Fedratinib (INREBIC)

Myelofibrosis

Myelofibrosis

• Oral: 400 mg PO once daily continuously

Available as 100 mg capsules. Capsules should NOT be opened. Store at room temperature.

Janus Associated Kinase (JAK) inhibitor / FLT3 Inhibitor

Take with or without food. Taking with food, particularly with a high-fat evening meal, may reduce nausea and vomiting

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, Thrombocytopenia, Diarrhea, Vomiting, Nausea, ALT increase, AST increase.

Less Common: Encephalopathy.

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

Baseline before treatment: CBC & differential, platelets, ALT, total bilirubin, creatinine.

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

• This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Wernicke's encephalopathy - Serious and fatal encephalopathy, including Wernicke’s, has occurred in patients treated with Fedratinib. Wernicke’s encephalopathy is a neurologic emergency. Assess thiamine levels in all patients prior to starting Fedratinib, periodically during treatment, and as clinically indicated. Do not start in patients with thiamine deficiency; replete thiamine prior to treatment initiation. If encephalopathy is suspected, immediately discontinue Fedratinib and initiate parenteral thiamine. Monitor until symptoms resolve or improve and thiamine levels normalize.

BC Cancer. BC Cancer Drug Manual. Fedratinib.  Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Fedratinib_monograph.pdf.Updated September 1, 2022.  Accessed February 2, 2024.

Lexicomp. Fedratinib 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/6852757?cesid=aE3oUmzuvl8&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dfedratinib%26t%3Dname%26acs%3Dtrue%26acq%3Dfedratinib. Updated January 24, 2024. Accessed February 2, 2024.

Cancer Care Ontario. Fedratinib Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/73921. Updated April 2023. Accessed January 22, 2024.

Novartis Pharmaceuticals Canada Inc. RYDAPT® Product Monograph. Dorval, Quebec. Updated November 23, 2023.