Daurismo
Daurismo (glasdegib) is a targeted cancer medication that’s used to treat a blood cancer called acute myeloid leukemia (AML). It’s specifically used for adults who are older than 75 years or for those who can’t tolerate high-intensity chemotherapy. Daurismo (glasdegib) is a tablet that you take by mouth, but it can cause side effects such as muscle spasms and changes in heart rhythm. This medication is very harmful to an unborn baby, so people who can get pregnant must use reliable birth control during treatment.
What is Daurismo (glasdegib)?
What is Daurismo (glasdegib) used for?
- Newly-diagnosed acute myeloid leukemia (AML), given with low-dose cytarabine (Ara-C) chemotherapy, in:
- Adults who are 75 years of age or older
- Adults who have other health problems that prevent them from receiving intensive chemotherapy
How Daurismo (glasdegib) works
Your body uses many pathways, such as the Hedgehog pathway, to send signals to your cells to help the cells grow. In cancers like leukemia, the Hedgehog pathway becomes overactive, leading to cancer growth.
When the Hedgehog pathway doesn't work as it normally should, it also seems to help leukemia cells outsmart some chemotherapy treatments. In other words, this pathway helps the cancer become drug resistant.
Daurismo (glasdegib) is a Hedgehog pathway inhibitor. By blocking the Hedgehog pathway, the medication slows cancer growth.
Blocking the pathway also helps prevent drug resistance and allows other leukemia medications like cytarabine (Ara-C) to work better. When Daurismo (glasdegib) is used with cytarabine, the two medications work together to fight the cancer.
Drug facts
Side effects of Daurismo (glasdegib)
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
- Higher blood creatinine levels (96%)
- Changes in electrolyte levels in blood (up to 54%)
- Anemia (low red blood cell count; 43%)
- Bleeding (36%)
- Tiredness (36%)
- Neutropenic fever (31%)
- Low platelet count (30%)
- Swelling (30%)
- Muscle, joint, or bone pain (30%)
- Nausea (29%)
- Higher liver enzyme levels in blood (up to 28%)
- Trouble breathing (23%)
- Lower appetite (21%)
- Taste changes (21%)
- Mouth sores (21%)
- Rash (20%)
- Constipation (20%)
Less Common Side Effects
- Muscle spasms
- Diarrhea
- Vomiting
- Dizziness
- Irregular heart beat
Note: Side effects reported by people taking Daurismo (glasdegib) with low-dose cytarabine.
Daurismo (glasdegib) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Changes in heart rhythm: lightheadedness, irregular heartbeat, blurry vision, fainting, loss of consciousness, seizures
The following Daurismo (glasdegib) 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
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Infection—fever, chills, cough, or sore throat
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Muscle injury—unusual weakness or fatigue, muscle pain, dark yellow or brown urine, decrease in amount of urine
- Unusual bruising or bleeding
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 Daurismo (glasdegib)
Pros
- Taken by mouth
- An option for people who can’t take intensive chemotherapy
- Works in a more specific, targeted way than traditional chemotherapy
Cons
- Can cause muscle spasms and taste changes
- Might interact with other medications (like antiarrhythmics and certain antibiotics)
- Very unsafe for pregnant women
Pharmacist tips for Daurismo (glasdegib)
- You can take Daurismo (glasdegib) with or without food. Take the medication at the same time each day, and swallow the tablets whole. Don’t crush or split the tablets.
- If you forget to take a dose of Daurismo (glasdegib) and it’s more than 12 hours until your next dose, take it as soon as you remember. But if your next dose is less than 12 hours away, skip the missed dose and take your next dose as you usually would.
- Check your body temperature regularly, ideally once a day. Call your provider if your temperature is 100.4 degrees Fahrenheit or higher; this means that you have a fever. Your provider will want to check to see whether you have a condition called neutropenic fever (a fever that happens when your white blood cell counts are low), which can sometimes be serious.
- Daurismo (glasdegib) can change the way things taste. If things don’t taste the way you expect them to, your appetite for those foods might also change. Sometimes, changing the amount of salt or spices in your food can help. It might also be helpful to meet with a dietician experienced in helping people with cancer to find ideas for what you can eat.
- Don’t donate blood, blood products, or semen while you’re taking Daurismo (glasdegib) and for at least 30 days after the last dose. It’s possible for females who can become pregnant to be given donated blood products containing the medication, which can be harmful to unborn babies.
- Ask your provider about the best way to safely handle Daurismo (glasdegib) and throw away any leftover medication. You might be able to bring it to their office or clinic for proper disposal. It’s important to be extra careful with Daurismo (glasdegib) because cancer medications can be harmful to people who handle or come in contact with them. Keep the medication up and away, so children and pets won’t be able to reach it.
Common questions about Daurismo (glasdegib)
No, Daurismo (glasdegib) isn’t considered a chemotherapy medication. Instead of targeting cells that grow very quickly like chemotherapy does, Daurismo (glasdegib) works in a more specific, targeted way. It specifically blocks the Hedgehog pathway, a signaling method that the body uses to help cells grow and that has become overactive in leukemia, causing some chemotherapy medications to work less well. Daurismo (glasdegib) is given together with a chemotherapy medication to help the chemotherapy work better.
Daurismo (glasdegib) might cause side effects such as muscle pain and muscle spasms. These side effects are typically mild, but they can sometimes be severe. Try stretching to help relieve the pain. But make sure to tell your provider if you have muscle pain, cramping, or spasms. Your provider might want to order blood tests to check for any signs of muscle damage or abnormal electrolyte levels (which can also cause muscle problems). It’s possible you’ll need to take a break from treatment or take a lower dose of Daurismo (glasdegib).
Sometimes, Daurismo (glasdegib) can cause nausea, but it’s usually not severe and it doesn’t always lead to vomiting. Your provider might recommend a medication that you can take by mouth to help manage nausea. Some common examples include ondansetron (Zofran) and prochlorperazine. Contact your provider if you’re experiencing nausea that’s severe or won’t go away.
Daurismo (glasdegib) can interact with several medications. For example, certain heart medications like verapamil or some HIV medications can raise the levels of Daurismo (glasdegib) in your body and make side effects worse. Others, such as carbamazepine (Tegretol) or St. John’s wort, might lower levels of Daurismo (glasdegib) in your body and make the cancer medication work less well. In addition, your risk for changes in heart rhythm goes up if you take Daurismo (glasdegib) with other medications that can affect your heart rhythm, such as amiodarone (Pacerone) or levofloxacin. Before you start Daurismo (glasdegib), your provider will review all the medications you’re taking, both prescription and over-the-counter. Once you start treatment, talk with your provider before starting any new medications.
Some people taking Daurismo (glasdegib) have changes in their heart rhythm. While this side effect doesn't always cause symptoms, the best way for your provider to check is through a test called an electrocardiogram (ECG or EKG). You’ll need an ECG before you start treatment, one week after you start, then once a month for the next two months. You might need ECGs more often if you were born with heart rhythm problems (e.g., long QT syndrome), if you have heart failure, or if you take certain medications that can also affect heart rhythm. Contact your provider right away if you have an abnormal heartbeat, feel lightheaded, or pass out.
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Risks and warnings for Daurismo (glasdegib)
Daurismo (glasdegib) 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.
Serious harm to unborn baby
Results from animal studies suggest that Daurismo (glasdegib) can cause serious harm or death to an unborn baby. For this reason, pregnant women shouldn’t take this medication. If you’re able to have children, you must confirm that you’re not pregnant (a negative pregnancy test result) before you start Daurismo (glasdegib).
Use effective birth control while you’re taking Daurismo (glasdegib) and for at least 30 days after the last dose. And men who are taking Daurismo (glasdegib) and have partners who can have children should also use condoms, even after a vasectomy. Continue using these birth control methods for at least 30 days after the last dose.
Abnormal heart rhythm
- Risk factors: Heart failure | History of abnormal heart rhythms | Abnormal electrolyte levels | Taking other medications that can affect heart rhythm
Some people taking Daurismo (glasdegib) have had changes in the electrical activity of their heart, leading to abnormal heart rhythms that can be life-threatening. You might be at higher risk if you were born with heart rhythm problems (e.g., long QT syndrome), if you have heart failure, or if you’re taking other medications that can affect heart rhythm.
To check your risk for these heart problems, your provider will monitor your heart rhythm with a test called an electrocardiogram (ECG or EKG). Your provider will also order blood tests to check your electrolyte levels because abnormal levels can affect your heart rhythm. You might need ECGs and lab tests more often if you’re at high risk for heart rhythm problems. Seek medical help right away if you have sudden chest pain, have an irregular heartbeat, feel very dizzy, or pass out; these can be signs of abnormal heart rhythm.
Muscle problems
Some people have had muscle problems such as muscle pain and muscle spasms while they were taking Daurismo (glasdegib). These side effects are most commonly mild, but it’s possible that they could be severe. Sometimes, people also had higher creatine phosphokinase (CPK) levels in their blood, which can suggest muscle damage.
Let your provider know if you have muscle pain, cramping, or spasms. Your provider might recommend stretching to relieve the pain. Your provider might also order blood tests to check your CPK levels and electrolyte levels (abnormal electrolyte levels can also cause muscle symptoms). Depending on how severe your muscle side effects are, it’s possible you’ll need to pause treatment, take a lower dose of Daurismo (glasdegib), or stop taking the medication altogether.
Daurismo (glasdegib) dosage
Typical dosage for Daurismo (glasdegib)
The typical dose is 100 mg by mouth once a day. Daurismo (glasdegib) is taken every day during each 28-day treatment cycle.
Daurismo (glasdegib) is taken together with a low dose of a chemotherapy medication called cytarabine, which is given as an injection on days 1 to 10 of the 28-day treatment cycle.
