Vorasidenib (Voranigo™)
Pronounce: VOR-a-SID-e-nib
Classification: Antineoplastic Isocitrate dehydrogenase (IDH1 and IDH2) inhibitor
About Vorasidenib (Voranigo™)
This medication is a type of targeted therapy called an isocitrate dehydrogenase (IDH) inhibitor. Vorasidenib works by targeting and blocking both IDH 1 and IDH 2 enzymes. In some cancers, these overactive enzymes cause cells to grow and divide too fast. By inhibiting these enzymes, this medication can slow tumor growth. Your oncology team will test your tumor for these abnormalities, which must be present in order to receive the medication.
How to Take Vorasidenib
This medication comes in tablet form that you take by mouth once daily, at about the same time each day. This medication may be taken with or without food. Do not break, crush or chew the tablets.
If a dose is missed, take the dose as soon as you remember, but no more than six hours after the missed dose. Return to the normal schedule for the next dose. If you vomit a dose, do not take a replacement dose.
It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed.
The blood levels of this medication can be affected by certain medications including ciprofloxacin, fluvoxamine, phenytoin, or rifampin, among others. Be sure to tell your healthcare provider about all medications and supplements you take. Smoking tobacco can also affect the blood levels of this medication so do not smoke while taking it.
Storage and Handling
Store your medication in the original, labeled container at room temperature and in a dry location (unless otherwise directed by your HCP or Pharmacist). This medication should not be stored in a pillbox. Keep containers out of reach of children and pets.
If a caregiver prepares your dose for you, they should consider wearing gloves or pour the pills directly from their container into the cap, a small cup, or directly into your hand. They should avoid touching the pills. They should always wash their hands before and after giving you the medication. Pregnant or nursing women should not prepare the dose for you. Ask your oncology team where to return any unused medication for disposal. Do not flush down the toilet or throw it in the trash.
Where do I get this medication?
Certain cancer medications, including vorasidenib, are only available through select specialty pharmacies. Your oncology team will work with your prescription drug plan to identify an in-network specialty pharmacy for the distribution of this medication and shipment directly to your home.
Insurance Information
This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals depending upon prescription drug coverage. Co-pay cards, which reduce the patient co-pay responsibility for eligible commercially (non-government sponsored) insured patients, may also be available. Your care team can help you find these resources if they are available.
Possible Side Effects
There are a number of things you can do to manage the side effects of vorasidenib. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:
Liver Toxicity
This medication can cause liver toxicity, which your oncology care team may monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown, or you have pain in your abdomen, as these can be signs of liver toxicity.
Fatigue
Fatigue is very common during cancer treatment and is an overwhelming feeling of exhaustion that is not usually relieved by rest. While on cancer treatment, and for a period after, you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team for helpful tips on dealing with this side effect
Muscle or Joint Pains/Ache and Headache
Your healthcare provider can recommend medications and other strategies to help relieve pain.
Diarrhea
Your oncology team can recommend medications to relieve diarrhea. Also, try eating low-fiber, bland foods, such as white rice and boiled or baked chicken. Avoid raw fruits, vegetables, whole grain breads, cereals and seeds. Soluble fiber is found in some foods and absorbs fluid, which can help relieve diarrhea. Foods high in soluble fiber include: applesauce, bananas (ripe), canned fruit, orange sections, boiled potatoes, white rice, products made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Drink 8-10 glasses of non-alcoholic, un-caffeinated fluid a day to prevent dehydration.
Sexual & Reproductive Concerns
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment and for 3 months after treatment. This medication can impact the effectiveness of hormonal birth control like birth control pills and intrauterine devices (IUDs). Use another type of birth control, like condoms, to prevent pregnancy. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should not breastfeed while taking this medication.