Oxbryta
Oxbryta (voxelotor) is a medication used to help prevent complications, such as extreme pain and anemia, in people with sickle cell disease. It was approved by the FDA in 2019, but it was also recently approved in 2021 for use in children 4 years and older. It's taken by mouth once per day and can be made into a liquid suspension for people who have a hard time swallowing tablets. Some common side effects include headache, diarrhea, and vomiting.
What is Oxbryta (voxelotor)?
What is Oxbryta (voxelotor) used for?
- Sickle cell disease in people 4 years and older
How Oxbryta (voxelotor) works
If you have sickle cell disease (SCD), the hemoglobins (proteins that help carry oxygen) inside your red blood cells (RBCs) clump together. This causes sickling, where your RBCs change from a round shape to a "C" shape ("sickle" shape). Sickling can result in a lot of complications, including extreme pain and anemia.
Oxbryta (voxelotor) works by attaching to your hemoglobins. This prevents them from clumping up, which in turn, prevents your RBCs from sickling.
Drug facts
Side effects of Oxbryta (voxelotor)
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
- Vomiting (33% children)
- Headache (32% adults, 18% children)
- Diarrhea (23% adults, 18% children)
- Stomach pain (23% adults, 18% children)
- Nausea (19% adults)
- Fever (15% adults, 36% children)
- Rash (15% adults, 20% children)
Oxbryta (voxelotor) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
Serious allergic reaction: rash, trouble breathing, swelling of lips, tongue, or face
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Pros and cons of Oxbryta (voxelotor)
Pros
- Works well to prevent anemia in people with SCD
- Can be used in children as young as 4 years old
- Taken by mouth once per day
- The 300 mg tablets for suspension are available for people who have trouble swallowing tablets.
Cons
- Brand name only, which can be expensive
- Interacts with a lot of medications
- Breastfeeding isn't recommended because Oxbryta (voxelotor) can get into breastmilk
- It's not clear how well Oxbryta (voxelotor) works in people 65 years of age and older because there aren't enough studies.
Pharmacist tips for Oxbryta (voxelotor)
- Make sure you know which tablet strength you have to avoid accidentally hurting yourself or wasting the medication. The 300 mg tablets for suspension are round shaped and are only to be used to make a suspension taken by mouth. The 500 mg tablets are oval shaped and can't be made into a suspension, crushed, or chewed.
- Take Oxbryta (voxelotor) with or without food. If it upsets your stomach, try taking it with food to help.
- There are many medications that interact with Oxbryta (voxelotor). Make sure to tell your provider about all of the prescription and over-the-counter medications, vitamins, and supplements you take before starting Oxbryta (voxelotor). Don't start any new medications while taking Oxbryta (voxelotor) without talking to your provider or pharmacist first.
- Make sure to tell your provider if you have liver problems because your dose of Oxbryta (voxelotor) might need to be changed.
For 300 mg tablets for suspension only:
- Don't swallow Oxbryta (voxelotor) 300 mg tablets by mouth whole. You need to dissolve them in water before you take them. The amount of water will depend on your dose, so ask your provider for instructions. Don't cut, crush, or chew the tablets.
- Make sure you understand how to prepare the suspension with Oxbryta (voxelotor) to avoid wasting the medication. Read the instructions and ask your pharmacist or provider if you have any questions.
- Only prepare your dose when you're ready to take Oxbryta (voxelotor). It can't be prepared ahead of time or saved for a later time because this might make the medication not work as well.
- Use a clear drink (e.g, water or clear soda) that's at room temperature to mix the Oxbryta (voxelotor). Using a drink that's cold or hot might damage the medication and make it not work as well for you.
- After adding the Oxbryta (voxelotor) tablet(s) to the clear drink, you'll need to swirl the cup until the tablet(s) dissolve in the drink. Don't crush the tablet(s). The tablet(s) won't completely dissolve in the mixture, which is okay. After mixing, wait 1 to 5 minutes. Then, gently swirl again and take the dose.
- If you notice any residue in the cup after taking the dose, add a little more clear liquid to the cup and swirl it around, then drink. This is to make sure you take your full dose.
- After taking your dose of Oxbryta (voxelotor), you or your child can drink more water or any type of drink.
Common questions about Oxbryta (voxelotor)
Sickle cell disease (SCD) is a genetic condition where there's a problem with the shape of your red blood cells (RBCs). RBCs are normally round-shaped, but are flexible to change shape as needed as they travel through your blood vessels. But in SCD, they're C-shaped ("sickle"-shaped) and also become hard and sticky. This is because the hemoglobin inside RBCs clump up, which cause the RBCs to change shape. Typical complications and symptoms include pain (the most common complication of SCD), anemia, infection, blood clots, and vision loss.
If you're prescribed the 500 mg tablets and are having trouble swallowing them, ask your provider to switch you to the 300 mg tablets for suspension and to show you how to turn it into a liquid suspension. This is because the 500 mg tablets must be swallowed whole and can't be cut, crushed, chewed, or made into a suspension that you can easily drink.
Oxbryta (voxelotor) isn't approved to treat an active pain crises from SCD. But, it might lower the number of pain crises that you experience from SCD if you take this medication regularly according to your provider's instructions. Ask your provider what you can do to treat pain from SCD. Typically, you provider might recommend over-the-counter pain medications for mild pain. But in very serious cases, you might need to go to the hospital. If you're having pain crises from SCD, speak to your provider about treatment options.
Studying a new medication usually takes many years. But in some cases, a medication can be approved in a shorter amount of time because it fills a medical need not currently met by other medications already available in the market. Oxbryta (voxelotor) underwent an accelerated approval in 2019 because it specifically targets the cause of SCD complications (e.g., damaged red blood cells) rather than just treating symptoms of SCD. The manufacturer is still required to study the medication to make sure it works well, and then it can get a traditional approval.
It's not known if Oxbryta (voxelotor) is safe in pregnant females because it hasn't been studied. In animal studies, unborn babies from mothers who received Oxbryta (voxelotor) weren't harmed. If you're pregnant or thinking of getting pregnant, talk to your provider before starting Oxbryta (voxelotor).
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Risks and warnings for Oxbryta (voxelotor)
Oxbryta (voxelotor) 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.
Allergic reaction
Rarely, Oxbryta (voxelotor) can cause a serious allergic reaction. If you get an allergic reaction, let your provider know because you'll need to stop Oxbryta (voxelotor) and consider other treatment options. Seek medical help right away if you experience symptoms of an allergic reaction, including rash, hives, shortness of breath, and swelling in the face.
Oxbryta (voxelotor) dosage
Typical dosage for Oxbryta (voxelotor)
Oxbryta (voxelotor) is available as 2 different tablet strengths, 300 mg and 500 mg. The 300 mg tablets for suspension are round shaped and are only to be used to make a suspension taken by mouth. The 500 mg tablets are oval shaped and must be swallowed whole.
Adults and children 12 years and older: The typical dose is 1,500 mg by mouth once per day.
Children 4 to 11 years old: The typical dose is based on your child's weight:
- 88 lbs or more: 1,500 mg by mouth once per day.
- 44 to 88 lbs: 900 mg by mouth once per day.
- 22 to 44 lbs: 600 mg by mouth once per day.
Your dose might differ if you have severe liver problems or if you're taking medications that interact with Oxbryta (voxelotor).
How much does Oxbryta (voxelotor) cost?
$4,008.39
What are alternatives to Oxbryta (voxelotor)?
