How it is administered

Enasidenib is taken by mouth as a tablet. It is available in 50 mg and 100 mg strengths. The usual dose is 100 mg once daily, with or without food. Tablets should be swallowed whole with a cup of water and should not be chewed, split, or crushed.

How it works

Enasidenib is a targeted therapy that works by inhibiting a specific enzyme called isocitrate dehydrogenase 2 (IDH2). In some patients with acute myeloid leukemia (AML), the IDH2 gene is mutated, leading to the production of an abnormal enzyme. This abnormal enzyme causes the buildup of a substance called 2-hydroxyglutarate (2-HG), which interferes with normal cell development and contributes to the growth of leukemia cells.

By blocking the mutant IDH2 enzyme, enasidenib reduces the levels of 2-HG. This allows immature blood cells (blasts) to mature and develop into healthy blood cells, which can help control the leukemia. Enasidenib is specifically designed for patients whose AML has an IDH2 mutation, as detected by an FDA-approved test.

Who Should take it

Enasidenib is indicated for adults with acute myeloid leukemia (AML) that has come back (relapsed) or has not responded to previous treatment (refractory), and who have an IDH2 gene mutation. The presence of this mutation must be confirmed by an FDA-approved test before starting treatment.

It is not used as a first-line treatment for AML, but rather for patients who have already tried other therapies without success or whose disease has returned. Your healthcare provider will determine if enasidenib is appropriate for you based on your specific genetic test results and treatment history.

Who should not take it

There are no absolute contraindications listed for enasidenib. However, it should not be taken by patients who are allergic to enasidenib or any of its ingredients.

Women who are pregnant or may become pregnant should not take enasidenib, as it can cause harm to an unborn baby. Effective contraception is recommended for both women and men with partners of childbearing potential during treatment and for at least 2 months after the last dose. Women should not breastfeed during treatment and for 2 months after the last dose.

Commonly used with

Enasidenib is used as a single agent for relapsed or refractory AML with IDH2 mutation. It may be used alongside supportive medications such as corticosteroids (for differentiation syndrome), hydroxyurea (for high white blood cell counts), and medications to manage side effects like nausea or diarrhea.

It is important to inform your healthcare provider about all medicines you are taking, as enasidenib can interact with other drugs, especially those metabolized by certain liver enzymes.

Commonly tested with

Enasidenib has been tested in combination with other medications that may be needed to manage side effects, such as corticosteroids for differentiation syndrome and hydroxyurea for high white blood cell counts. It has also been studied for its interactions with drugs like caffeine, omeprazole, dextromethorphan, midazolam, rosuvastatin, and digoxin, to understand how it affects or is affected by these medications.

Before starting enasidenib, your doctor will test for the IDH2 mutation to confirm that this treatment is suitable for you.