Vorasidenib at a glance
Medicine class
Mutant IDH1 and IDH2 inhibitor
Licensed role
Selected grade 2 IDH-mutant astrocytoma or oligodendroglioma after surgery
Who it is for
Adults and adolescents aged 12 years and older who do not need immediate chemotherapy or radiotherapy
Administration
Swallow tablets whole with water on an empty stomach
Key monitoring
Regular blood tests are required, particularly for liver injury
What is Vorasidenib used for?
The UK licence covers:
Grade 2 astrocytoma or oligodendroglioma with a susceptible IDH1 or IDH2 mutation following surgery, in adults and adolescents aged 12 years or older who do not need immediate chemotherapy or radiotherapy.
How does Vorasidenib work?
Mutated IDH1 or IDH2 can produce excessive 2-hydroxyglutarate, contributing to tumour growth. Vorasidenib blocks these enzymes, reducing this abnormal metabolite and malignant-cell proliferation.
Vorasidenib preparations and strengths
Tablet
Route: Oral
Strengths: 10 mg, 40 mg
How to take Vorasidenib
Follow the specialist team's instructions.
Swallow each tablet whole with water; do not split, crush or chew it.
Take it on an empty stomach.
Do not swallow the desiccant canisters supplied inside the bottle.
Vorasidenib side effects
Common or expected effects
- Raised liver enzymes
- Tiredness
- Diarrhoea
- Abdominal pain
- Reduced platelet count
- Reduced appetite
- Raised blood glucose
- Low blood phosphate
Get urgent medical advice
- Liver injury, including jaundice, dark urine, upper-right abdominal pain, loss of appetite or marked tiredness
- Severe liver inflammation, autoimmune hepatitis or liver-cell injury
Vorasidenib in pregnancy
Vorasidenib can harm an unborn baby and should not be used during pregnancy. Pregnancy testing is recommended where relevant. Effective contraception is required during treatment and for at least 3 months afterwards. Hormonal contraceptives may be less effective, so an additional barrier method is advised.
Vorasidenib while breastfeeding
It is unknown whether vorasidenib enters human milk. Breastfeeding should stop during treatment and for at least 2 months afterwards.
Vorasidenib interactions
The specialist team should review all prescribed, over-the-counter and complementary products. Important examples include:
Ciprofloxacin or fluvoxamine
May raise vorasidenib exposure and should generally be avoided in favour of alternatives.
Rifampicin or phenytoin
May lower vorasidenib exposure and reduce its activity.
Warfarin, tacrolimus, ciclosporin and other narrow-therapeutic-index CYP substrates
Vorasidenib may reduce their concentrations, so concurrent use should generally be avoided.
Common questions about Vorasidenib
Answers are fully visible for fast scanning and source review.
Why is Vorasidenib used after glioma surgery?
It is intended for selected IDH-mutant grade 2 tumours when immediate chemotherapy or radiotherapy is not needed.
Does Vorasidenib require an IDH mutation test?
Yes. A tumour test must confirm a susceptible IDH1 or IDH2 mutation before treatment.
Why are liver blood tests needed?
Vorasidenib commonly raises liver enzymes and can occasionally cause serious liver injury, sometimes before symptoms develop.
Can Vorasidenib affect contraception?
Yes. It may reduce the effectiveness of hormonal contraception, so an additional barrier method is advised.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.