Before taking pemazyre(pemigatinib)

Before using pemigatinib for the treatment of cholangiocarcinoma and myeloid/lymphoid neoplasms, both patients and physicians should be aware of certain important precautions. This article aims to introduce the precautions for pemigatinib, to help patients and physicians better understand and respond to potential special situations. Understanding these precautions enables patients to follow correct medication guidelines during treatment, avoid potential adverse reactions or drug interactions, and ensure the optimal efficacy of the drug. Meanwhile, patients should also maintain close communication with physicians and promptly report any uncomfortable symptoms, so that the treatment plan can be adjusted in a timely manner.

Precautions for Pemigatinib

1. Ocular Toxicity

(1) Retinal Pigment Epithelial Detachment (RPED)

① Pemigatinib may cause retinal pigment epithelial detachment (RPED), which can lead to symptoms such as blurred vision, visual floaters, or photopsia.

② Before initiating pemigatinib treatment, a comprehensive ophthalmic examination (including optical coherence tomography, OCT) should be performed. During treatment, ophthalmic examinations should be conducted every 2 months for the first 6 months, and then every 3 months thereafter. If visual symptoms occur, the patient should be immediately referred for ophthalmic evaluation, with follow-up examinations every 3 weeks until the symptoms resolve or pemigatinib is discontinued.

(2) Dry Eye

Pemigatinib may cause dry eye. Administer ocular lubricants to patients as needed.

2. Hyperphosphatemia and Soft Tissue Mineralization

(1)Pemigatinib may cause hyperphosphatemia, which can lead to soft tissue mineralization, cutaneous calcification, calciphylaxis, and non-uremic calcific uremic arteriolopathy.

(2)When the serum phosphate level exceeds 5.5 mg/dL, monitor for hyperphosphatemia and initiate a low-phosphate diet. If the serum phosphate level exceeds 7 mg/dL, initiate phosphate-lowering therapy, and pause, reduce the dose, or permanently discontinue pemigatinib based on the duration and severity of hyperphosphatemia.

3. Embryo-Fetal Toxicity

(1)Administration of pemigatinib to pregnant women may cause fetal harm.

(2)Inform pregnant women of the potential risk to the fetus. Advise female patients of reproductive potential to use effective contraception during treatment with pemigatinib and for 1 week after the last dose. Advise male patients with female partners of reproductive potential to use effective contraception during treatment with pemigatinib and for 1 week after the last dose.