pregnancy test before you can start taking Pemazyre. If you can get pregnant or get your partner pregnant, you should use an effective method of birth control while taking Pemazyre and for one week after your last dose. If you become pregnant or think you may be pregnant while taking Pemazyre, tell your health care provider right away.

Breastfeeding. It is not known if Pemazyre passes into breast milk. You should not breastfeed while you are taking Pemazyre or for one week after your last dose. Tell your health care provider if you are breastfeeding or plan to breastfeed. 

How can I get more information about Pemazyre?

For more information about Pemazyre, you can visit the drugmaker’s website at www.pemazyre.com or call them at 855-4-MEDINFO (855-463-3463).

Interactions

Does Pemazyre interact with foods or drinks?

Avoid eating or drinking things with grapefruit or grapefruit juice in them while taking Pemazyre. Grapefruit juice can increase your risk of side effects. See the Side Effects section for more details. 

It is unknown if drinking alcohol will affect Pemazyre, but heavy drinking can slow your immune response and make it harder for your body to fight cancer.

Does Pemazyre interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking Pemazyre.

  • Itraconazole (Sporanox, Tolsura) or ketoconazole, which is a medicine used for fungal infections
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
  • St. John’s wort, which is a supplement that may be used for depression

Many other medicines may alter the blood levels of Pemazyre. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Pemazyre. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Pemazyre?

If you or someone else has used too much Pemazyre, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Pemazyre?

If you miss a dose and it is less than four hours from when you should have taken the dose, take it right away. If it has been four hours or more since the dose was due, skip the missed dose and take your next dose when you normally would. Do not take double or extra doses. 

If you vomit after taking a dose, do not take an extra dose. Just take your next dose when you normally would.