Names and pronunciation
(bel-ZOO-ti-fan) B Welireg
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Drug reference
(bel-ZOO-ti-fan) B Welireg
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Func. class.: Misc. antineoplastic
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Chem. class.: Kinase inhibitor
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ACTION: Inhibits hypoxia-inducible factor that plays a role in oxygen sensing by regulating genes that promote adaptation to hypoxia
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USES: Von Hippel-Lindau disease who require therapy for renal cell carcinoma, NS hemangioblastomas/pancreatic neuroen- docrine tumors not requiring immediate surgery
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CONTRAINDICATIONS Hypersensitivity BBW: Pregnancy Precautions: Anemia, hypoxia, breast feeding
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SIDE EFFECTS CNS: Fatigue, headache, dizziness GI: Nausea RESP: Hypoxia HEMA: Anemia
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INTERACTIONS Increased: belzutifan effect—UGT2B17 or CYP2C19 inhibitors, monitor for ane- mia and hypoxia Increased: contraceptive failure—hor- monal contraceptives, use alternative contraceptive measures Avoid use with sensitive CYP3A4 substrates
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Black Box Warning: Pregnancy/lacta- tion: Obtain a pregnancy test before start- ing treatment. A nonhormonal contracep- tive should be used during and for 1 wk after last dose. Both males and females should use contraceptives; infertility may occur, and it is not known if it is reversible Black Box Warning: Pregnancy/lacta- tion: Do not use in pregnancy, use a non- hormonal contraceptive during and for 1 wk after last dose. Because hormonal contraceptives may not work, both males and females should use effective contra- ception; infertility may occur and it isn’t known if reversible
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DOSAGE AND ROUTES • Adult: PO 120 mg daily until disease progression or unacceptable toxicity
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Available forms: Tabs 40 mg
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Administer: • Take at the same time each day, use without regard to food • Swallow tablets whole. Do not chew, crush, split • If a dose is missed, take as soon as pos- sible on the same day. Resume the regular daily dose schedule the next day. Do not take dose to make up for a missed dose • If vomiting occurs after taking, do not retake the dose. Take the next dose on the next day
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Assess: • Hypoxia: Monitor O2 saturation base- line and periodically; for decreased O2 saturation with exercise (pulse oximeter <88% or PaO2 ≤55 mm Hg), consider withholding until pulse oximetry with ex- ercise is greater than 88%, then resume at the same dose or at a reduced dose. For decreased oxygen saturation at rest (pulse oximeter <88% or PaO2 ≤55 mm Hg) or urgent intervention indicated, withhold until resolved and resume at a reduced dose or discontinue. For life- threatening hypoxia or for recurrent symptomatic hypoxia, permanently dis- continue • Anemia: Monitor for anemia baseline and periodically. Closely monitor patients who are dual UGT2B17/CYP2C19 poor metabolizers, transfusions may be needed, HB <9 g/dL, withhold until ≥9 g/ dL, then resume at reduced dose or per- manently discontinue depending on the severity of anemia. For life-threatening anemia or when urgent intervention is indicated, withhold until HB ≥9 g/dL, then resume at a reduced dose or perma- nently discontinue
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Evaluate: • Therapeutic response: Prevention of spread of cancer
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Patient and caregiver information: • Teach the patient to take without re- gard to food, if vomiting occurs do not retake dose • Laboratory testing will be needed, if blood counts are low, a transfusion may be needed • Advise health care provider if tired, short of breath, chest pain or rapid heartbeat occurs
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PHARMACOKINETICS Peak 1-2 hr NURSING CONSIDERATIONS
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• Adult: PO 120 mg daily until disease progression or unacceptable toxicity
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