Braftovi
Braftovi (encorafenib) is a targeted therapy that’s used to treat colon cancer and a type of skin cancer called melanoma. It’s used for these types of cancers that have a certain mutation known as a BRAF mutation, and it’s typically taken with another anticancer medication. Braftovi (encorafenib) is a convenient option because it’s a capsule that you take by mouth. But some side effects can include tiredness, nausea, and joint pain.
What is Braftovi (encorafenib)?
What is Braftovi (encorafenib) used for?
- Melanoma with certain BRAF mutations that has spread (metastatic) or that can’t be removed by surgery, used with Mektovi (binimetinib)
- Colorectal cancer with a certain BRAF mutation that has spread (metastatic), used with Erbitux (cetuximab)
How Braftovi (encorafenib) works
Braftovi (encorafenib) is a kinase inhibitor known as a BRAF inhibitor. The BRAF protein is part of a whole chain of proteins that help cells (including cancer cells) grow. When the BRAF protein is mutated, the cancer grows uncontrollably and can spread more quickly. By blocking BRAF, Braftovi (encorafenib) helps stop tumor growth.
Drug facts
Side effects of Braftovi (encorafenib)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
The side effects you might experience can differ depending on the type of cancer you have and whether you’re taking Braftovi (encorafenib) with Mektovi (binimetinib) or Erbitux (cetuximab).
- Fatigue (up to 51%)
- Nausea (up to 41%)
- Lower red blood cells (anemia, up to 36%)
- Vomiting (up to 30%)
- Stomach pain (up to 30%)
- Higher liver enzymes in blood (up to 29%)
- Joint pain (up to 27%)
- Lower white blood cell count (up to 24%)
- Muscle pain (up to 23%)
- Constipation (up to 22%)
- Rash (up to 26%)
- Headache (up to 22%)
Less Common Side Effects
- Fever
- Bleeding
- Dry skin
- Thickened skin
- Numbness and tingling in fingers and toes
- Dizziness
- Diarrhea
- Lower appetite
Braftovi (encorafenib) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Bleeding: blood in stool, bleeding from rectum, sudden headache
- Changes in heart rhythm: lightheadedness, fainting, seizures, loss of consciousness
The following Braftovi (encorafenib) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
- Eye pain, redness, irritation, or discharge with blurry or decreased vision
- Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Redness, swelling, and blistering of the skin over hands and feet
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Braftovi (encorafenib)
Pros
- Works in a more specific, targeted way than traditional chemotherapy
- Can take with or without food
- Recommended for people with melanoma or colorectal cancer and certain BRAF mutations
Cons
- Must take with a second medication
- Only comes in capsules, so not ideal for people with difficulty swallowing
- Must take many capsules at once for each dose
- Might cause nausea, tiredness, and headache
Pharmacist tips for Braftovi (encorafenib)
- You should store Braftovi (encorafenib) in the original bottle with the drying agent (desiccant) at room temperature. This helps protect the medication from moisture.
- For each dose, you’ll need to take several capsules of Braftovi (encorafenib) all at once (or one right after another). Don’t split up when you take the capsules throughout the day.
- You can take Braftovi (encorafenib) with or without food. If you have an upset stomach after taking the medication, taking it with food next time might help lessen these side effects.
- If you miss a dose of Braftovi (encorafenib) and it’s within 12 hours of your next scheduled dose, skip it and start again with the next dose.
- Don’t eat grapefruit or drink grapefruit juice while you’re getting treated with Braftovi (encorafenib). Grapefruit can raise the level of Braftovi (encorafenib) in your body and raise your risk of side effects.
- Tell your provider before you start any new medications while you’re taking Braftovi (encorafenib). There are some medications that you should avoid taking with Braftovi (encorafenib) because they might affect the level of Braftovi (encorafenib) in your body, which can affect how well the medication works or affect your risk of side effects.
- If you’re a woman who’s able to have children, be sure to use non-hormonal birth control, such as condoms, while you’re taking Braftovi (encorafenib) and for 2 weeks after the last dose. This medication can harm an unborn baby so it’s important to prevent getting pregnant during treatment, but the medication might make hormonal birth control work less well.
- Women who are taking Braftovi (encorafenib) shouldn’t breastfeed. We don’t know whether Braftovi (encorafenib) is found in breast milk and whether it affects breastfed babies. But because of the possible risks to a baby, it’s best to avoid nursing while you’re taking Braftovi (encorafenib) and for 2 weeks after the last dose.
- Ask your provider about the best way to handle and throw away Braftovi (encorafenib) safely. Anticancer medications can be harmful to people who handle or come in contact with them. Store Braftovi (encorafenib) in a safe place away from children and pets.
Common questions about Braftovi (encorafenib)
People who don’t have a BRAF mutation in their cancer shouldn’t take Braftovi (encorafenib). This medication is specifically approved for people with this mutation. Additionally, it’s possible for Braftovi (encorafenib) to raise the risk of cancer growth (instead of stopping growth) if the cancer doesn’t have a BRAF mutation to begin with. Talk to your provider if you’re unsure whether you have a BRAF mutation or not.
Some people can feel nauseous while taking Braftovi (encorafenib), but it’s usually mild. Your provider might give you an antiemetic medication, like ondansetron (Zofran) or prochlorperazine, to help prevent or manage nausea. Contact your provider if you have severe nausea while you’re taking Braftovi (encorafenib).
In clinical studies, 14% of people with melanoma who took Braftovi (encorafenib) with Mektovi (binimetinib) experienced some type of hair loss, sometimes including complete hair loss. If you notice hair loss, using a soft-bristled brush, only washing your hair when necessary, and using mild shampoos might help you manage this side effect. Also talk to your provider because there can be other causes of hair loss.
There are some medications you should avoid if possible while you’re taking Braftovi (encorafenib). Because Braftovi (encorafenib) can affect your heart rhythm, you usually shouldn’t take it with other medications that can also do the same. These medications can include amiodarone (Pacerone) and levofloxacin, among others. In addition, certain seizure medications can make Braftovi (encorafenib) not work as well if they’re taken together. Other medications, like diltiazem (Cardizem), can raise the levels of Braftovi (encorafenib) in your body and raise your risk of side effects from the cancer medication. But if the benefit is greater than the risk of harm, your provider might let you take these medications together with Braftovi (encorafenib). They'll check in on you more often or adjust your doses to make sure your medications are safe for you. Your providers will review all the medications that you’re taking before you start treatment to make sure there aren’t any dangerous interactions.
How long you take Braftovi (encorafenib) depends on which type of cancer you have, how well the medication is working for you, and whether you’re having any side effects. Your provider will regularly follow up with you while you’re taking Braftovi (encorafenib). They’ll determine how well the medication is working for you based on your scan results and your symptoms. They’ll also ask you during your regular visits whether you’re experiencing any side effects. Let your provider know if you have side effects, such as severe nausea, rash, bleeding, or vision changes. In general, don’t stop taking Braftovi (encorafenib) without first discussing with your provider.
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Risks and warnings for Braftovi (encorafenib)
Braftovi (encorafenib) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
New cancers
Some people taking Braftovi (encorafenib) developed a new skin cancer. Based on the way Braftovi (encorafenib) works, it might also be possible for the medication to cause other types of cancer, too. While you’re taking Braftovi (encorafenib), your provider will monitor you for new signs and symptoms of cancer, especially skin cancers.
Not for people with cancers without a BRAF mutation
Braftovi (encorafenib) isn’t recommended for people with cancers without a BRAF mutation. Lab studies have shown that if a BRAF inhibitor is used to treat a cancer that doesn’t have a BRAF mutation, it might cause cancer cells to grow. For this reason, BRAF inhibitors like Braftovi (encorafenib) should only be used in people with certain BRAF mutations. Your provider will confirm that you have a BRAF mutation before you start taking Braftovi (encorafenib).
Bleeding
Some people who took Braftovi (encorafenib) with either Mektovi (binimetinib) or Erbitux (cetuximab) experienced bleeding during treatment. This can include nosebleeds, bleeding in the gut, blood in stools, and rarely, bleeding in the brain. If you have any unusual bleeding or a sudden severe headache, tell your provider right away. If it’s mild, your provider might pause Braftovi (encorafenib) and you might be able to restart it later at a lower dose. But sometimes, the medication must be permanently stopped.
Serious eye problems
Rarely, people taking Braftovi (encorafenib) with Mektovi (binimetinib) developed swelling inside their eye, also called uveitis. Your provider or ophthalmologist will give you an eye exam regularly to make sure your eyes are okay. Contact your provider if you have vision changes, eye pain, or light sensitivity. You might have to pause treatment while your provider or an ophthalmologist looks into the problem.
Changes in heart rhythm
- Risk factors: Heart rhythm problems (arrhythmias) | Severe or uncontrolled heart failure | Taking medications that can change heart rhythm
Some people taking Braftovi (encorafenib) have had changes in their heart rhythm, also called QT prolongation. This lengthens the time it takes for your heart to recharge after each beat. Tell your provider about all the medical conditions you have and the medications you take. If you’re born with this heart rhythm problem (long QT syndrome) or if you take another medication that can raise your risk of this heart rhythm problem, your provider might monitor you more closely. They might periodically track the electrical activity of your heart using a test called an electrocardiogram (EKG). If the EKG shows that you have a heart rhythm problem and you experience symptoms, such as dizziness, chest pain, or weakness, your provider might switch you to a different medication.
Harm to unborn baby
Based on animal studies, Braftovi (encorafenib) might harm an unborn baby or raise the risk for miscarriage (pregnancy loss). Because of these risks, if you’re a woman who can get pregnant, you should use birth control while taking Braftovi (encorafenib) and for 2 weeks after the last dose. It’s important to use non-hormonal birth control when you’re taking Braftovi (encorafenib) because this medication might make hormonal birth control methods, like birth control pills, work less well. Let your provider know right away if you become pregnant during treatment.
Risks with taking Braftovi (encorafenib) by itself
Usually when people take Braftovi (encorafenib) for melanoma, it’s taken together with another medication called Mektovi (binimetinib). In studies, some side effects, like rash, were worse when people took Braftovi (encorafenib) by itself (such as when Mektovi was temporarily paused) than when the two medications were taken together. Because of the risk of having worse side effects when Braftovi (encorafenib) is used by itself, your provider might lower your dose of Braftovi (encorafenib) if you’re taking the medication for melanoma and you need to take a temporary break from Mektovi. When you’re able to restart Mektovi treatment, your provider might adjust your Braftovi (encorafenib) dose accordingly.
Braftovi (encorafenib) dosage
Typical dosage for Braftovi (encorafenib)
- Melanoma: The typical dose is 450 mg (six 75 mg capsules) by mouth once daily.
- Colorectal cancer: The typical dose is 300 mg (four 75 mg capsules) by mouth once daily.
Your dose might differ depending on the other medications you might be taking and whether they can interact with Braftovi (encorafenib).
What are alternatives to Braftovi (encorafenib)?
