Turalio
Turalio (pexidartinib) is a targeted therapy used to treat a rare condition called tenosynovial giant cell tumor (TGCT). It’s used when these noncancerous growths cause symptoms that severely interfere with daily life and surgery isn’t an option. Turalio (pexidartinib) comes as a capsule that you take by mouth two times a day with a low-fat meal. Common side effects are hair color changes and tiredness. There’s a rare risk of serious liver injury so your care team will monitor you closely during treatment.
What is Turalio (pexidartinib)?
What is Turalio (pexidartinib) used for?
- Tenosynovial giant cell tumor (TGCT) in adults with severe symptoms or limitations that aren’t likely to get better with surgery
How Turalio (pexidartinib) works
Turalio (pexidartinib) is a type of kinase inhibitor. It blocks certain proteins or kinases in the body, one of which is called CSF1R.
In TGCT, the CSF1R protein becomes too active. This causes cells to grow too much and collect in areas of the body around joints and tendons. This forms noncancerous growths that can cause pain, swelling, and trouble moving.
By blocking CSF1R, Turalio (pexidartinib) blocks this cell growth signal. This prevents tumor growth.
Drug facts
Side effects of Turalio (pexidartinib)
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
- Hair color changes (e.g., lighter color; 67%)
- Feeling very tired (64%)
- Higher liver enzyme levels (up to 61%)
- Higher cholesterol (44%)
- Lower white blood cell count (up to 44%)
- Lower hemoglobin levels (30%)
- Swelling around the eye (30%)
- Rash (28%)
- Changes in taste or loss of taste (26%)
- Lower phosphate levels in the blood (25%)
- Swelling in the arms or legs (20%)
- Vomiting (20%)
Less Common Side Effects
- Constipation
- Lower appetite
- Feeling itchy
- Tingling, numbness, or burning feeling in the arms or legs
- High blood pressure
- Low platelet count
Turalio (pexidartinib) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Liver injury: pain in the upper right side of the stomach, dark urine, yellowing of the eyes or skin
The following Turalio (pexidartinib) 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
- 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
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Change in hair color
- Change in taste
- Fatigue
- Loss of appetite
- Swelling around the eyes
- Swelling of the ankles, hands, or feet
- Vomiting
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Pros and cons of Turalio (pexidartinib)
Pros
- A pill that’s taken by mouth
- Recommended option for TCGT if surgery isn’t likely to help
- Helps shrink tumors and improve stiffness and range of motion
Cons
- Need to take twice a day, each time with a low-fat meal
- Can cause serious liver injury, so need to do blood tests often to check on the liver
- Can interact with many medications, including heartburn medications and hormonal birth control
Pharmacist tips for Turalio (pexidartinib)
- Check with your care team to be sure how many capsules of Turalio (pexidartinib) to take each time. For the usual 250 mg dose, you’ll take 2 capsules each time. This is because each capsule has 125 mg of medication. The number of capsules you need can be different if your dose is different.
- Take Turalio (pexidartinib) twice a day with low-fat meals that has about 11 to 14 grams of fat. Eating a fattier meal can raise the amount of medication in your body. This can raise your risk of side effects, including liver problems. Ask your care team or a dietician about meal planning and helpful guides for fat content in foods.
- Avoid eating grapefruit or drinking grapefruit while taking Turalio (pexidartinib). Grapefruit can raise how much of the medication is in your body. This can put you at higher risk of side effects.
- Swallow the Turalio (pexidartinib) capsules whole. Don’t crush, chew, or break open the capsules.
- Write down your blood test appointments in your calendar. Turalio (pexidartinib) can cause serious liver damage. These blood tests help check your liver and make sure the medication is still safe for you. You’ll need tests every week for the first 2 months, every 2 weeks for the next month, and then every 3 months after that.
- Turalio (pexidartinib) can make your skin more sensitive to sunlight and raise the risk of getting sunburns. Try to limit the amount of time you spend in direct sunlight. If you have to be in the sun, apply sunscreen and keep your skin covered with loose-fitting clothes or a hat.
- Don’t take any medications for heartburn without talking to your care team first to make sure it’s safe. Don’t take any proton pump inhibitors (PPIs) like omeprazole (Prilosec). They can make Turalio (pexidartinib) work less well. Instead, you can take antacids like Tums at least 2 hours before or at least 2 hours after Turalio (pexidartinib). Or, you can take an H2 blocker like famotidine (Pepcid AC) at least 10 hours before or 2 hours after Turalio (pexidartinib).
- Share a full list of medications and supplements you take and plan to take with your care team. It’s very important for them to check for harmful drug interactions with Turalio (pexidartinib). Some interactions can make Turalio (pexidartinib) work less well. Others can raise your risk of side effects. To keep you safe, your care team might adjust the dose of your medications or suggest a change in treatment.
- If you can become pregnant, use non-hormonal birth control while taking Turalio (pexidartinib) and for 1 month after your last dose. This medication might harm an unborn baby and might make hormonal birth control work less well. Tell your care team right away if you become pregnant during treatment.
- If you can get someone pregnant, use effective birth control like condoms while taking Turalio (pexidartinib) and for 1 week after your last dose. This medication can harm an unborn baby. If your partner becomes pregnant, let your care team know right away.
- Store the Turalio (pexidartinib) bottle at room temperature. Keep it closed tightly. Also make sure to keep the drying agent, or desiccant, inside the bottle.
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Risks and warnings for Turalio (pexidartinib)
Turalio (pexidartinib) 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.
Liver injury
- Risk factors: History of liver, bile duct, or gallbladder problems | Taking Turalio (pexidartinib) with high-fat meals (55 to 65 grams of total fat) | Taking other medications that can harm the liver
Turalio (pexidartinib) can cause stress to the liver. This is often mild and shows up as higher liver enzyme levels on blood tests. In some cases, it can cause serious liver damage that can be life-threatening. Before starting Turalio (pexidartinib), tell your prescriber if you have liver or bile duct problems. This medication might not be safe for you.
Because of the risk of liver injury, this medication has a Risk Evaluation and Mitigation Strategy (REMS) program. Your prescriber and the pharmacy must enroll in the Turalio REMS program. Your prescriber will also help sign you up for the program and share information about your liver health. This special safety program helps everyone involved understand the risks and make sure there’s proper monitoring.
You’ll need regular blood tests to check your liver. These are done before starting Turalio (pexidartinib), every week for the first 2 months, and every 2 weeks for the next month. Then, you’ll keep doing blood tests every 3 months. If liver problems show up on your tests, your prescriber might temporarily stop the medication. They might adjust your dose after your liver labs improve. If the liver damage is severe, you might need to stop taking the medication completely.
Keep in mind that liver problems can still happen even with careful monitoring. Watch for more noticeable symptoms of liver problems while taking Turalio (pexidartinib). If you have pain on the upper right side of your stomach, dark urine, or yellow skin or eyes, call your care team right away.
Safety risks when taken with high-fat meal
Taking Turalio (pexidartinib) with high-fat meals can raise the medication levels in the body. This can raise the risk of side effects, including liver injury. It can also raise the risk of these side effects being more severe.
To stay safe, make sure to take Turalio (pexidartinib) with a low-fat meal (11 to 14 grams total fat). If you’re not sure about what you can eat, talk to your care team. They might refer you to a dietitian to help you with meal planning during treatment.
Harm to an unborn baby
Based on animal studies and how it works, Turalio (pexidartinib) might harm an unborn baby. If you’re able to become pregnant, your prescriber will have you take a pregnancy test before starting this medication. It’s important to double check that you’re not pregnant before treatment begins because of this risk.
If you can become pregnant, use birth control while taking Turalio (pexidartinib) and for 1 month after your last dose. This medication can make hormonal birth control work less, well, so use a non-hormonal method. If you can get someone pregnant, also use birth control like condoms while taking Turalio (pexidartinib) and for 1 week after stopping it. Tell your care team right away if you or your partner becomes pregnant during treatment.
Turalio (pexidartinib) dosage
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 125mg | 120 capsules | $24,332.94 | $202.77 |
Typical dosage for Turalio (pexidartinib)
The typical dose is 250 mg (2 capsules) by mouth twice a day with a low-fat meal.
Your dose might be different depending on a few things. This includes if you have liver or kidney problems or take medications that interact with Turalio (pexidartinib). Your prescriber might also lower the dose if you have bothersome or serious side effects.
How much does Turalio (pexidartinib) cost?
$24,332.94
Turalio (pexidartinib) images
