provider image
Welcome! You’re in GoodRx for healthcare professionals. Now, you’ll enjoy a streamlined experience created specifically for healthcare professionals.
Skip to main content

Xermelo

telotristat ethy
Used for Diarrhea
Used for Diarrhea

Xermelo (telotristat ethyl) is a medication taken by mouth used to treat diarrhea in people with carcinoid syndrome who aren't responding to somatostatin analog medications alone. It's available as a brand name only, which can be expensive.

Reviewed by:
reviewer
Robert Chad Hakim, PharmD, BCCCP
reviewer
Allison Gourley, PharmD
Last reviewed on March 31, 2022
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageAlternativesPricesMedicare
basics-icon

What is Xermelo (telotristat ethyl)?

What is Xermelo (telotristat ethyl) used for?

How Xermelo (telotristat ethyl) works

Xermelo (telotristat ethyl) is a tryptophan hydroxylase inhibitor. It blocks tryptophan hydroxylase, an enzyme (protein) that helps your body make a chemical called serotonin in your gut. People with carcinoid syndrome have too much serotonin in their gut which can cause diarrhea. Xermelo (telotristat ethyl) stops tryptophan hydroxylase from working, which lowers the amount of serotonin in the gut. This then leads to fewer bowel movements.

Drug Facts

Common BrandsXermelo
Drug ClassTryptophan hydroxylase inhibitor
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
basics-icon

What are the side effects of Xermelo (telotristat ethyl)?

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

  • Nausea (13%)
  • Headache (11%)
  • Depression (9%)
  • Swelling in arms and legs (7%)
  • Passing gas (7%)
  • Low appetite (7%)
  • Fever (7%)

Other Side Effects

  • Stomach pain
  • Constipation

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Severe constipation

Source: DailyMed

The following side effects have also been reported

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

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

pros-and-cons

Pros and cons of Xermelo (telotristat ethyl)

thumbs-up

Pros

Works well to treat carcinoid syndrome diarrhea

Available as an oral tablet

Comes as a daily dose pack that has 3 tablets in it

thumbs-down

Cons

Can cause severe constipation

Only approved for use in combination with an SSA

Needs to be taken three times a day

pharmacist-tips

Pharmacist tips for Xermelo (telotristat ethyl)

pharmacist

  • Xermelo (telotristat ethyl) might cause constipation because it works by slowing down the movement in your gut. If you become constipated while taking Xermelo (telotristat ethyl), let your provider know. In cases of severe constipation or worsening stomach pain, stop taking the medication and contact your provider right away.

    • Take each dose of Xermelo (telotristat ethyl) with food so your body can absorb all of the medication for it to work better.

      • Xermelo (telotristat ethyl) can interact with many commonly used medications. Make sure to tell your provider and pharmacist about all the medications you're taking, including over-the-counter (OTC) medications, vitamins, and supplements before starting Xermelo (telotristat ethyl). Don't start any new medications while taking Xermelo (telotristat ethyl) without talking to your provider or pharmacist first.

        • If you're taking short-acting octreotide injection (Sandostatin, Bynfezia Pen), give yourself the octreotide injection at least 30 minutes after taking your dose of Xermelo (telotristat ethyl). This will make sure the Xermelo (telotristat ethyl) levels in your body stay high so it can work to treat your diarrhea.

          • If you miss your dose of Xermelo (telotristat ethyl), take your next dose at the regular time. Don't take 2 doses at the same time to make up for the missed dose.

            faqs

            Frequently asked questions about Xermelo (telotristat ethyl)

            Can Xermelo (telotristat ethyl) be used alone for my diarrhea?
            No, it's only FDA approved to be used together with a somatostatin analog (SSA) (e.g., octreotide or lanreotide) for carcinoid syndrome diarrhea in people who aren't getting better with SSA alone. It's not known how well Xermelo (telotristat ethyl) works to treat diarrhea when used alone.
            Can I take Xermelo (telotristat ethyl) with food?
            Yes. In fact, it's recommended that you take Xermelo (telotristat ethyl) with food. If you don't take it with food, you might not absorb all of the medication into your body, which will make it not work as well for you.
            How fast does Xermelo (telotristat ethyl) start to work?
            Xermelo (telotristat ethyl) can begin to work as early as 1 to 3 weeks after starting the medication. But in some people, it might take up to 3 months before you start to see a difference.
            Is it safe to use another anti-diarrheal medication with Xermelo (telotristat ethyl)?
            Yes, other anti-diarrheal medications can be used with Xermelo (telotristat ethyl) to help treat diarrhea. However, there might be some medications that interact with Xermelo (telotristat ethyl), so don't start any new medications without talking to your provider or pharmacist first. Make sure to tell your provider and pharmacist about all the medications you take before starting Xermelo (telotristat ethyl).
            Can I use Xermelo (telotristat ethyl) if I'm pregnant?
            Xermelo (telotristat ethyl) hasn't been studied in people who are pregnant, so it's not completely known if it's safe or works well. Also, the studies on Xermelo (telotristat ethyl) in animals are inconsistent. If you're pregnant or thinking of getting pregnant, don't start taking Xermelo (telotristat ethyl) until you've talked to your provider first.
            GoodRxEducationalIcon

            How to save using GoodRx

            Compare Prices
            1. Compare PricesSpecify your dosage and quantity to find out exactly how much you can save.
            Select your free coupon
            2. Select your free couponYou can use the displayed coupon, or compare prices at other pharmacies near you.
            Show coupon to your pharmacist
            3. Show coupon to your pharmacistPresent your printed or electronic coupon when you pick up your prescription.
            Get free couponLearn more
            warings-icon

            What are the risks and warnings for Xermelo (telotristat ethyl)?

            Xermelo (telotristat ethyl) 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 constipation

            Since Xermelo (telotristat ethyl) lowers the number of bowel movements you have, it might cause constipation. If it becomes severe, it could lead to serious gut complications that can be life-threatening. If you develop severe constipation or severe, constant, or worsening stomach pain while taking Xermelo (telotristat ethyl), stop taking it and contact your provider right away.

            dosage

            Xermelo (telotristat ethyl) dosage forms

            Typical dosing for Xermelo (telotristat ethyl)

            The typical dose is 250 mg by mouth taken with food three times a day.

            alternatives

            What are alternatives to Xermelo (telotristat ethyl)?

            There are a number of medications that your doctor can prescribe in place of Xermelo (telotristat ethyl). Compare a few possible alternatives below.
            Xermelo (telotristat ethyl)
            Used for:
            View Prices
            Lanreotide (Somatuline Depot)
            Used for:
            $2436.56 Lowest GoodRx priceView Prices
            Sandostatin Lar Depot (octreotide)
            Used for:
            $3455.91 Lowest GoodRx priceView Prices

            Get savings updates for Xermelo (telotristat ethyl)

            Receive price alerts, news, and other messages from GoodRx about Xermelo (telotristat ethyl) and other healthcare topics and relevant savings offers.

            By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.

            Browse medications

            View All

            Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.