IMPORTANT SAFETY INFORMATION
What is the most important information I should know about ICLUSIG®
(ponatinib)?
ICLUSIG can cause serious side effects, including:
Blood clots or blockage in your blood vessels (arteries and
veins).
Blood clots or blockage in your blood vessels may lead to heart
attack, stroke, or death. A blood clot or blockage in your blood
vessels can prevent proper blood flow to your heart, brain, bowels
(intestines), legs, eyes, and other parts of your body. You may need
emergency surgery or treatment in a hospital. Get medical help right
away if you get any of the following symptoms:
- chest pain or pressure
- pain in your arms, legs, back, neck or jaw
- shortness of breath
- numbness or weakness on one side of your body
- leg swelling
- trouble talking
- headache
- dizziness
- severe stomach area pain
- decreased vision or loss of vision
Blood clots or blockage in your blood vessels can happen in people
with or without risk factors for heart and blood vessel disease,
including people 50 years of age or younger. The most common risk
factors for these problems are a history of high blood pressure
(hypertension), high levels of fat in the blood (hyperlipidemia), and
heart disease. Blood clots or blockages in your blood vessels happen
more often in people as they get older, and in people with a past
history of decreased blood flow, high blood pressure, diabetes, or
high levels of fats in the blood.
INDICATION
ICLUSIG® (ponatinib) is a prescription medicine used to treat adults
who have:
-
chronic phase, accelerated phase, or blast phase chronic myeloid
leukemia (CML) or Philadelphia chromosome positive acute
lymphoblastic leukemia (Ph+ ALL) who cannot receive any other
tyrosine kinase inhibitor (TKI) medicines
-
a specific type of abnormal gene (T315I-positive) chronic phase,
accelerated phase, or blast phase CML, or T315I-positive Ph+ ALL
ICLUSIG is not for use to treat people with newly diagnosed chronic
phase CML.
It is not known if ICLUSIG is safe and effective in children less than
18 years of age.
Heart problems. ICLUSIG can cause heart
problems, including heart failure which can be serious and may lead to
death. Heart failure means your heart does not pump blood well enough.
ICLUSIG can also cause irregular slow or fast heartbeats and heart attack.
Your healthcare provider will check you for heart problems during your
treatment with ICLUSIG. Get medical help right away if you get any of the
following symptoms: shortness of breath, chest pain, fast or irregular
heartbeats, dizziness, or feel faint.
Liver problems. ICLUSIG can cause liver
problems, including liver failure, which can be severe and may lead to
death. Your healthcare provider will do blood tests before and during your
treatment with ICLUSIG to check for liver problems. Get medical help right
away if you get any of these symptoms of liver problems during treatment:
- yellowing of your skin or the white part of your eyes (jaundice)
- dark "tea-colored" urine
- sleepiness
- loss of appetite
- bleeding or bruising
See
"What are the possible side effects of ICLUSIG?"
for information about side effects.
What is ICLUSIG?
ICLUSIG is a prescription medicine used to treat adults who have:
-
chronic phase, accelerated phase, or blast phase chronic myeloid
leukemia (CML) or Philadelphia chromosome positive acute lymphoblastic
leukemia (Ph+ ALL) who cannot receive any other tyrosine kinase
inhibitor (TKI) medicines
-
a specific type of abnormal gene (T315I-positive) chronic phase,
accelerated phase, or blast phase CML, or T315I-positive Ph+ ALL
ICLUSIG is not for use to treat people with newly diagnosed chronic phase
CML.
It is not known if ICLUSIG is safe and effective in children less than 18
years of age.
Before you take ICLUSIG, tell your healthcare provider about all of your
medical conditions, including if you:
-
have a history of blood clots in your blood vessels (arteries or veins)
-
have heart problems, including heart failure, irregular heartbeats, and
QT prolongation
- have diabetes
- have a history of high cholesterol
- have liver problems
- have had inflammation of your pancreas (pancreatitis)
- have high blood pressure
-
are pregnant or plan to become pregnant. ICLUSIG can harm your unborn
baby.
-
Your healthcare provider will do a pregnancy test before you start
taking ICLUSIG.
-
You should not become pregnant during treatment with ICLUSIG.
-
For females who can become pregnant:
-
— Use an effective form of birth control during treatment
and for 3 weeks after your last dose of
ICLUSIG.
-
— Tell your healthcare provider right away if you become
pregnant or think you might be pregnant during treatment with
ICLUSIG.
-
— ICLUSIG may affect your ability to have children. Tell
your healthcare provider if this is a concern for you.
-
are breastfeeding or plan to breastfeed. It is not known if ICLUSIG
passes into your breast milk. Do not breastfeed during
treatment and for 6 days after your last dose of
ICLUSIG.
- have bleeding problems
- plan to have surgery or have had a recent surgery. You should stop taking ICLUSIG at least 1 week before any planned surgery. See "What are the possible side effects of ICLUSIG?"
-
are lactose (milk sugar) intolerant. ICLUSIG tablets contain lactose.
- drink grapefruit juice
Tell your healthcare provider about all the medicines you take,
including prescription medicines and over-the-counter medicines, vitamins,
and herbal supplements. ICLUSIG and other medicines may affect each other
causing side effects.
Know the medicines you take. Keep a list of them to show your healthcare
provider and pharmacist when you get a new medicine.
How should I take ICLUSIG?
-
Take ICLUSIG exactly as your healthcare provider tells you to take it.
-
Swallow ICLUSIG tablets whole. Do not crush or dissolve ICLUSIG tablets.
- You may take ICLUSIG with or without food.
-
If you miss a dose of ICLUSIG, take your next dose at your regular time.
Do not take 2 doses at the same time to make up for a missed dose.
-
If you take too much ICLUSIG, call your healthcare provider or go to the
nearest hospital emergency room right away.
What are the possible side effects of ICLUSIG?
ICLUSIG may cause serious side effects, including:
-
See "What is the most important information I should know about ICLUSIG?"
-
High blood pressure. Your blood pressure
should be checked regularly and any high blood pressure should be
treated while you are taking ICLUSIG. Tell your healthcare provider if
you get confusion, headaches, dizziness, chest pain or shortness of
breath.
-
Inflammation of the pancreas (pancreatitis).
Tell your healthcare provider if you get any of the following symptoms:
sudden stomach-area pain or discomfort, nausea, and vomiting. Your
healthcare provider should do blood tests to check for pancreatitis
during treatment with ICLUSIG.
-
Neuropathy. ICLUSIG may cause damage to the
nerves in your arms, brain, hands, legs, or feet (neuropathy). Tell your
healthcare provider if you get any of these symptoms during treatment
with ICLUSIG:
-
— muscle weakness, tingling, burning, pain, and loss of
feeling in your hands and feet
-
— double vision and other problems with eyesight, trouble
moving the eye, drooping of part of the face, sagging or drooping
eyelids, and
change in taste
-
Effects on the eye. Serious eye problems
that can lead to blindness or blurred vision may happen with ICLUSIG.
Tell your healthcare provider if you get any of the following symptoms:
bleeding in the eye, perceived flashes of light, light sensitivity,
floaters, dry inflamed, swollen, or itchy eyes, and eye pain. Your
healthcare provider will monitor your vision before and during your
treatment with ICLUSIG.
-
Severe bleeding. ICLUSIG can cause bleeding
which can be serious and may lead to death. Tell your healthcare
provider if you get any signs of bleeding during treatment with ICLUSIG
including:
-
— vomiting blood or if your vomit looks like coffee-grounds
- — pink or brown urine
- — red or black (looks like tar) stools
- — coughing up blood or blood clots
-
— unusual bleeding or bruising of your skin
-
— menstrual bleeding that is heavier than normal
- — unusual vaginal bleeding
- — nose bleeds that happen often
- — drowsiness or difficulty being awakened
- — confusion
- — headache
- — change in speech
-
Fluid retention. Your body may hold too
much fluid (fluid retention). Tell your healthcare provider right away
if you get any of these symptoms during treatment with ICLUSIG:
-
— swelling of your hands, ankles, feet, face, or all over your
body
- — weight gain
- — shortness of breath and cough
-
Irregular heartbeat. ICLUSIG may cause an
irregular heartbeat. Tell your healthcare provider right away if you
experience loss of consciousness, fainting, dizziness, chest pain or
palpitations.
-
Low blood cell counts. ICLUSIG may cause
low blood cell counts, which can be severe. Your healthcare provider
will check your blood counts regularly during treatment with ICLUSIG.
Tell your healthcare provider right away if you have a fever or any
signs of an infection while taking ICLUSIG.
-
Tumor Lysis Syndrome (TLS). TLS is caused
by a fast breakdown of cancer cells. TLS can cause you to have:
-
— kidney failure and the need for dialysis treatment
- — an abnormal heartbeat
Your healthcare provider may do blood tests to check for TLS.
-
Reversible Posterior Leukoencephalopathy Syndrome (RPLS – also known
as Posterior Reversible Encephalopathy Syndrome - PRES).
ICLUSIG may trigger a condition called RPLS. Call your healthcare
provider right away if you get headaches, seizures, confusion, changes
in vision or problems thinking.
-
Wound healing problems. Wound healing problems have happened in some people who take ICLUSIG. Tell your healthcare provider if you plan to have any surgery before or during treatment with ICLUSIG.
-
— You should stop taking ICLUSIG at least 1 week before planned surgery.
- — Your healthcare provider should tell you when you may start taking ICLUSIG again after surgery.
-
A tear in your stomach or intestinal wall (perforation).
Tell your healthcare provider right away if you get:
-
— severe pain in your stomach-area (abdomen)
- — swelling of the abdomen
- — high fever
The most common side effects of ICLUSIG include:
- stomach-area (abdomen) pain
- skin rash
- constipation
- headache
- dry skin
- blood clots or blockage in blood vessels (arteries)
- tiredness
- high blood pressure
- fever
- joint pain
- nausea
- diarrhea
-
increase in lipase levels (a blood test done to check your pancreas)
- vomiting
- muscle pain
- pain in arms, hands, legs, and feet
Your healthcare provider may change your dose, temporarily stop, or
permanently stop treatment with ICLUSIG if you have certain side effects.
Talk to your doctor if you have a side effect that bothers you or does not
go away. These are not all of the possible side effects of ICLUSIG. For more
information, ask your healthcare provider or pharmacist.
To report SUSPECTED ADVERSE REACTIONS, contact Takeda at 1-844-817-6468 or FDA at 1-800-FDA-1088 or
www.fda.gov/medwatch.
Please read the
Medication Guide
in the full Prescribing Information,
including Important Serious Side Effects.