Nirogacestat dihydrobromide at a glance
Medicine class
Gamma-secretase inhibitor and antineoplastic agent
Licensed use
Progressing desmoid tumours in adults requiring systemic treatment
Administration
Swallow tablets whole, with or without food
Avoid
Grapefruit and grapefruit juice
Safety status
Subject to additional monitoring
What is Nirogacestat dihydrobromide used for?
Its UK-licensed use is:
Monotherapy for adults with progressing desmoid tumours who require systemic treatment.
How does Nirogacestat dihydrobromide work?
Nirogacestat reversibly blocks gamma-secretase, preventing activation of Notch receptors involved in cell-growth signalling. This can slow desmoid tumour growth.
Nirogacestat dihydrobromide preparations and strengths
Tablet
Route: Oral
Strengths: 150 mg
How to take Nirogacestat dihydrobromide
Follow the specialist team's instructions.
Swallow tablets whole; do not break, crush or chew them.
Take with or without food.
Avoid grapefruit and grapefruit juice.
Check with the specialist team before starting prescription, non-prescription or herbal products.
Nirogacestat dihydrobromide side effects
Common or expected effects
- Diarrhoea, nausea, mouth soreness or ulcers and dry mouth
- Rash, itching, dry skin, folliculitis and hair loss
- Tiredness, headache or dizziness
- Low phosphate or potassium on blood tests
- Changes in liver tests or urine protein and glucose
- Menstrual changes, hot flushes, night sweats or vaginal dryness associated with ovarian toxicity
- Cough, upper-respiratory infection, breathlessness or nosebleeds
Get urgent medical advice
- Severe or persistent diarrhoea
- Severe hypersensitivity
- New or changing skin lesions; non-melanoma skin cancers have been reported
- Marked liver-test or electrolyte abnormalities
Nirogacestat dihydrobromide in pregnancy
Nirogacestat is contraindicated during pregnancy because it may harm the unborn baby. Pregnancy must be excluded before treatment. Highly effective contraception is required for patients who could become pregnant and male patients with partners who could become pregnant. Contact the specialist team immediately if pregnancy is suspected.
Nirogacestat dihydrobromide while breastfeeding
Breastfeeding is contraindicated during treatment because serious effects in a breastfed child cannot be excluded.
Nirogacestat dihydrobromide interactions
The specialist team should review all medicines and herbal products. Important interactions include:
Strong or moderate CYP3A4 inhibitors, including clarithromycin, itraconazole, erythromycin and fluconazole
These can substantially increase nirogacestat exposure and should generally be avoided.
CYP3A4 inducers, including rifampicin, carbamazepine, phenytoin, phenobarbital and St John’s wort
These may lower exposure and reduce effectiveness, so concurrent use should be avoided.
Proton-pump inhibitors and H2-receptor antagonists
Reduced stomach acidity may impair absorption; concurrent use is not recommended.
Common questions about Nirogacestat dihydrobromide
Answers are fully visible for fast scanning and source review.
What is Nirogacestat dihydrobromide used for?
It is licensed in the UK for adults with progressing desmoid tumours who require systemic treatment.
Is Nirogacestat dihydrobromide chemotherapy?
It is an antineoplastic treatment, but it is a targeted gamma-secretase inhibitor rather than conventional cytotoxic chemotherapy.
Does Nirogacestat dihydrobromide cure desmoid tumours?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.