Decitabine-cedazuridine (INQOVI)

Myelodysplastic syndromes

Chronic myelomonocytic leukemia

Myelodysplastic syndromes

• Oral: 35-100 mg daily on days 1 to 5 of each 28-day treatment cycle. Continue until progression or unacceptable toxicity.

Chronic myelomonocytic leukemia‍

• Oral: 35-100 mg daily on days 1 to 5 of each 28-day treatment cycle. Continue until progression or unacceptable toxicity.

‍

‍

Available as film-coated tablets containing 35 mg decitabine and 100 mg cedazuridine per tablet. Tablets contain lactose. Tablets should NOT be crushed or broken. Store at room temperature in original packaging.

Antimetabolite

Take on an empty stomach; do not consume food 2 hours before and 2 hours after dose

If a dose is missed, patients should be instructed to take it as soon as they can if it is within 12 hours of the missed dose. If it is over 12 hours since the missed dose, patients should skip the missed dose and resume with the next scheduled dose.

Common: Anemia, Neutropenia, Thrombocytopenia, Constipation, Diarrhea, Mucositis, Nausea, Fatigue , Pneumonia, ALT increase, AST increase , Appetite decrease, Arthralgia, Myalgia, Dizziness, Headache, Dyspnea, Rash, Hemorrhage.

‍Less Common: Sepsis, Neuropathy.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC & differential, platelets, bilirubin, ALT, alkaline phosphatase, creatinine, HIV, HBsAg, HBsAb, HBcAb.

Weekly for the first cycle: CBC & differential, platelets.

During treatment: CBC & differential, platelets, bilirubin, ALT, alkaline phosphatase, creatinine.

• Gastric pH modifying drugs should be avoided, particularly within 4 hours of taking decitabine-cedazuridine.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Fatal and serious myelosuppression can occur. Obtain complete blood cell counts prior to initiation of Decitabine-cedazuridine, prior to each cycle, and as clinically indicated to monitor response and toxicity.

BC Cancer. BC Cancer Drug Manual. Decitabine-Cedazuridine.  Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Decitabine-cedazuridine_monograph.pdf. Updated March 1, 2023. Accessed January 22, 2024.

Lexicomp. Decitabine-Cedazuridine Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at:  https://online-lexi-com.qe2a-proxy.mun.ca/lco/action/doc/retrieve/docid/patch_f/6970006?cesid=5kJoVfdyM5M&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3DDecitabine-cedazuridine%26t%3Dname%26acs%3Dfalse%26acq%3DDecitabine-cedazuridine. Updated January 24, 2024. Accessed January 31, 2024.

Cancer Care Ontario.  Decitabine-Cedazuridine Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/70411. Updated January 2023. Accessed January 22, 2024.

Taiho Pharma Canada Inc. INQOVI® Product Monograph. Oakville, Ontario. Updated March 21, 2022.