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Vijoice

alpelisib
Used for PROS Disorders
Used for PROS Disorders

Vijoice (alpelisib) is used for a rare condition called PIK3CA-related overgrowth spectrum (PROS). It's taken by mouth once per day with food. The tablets can be made into a solution that you can drink if you have trouble swallowing pills.

Reviewed by:
reviewer
Robert Chad Hakim, PharmD, BCCCP
reviewer
Kristianne Hannemann, PharmD
Last reviewed on September 29, 2022
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostPricesMedicare
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What is Vijoice (alpelisib)?

What is Vijoice (alpelisib) used for?

  • PIK3CA-related overgrowth spectrum (PROS)

How Vijoice (alpelisib) works

Vijoice (alpelisib) is a kinase inhibitor. It works by preventing PI3K (a protein that signals your cells to grow) from working properly. People with PROS have abnormal PI3K proteins that cause uncontrollable cell growth, which lead to complications of the condition. By blocking PI3K from working properly, Vijoice (alpelisib) helps stop your cells from growing too quickly.

Are you looking for information on Piqray (alpelisib) instead?

Drug Facts

Common BrandsVijoice
Drug ClassKinase inhibitor
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the side effects of Vijoice (alpelisib)?

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

  • Diarrhea (16%)
  • Inflammation and sores in mouth (16%)
  • High blood sugar (12%)
  • Eczema (7%)
  • Dry skin (7%)
  • Hair loss (5%)

Other Side Effects

  • Headache
  • Low appetite
  • Nausea or vomiting
  • Skin infection
  • Acne

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Severe allergic reaction: hives; swelling of the lips, tongue, or face; difficulty breathing
  • Severe skin reactions: red or purple skin rash, blisters on skin, peeling skin, fever
  • Dangerously high blood sugar: frequently thirsty, needing to urinate often, difficulty breathing, rapid heartbeat, fruity breath, dry mouth, confusion
  • Lung inflammation: cough, shortness of breath, chest pain
  • Dehydration: dry mouth, not urinating as much, lightheadedness, dizziness

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
  • Dry cough, shortness of breath or trouble breathing
  • High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
  • Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
  • Rash, fever, and swollen lymph nodes
  • Redness, blistering, peeling, or loosening of the skin, including inside the mouth
  • Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Vijoice (alpelisib)

thumbs-up

Pros

Works well to treat symptoms and complications of PROS

Taken just once per day

Can make into a drinkable solution for people who are having trouble swallowing tablets

Can be used in children as young as 2 years old

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Cons

Available as a brand name only, which can be expensive

Has a lot of potential risks and side effects (e.g., severe diarrhea, high blood sugar, severe skin reactions)

Hasn't been studied in adults 65 years and older

Can't use if pregnant or breastfeeding

pharmacist-tips

Pharmacist tips for Vijoice (alpelisib)

pharmacist

  • Your Vijoice (alpelisib) blister pack contains your full daily dose and is marked with the day of therapy (e.g., day 1, day 2, etc.). It's also colored-coded based on the dose you're prescribed and the strength of the tablets. Follow the colors on your blister pack to make sure you know what dose to take. If you have questions, speak to your provider or pharmacist.

    • Swallow Vijoice (alpelisib) tablets whole with food at the same time each day. Don't split or chew the tablets.

      • If you're having trouble swallowing the tablets, you can make a liquid mixture in a cup by following a few steps. Once it's prepared, drink the Vijoice (alpelisib) solution right away. Afterwards, add a couple tablespoons of water to the same cup you used, stir with the same spoon you used, and drink everything in the cup to get any leftover medication residue. Throw away any remaining contents in the cup that's not taken within 1 hour after it's prepared.

        • Make sure to stay hydrated as much as possible to avoid dehydration from possible diarrhea. During treatment, let your provider know if you get dehydrated (e.g., dry mouth, not urinating as much, lightheadedness, dizziness).

          • If you miss a dose of Vijoice (alpelisib), take the dose within 9 hours of when you usually take the medication. If it's been more than 9 hours since the dose was due, skip the dose for that day and continue your normal dosing schedule the next day. Don't take two tablets to make up the missed dose because this can lead to side effects.

            • If you vomit shortly after taking the dose, don't take an additional dose that day. Continue your normal dosing schedule the next day.

              • Vijoice (alpelisib) can interact with a lot of commonly used prescription and over-the-counter medications. Make sure to tell your provider or pharmacist about all the medications you take before starting Vijoice (alpelisib), and don't start any new medications during treatment without talking to them first. They can help make sure the combination is safe to take together.

                • Based on animal studies, Vijoice (alpelisib) might affect your ability to have children (fertility). If this concerns you, speak to your provider.

                  faqs

                  Frequently asked questions about Vijoice (alpelisib)

                  What is PIK3CA-related overgrowth spectrum (PROS)?
                  PIK3CA-related overgrowth spectrum (PROS) is a range of medical problems that cause your body's tissues to grow too much. In PROS, there are mutations (changes) in the PIK3CA gene, which cause your tissues to grow uncontrollably. Specific complications include abnormal growth (e.g., head, fingers, muscles), malformations in your blood vessels and lymphatic system, and other complications such as seizures and problems with your organs. Vijoice (alpelisib) helps because it prevents the protein that's made by the PIK3CA gene from working, which slows down the growth of your tissues.
                  How well does Vijoice (alpelisib) work?
                  After 6 months of Vijoice (alpelisib) treatment, overgrowths shrunk by at least a fifth in size in 27% of people during studies. Reductions were maintained for at least 6 months in 70% of people and for at least 12 months in 60% of people taking the medication. Additionally, about 74% of people taking Vijoice (alpelisib) had their overgrowth shrink by any size. Overall, over 55% of people taking the medication felt an improvement in their PROS signs and features in 6 months.
                  Why do I have to take Vijoice (alpelisib) with food?
                  You need to take Vijoice (alpelisib) with food because studies showed that food helps increase the amount of medication that gets absorbed into your body. This means if you take it on an empty stomach, it's possible that your body might not absorb as much medication, which could possibly affect how well it works for you.
                  What's the difference between Vijoice (alpelisib) and Piqray (alpelisib)?
                  Both Vijoice (alpelisib) and Piqray (alpelisib) contain the same active ingredient, alpelisib. The difference between the two medications is what conditions they're used for. Vijoice (alpelisib) is used for PROS, while Piqray is used for breast cancer (in combination with other anticancer medications). The dosing between the two medications is also different since they're used to treat different illnesses.
                  Can Vijoice (alpelisib) be used in pregnancy or breastfeeding?
                  No. Based on animal studies, Vijoice (alpelisib) can cause harm to unborn babies, including death, low weight, and developmental abnormalities, at doses typically used in humans. Additionally, there isn't enough information to know how Vijoice (alpelisib) affects break milk production and if it's safe for breastfed babies. Vijoice (alpelisib) shouldn't be used if you're pregnant or breastfeeding. Whether you're male or female, if you or your partner is able to become pregnant, you should use effective birth control and condoms while taking Vijoice (alpelisib) and for at least 1 week after your last dose. Similarly, it's not recommended to breastfeed during treatment and for 1 week after your last dose.
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                  What are the risks and warnings for Vijoice (alpelisib)?

                  Vijoice (alpelisib) 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.

                  risk-warning

                  Severe allergic reactions

                  Severe allergic reactions to Vijoice (alpelisib) are possible, including life-threatening reactions like facial swelling, hives, and anaphylaxis (e.g., closing of the throat). Vijoice (alpelisib) can also cause severe skin reactions that typically start off as cough, aching, headaches, fever, or a burning sensation in the eyes. You could also get blisters, redness, or a red or purple rash on your skin. If you notice dizziness, fast heartbeat, a choking sensation, difficulty breathing, swelling around your eyes, swelling of the lips or tongue, or any signs of a severe skin reaction after taking Vijoice (alpelisib), get medical attention right away.

                  risk-warning

                  High blood sugar

                  • Risk factors: History of type 1 or type 2 diabetes | People who identify as obese | Taking oral corticosteroids | 75 years of age or older

                    Vijoice (alpelisib) can cause your blood sugars and hemoglobin A1c levels to be too high. In some cases, it can lead to dangerously high blood sugar levels and cause serious complications that require urgent treatment. Your provider will monitor your blood sugar and A1c levels during treatment with Vijoice (alpelisib). If your blood sugars or A1c continue to be too high, you might need to start diabetes medications, or you might need a lower dose of Vijoice (alpelisib). Make sure to have a general healthy, balanced diet and regular exercise while taking Vijoice (alpelisib). Let your provider know if you have diabetes before starting Vijoice (alpelisib).

                    risk-warning

                    Lung inflammation

                    Lung inflammation (pneumonitis) might happen in people taking Vijoice (alpelisib). Contact your provider if you have symptoms of lung inflammation, such as fever, cough, chills, or shortness of breath. Your provider might do a physical exam and chest imaging scans to figure out what's going on.

                    risk-warning

                    Severe diarrhea

                    A common side effect of Vijoice (alpelisib) is severe diarrhea, which can cause dehydration (e.g., dry mouth, not urinating as much, lightheadedness, dizziness). Contact your provider if you feel dehydrated. Your provider can adjust your dose to help manage this side effect.

                    risk-warning

                    Harm to unborn babies

                    It's not recommended to take Vijoice (alpelisib) during pregnancy due to the potential risk of severe harm to unborn babies. If you're a female who can have children, you might need to take a pregnancy test to make sure you aren't pregnant before starting this medication. If you or your partner is able to become pregnant, make sure you use effective birth control and condoms during treatment and for at least 1 week after your last dose of Vijoice (alpelisib).

                    dosage

                    Vijoice (alpelisib) dosage forms

                    Typical dosing for Vijoice (alpelisib)

                    • Adults 18 years of age and older: The typical dose is 250 mg by mouth once per day.

                    • Children ages 2 to 18 years old: The typical starting dose is 50 mg by mouth once per day. If your child is at least 6 years old and isn't responding well to the medication, your child's provider might raise the dose to 125 mg once per day.

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