Enfortumab vedotin is an antibody-drug conjugate used in the treatment of patients with advanced, treatment-resistant urothelial cancers.[rx] It is comprised of a fully human monoclonal antibody targeted against Nectin-4 and a microtubule-disrupting chemotherapeutic agent, monomethyl auristatin E (MMAE), joined by a protease-cleavable link.[rx] It is similar to brentuximab vedotin, another antibody conjugated with MMAE that targets CD-30 instead of Nectin-4.
The clinical development of enfortumab vedotin was the result of a collaboration between Astellas Pharma and Seattle Genetics [rx] and it was first approved for use in the United States in December 2019 under the brand name PadcevTM.[rx] Enfortumab vedotin was later approved by the European Commission on April 13, 2022.[rx]
Mechanism of action
Enfortumab vedotin is an antibody-drug conjugate comprised of multiple components.[rx] It contains a fully human monoclonal antibody directed against Nectin-4, an extracellular adhesion protein that is highly expressed in urothelial cancers,1 attached to a chemotherapeutic microtubule-disrupting agent, monomethyl auristatin E (MMAE). These two components are joined via a protease-cleavable linker. Enfortumab vedotin binds to cells expressing Nectin-4 and the resulting enfortumab-Nectin-4 complex is internalized into the cell. Once inside the cell, MMAE is released from enfortumab vedotin via proteolytic cleavage and goes on to disrupt the microtubule network within the cell, arresting the cell cycle and ultimately inducing apoptosis.[rx]
Enfortumab vedotin is an anti-cancer agent that destroys tumor cells by inhibiting their ability to replicate.[rx] Patients with moderate to severe hepatic impairment should not use enfortumab vedotin – although it has not been studied in this population, other MMAE-containing antibody-drug conjugates have demonstrated increased rates of adverse effects in patients with moderate-severe hepatic impairment.[rx] Enfortumab vedotin may also cause significant hyperglycemia leading, in some cases, to diabetic ketoacidosis, and should not be administered to patients with a blood glucose level >250 mg/dl.[rx]
Indications
- Enfortumab vedotin is indicated for the treatment of adult patients with locally advanced or metastatic urothelial cancer who have previously received a programmed death receptor-1 (PD-1) or programmed death-ligand 1 (PD-L1) inhibitor, and platinum-containing chemotherapy in the neoadjuvant/adjuvant, locally advanced, or metastatic setting.[rx,rx]
- Enfortumab vedotin is an antibody-drug conjugate comprised of a fully human monoclonal antibody and microtubule-disrupting chemotherapeutic agent used in the treatment of advanced or metastatic urothelial cancer.
- For locally advanced or metastatic urothelial cancer (mUC) who have previously received a programmed death receptor-1 (PD-1) or programmed death-ligand 1 (PD-L1) inhibitor, and platinum-containing chemotherapy in the neoadjuvant/adjuvant, locally advanced or metastatic setting
- Locally Advanced Urothelial Cancer
- Metastatic Urothelial Cancer
Use in Cancer
Enfortumab vedotin-ejfv is approved to treat adults with:
- Urothelial cancer (a type of cancer in the bladder or urinary tract) that has spread or cannot be removed by surgery. It is used in:
- Patients who have received platinum chemotherapy and immunotherapy.
- Patients who have received at least one other type of treatment and cannot receive cisplatin.
Enfortumab vedotin-ejfv is also being studied in the treatment of other types of cancer.
Contraindications
- diabetes
- a painful condition that affects the nerves in the legs and arms called peripheral neuropathy
- high blood sugar
- pregnancy
- a patient who is producing milk and breastfeeding
Dosage
Strengths: ejfv 20 mg; ejfv 30 mg
Urothelial Carcinoma
- 1.25 mg/kg (up to a maximum of 125 mg for patients 100 kg or greater) IV over 30 minutes on Days 1, 8. and 15 of a 28-day cycle until disease progression or unacceptable toxicity
Dose Adjustments
RECOMMENDED DOSE REDUCTION SCHEDULE:
- Starting dose: 1.25 mg/kg up to 125 mg
- First dose reduction: 1 mg/kg up to 100 mg
- Second dose reduction: 0.75 mg/kg up to 75 mg
- Third dose reduction: 0.5 mg/kg up to 50 mg
DOSE MODIFICATIONS:
HYPERGLYCEMIA:
- Blood glucose greater than 250 mg/dL: Withhold this drug until elevated blood glucose has improved to 250 mg/dL or less then resume therapy at the same dose level.
PERIPHERAL NEUROPATHY:
- Grade 2: Withhold until Grade 1 or less, then resume therapy at the same dose level (if first occurrence); for a recurrence, withhold until Grade 1 or less then, resume therapy reduced by one dose level.
- Grade 3 or greater: Permanently discontinue this drug.
SKIN REACTIONS:
- Grade 3 (severe): Withhold this drug until Grade 1 or less, then resume therapy at the same dose level or consider dose reduction by one dose level.
- Grade 4 or recurrent Grade 3: Permanently discontinue this drug.
OTHER NONHEMATOLOGIC TOXICITY:
- Grade 3: Withhold this drug until Grade 1 or less, then resume therapy at the same dose level or consider dose reduction by one dose level.
- Grade 4: Permanently discontinue this drug.
HEMATOLOGIC TOXICITY:
- Grade 3 or 3 thrombocytopenia: Withhold this drug until Grade 1 or less, then resume therapy at the same dose level or consider dose reduction by one dose level.
- Grade 4 thrombocytopenia: Withhold until Grade 1 or less, then reduce dose by one dose level or discontinue therapy.
Administration advice:
- After reconstitution, immediately administer the infusion IV over 30 minutes.
- If the infusion is not administered immediately, the prepared infusion bag should not be stored longer than 8 hours at 2C to 8C (36 F to 46 F). NOTE: Do not freeze.
- Do not administer this drug as an IV push or bolus.
- Do not mix this drug with, or administer it as an infusion with, other medicinal products.
Side Effects
The Most Common
- diarrhea
- vomiting
- nausea
- loss of appetite
- weight loss
- taste changes
- hair loss
- dry skin
- shortness of breath
- trouble breathing
- cough
- pale skin
- skin redness, swelling, fever, or pain at the injection site
- blurred vision, loss of vision, eye pain or redness, or other visual changes
- numbness, burning or tingling in hands or feet
- muscle weakness
- extreme tiredness or lack of energy
More common
- Blurred vision
- burning, dry, or itching eyes
- burning, numbness, tingling, or painful sensations
- discharge, excessive tearing
- dry eyes
- dry mouth
- eye redness, irritation, or pain
- flushed, dry skin
- fruit-like breath odor
- increased hunger
- increased thirst
- increased urination
- lack or loss of strength
- nausea
- rash with flat lesions or small raised lesions on the skin
- redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
- stomach pain
- sweating
- trouble breathing
- unexplained weight loss
- unsteadiness or awkwardness
- unusual tiredness or weakness
- vomiting
- weakness in the arms, hands, legs, or feet
Rare
- Chest pain
- chills
- cough
- fever
- a general feeling of discomfort or illness
- thickening of bronchial secretions
- Blistering, peeling, or loosening of the skin
- diarrhea
- itching
- joint or muscle pain
- red irritated eyes
- red skin lesions, often with a purple center
- redness, tenderness, itching, burning, or peeling of the skin
- sore throat
- sores, ulcers, or white spots in the mouth or on the lips
- Change in taste
- cracks in the skin
- decreased appetite
- dry skin
- hair loss or thinning of the hair
- loss of heat from the body
- loss of taste
- nausea
- painful blisters on the trunk of the body
- red, swollen skin redness, swelling, or pain of the skin
- scaling of the skin on the hands and feet
- skin blisters
- tingling of the hands and feet
- ulceration of the skin
- vomiting
- Pain, redness, or swelling at the injection site
Drug Interactions
DRUG | INTERACTION |
---|---|
Abametapir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Abametapir. |
Abemaciclib | The serum concentration of Abemaciclib can be increased when it is combined with Enfortumab vedotin. |
Abrocitinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Abrocitinib. |
Afatinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Afatinib. |
Ambrisentan | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ambrisentan. |
Amiodarone | The serum concentration of Enfortumab vedotin can be increased when it is combined with Amiodarone. |
Amprenavir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Amprenavir. |
Apalutamide | The serum concentration of Enfortumab vedotin can be decreased when it is combined with Apalutamide. |
Apixaban | The serum concentration of Enfortumab vedotin can be increased when it is combined with Apixaban. |
Aprepitant | The metabolism of Enfortumab vedotin can be decreased when combined with Aprepitant. |
Arsenic trioxide | The serum concentration of Enfortumab vedotin can be increased when it is combined with Arsenic trioxide. |
Articaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Articaine. |
Asciminib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Asciminib. |
Asunaprevir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Asunaprevir. |
Atazanavir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Atazanavir. |
Avanafil | The serum concentration of Avanafil can be increased when it is combined with Enfortumab vedotin. |
Avatrombopag | The serum concentration of Enfortumab vedotin can be increased when it is combined with Avatrombopag. |
Axitinib | The serum concentration of Axitinib can be increased when it is combined with Enfortumab vedotin. |
Belantamab | The serum concentration of Belantamab mafodotin can be increased when it is combined with Enfortumab vedotin. |
Belinostat | The serum concentration of Enfortumab vedotin can be increased when it is combined with Belinostat. |
Belumosudil | The serum concentration of Enfortumab vedotin can be increased when it is combined with Belumosudil. |
Bendamustine | The serum concentration of Bendamustine can be increased when it is combined with Enfortumab vedotin. |
Benzocaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Benzocaine. |
Benzyl alcohol | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Benzyl alcohol. |
Berotralstat | The metabolism of Enfortumab vedotin can be decreased when combined with Berotralstat. |
Betrixaban | The serum concentration of Enfortumab vedotin can be increased when it is combined with Betrixaban. |
Binimetinib | The serum concentration of Binimetinib can be increased when it is combined with Enfortumab vedotin. |
Bisoprolol | The serum concentration of Enfortumab vedotin can be increased when it is combined with Bisoprolol. |
Boceprevir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Boceprevir. |
Bortezomib | The serum concentration of Bortezomib can be increased when it is combined with Enfortumab vedotin. |
Bosutinib | The serum concentration of Bosutinib can be increased when it is combined with Enfortumab vedotin. |
Brentuximab | The serum concentration of Brentuximab vedotin can be increased when it is combined with Enfortumab vedotin. |
Bupivacaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Bupivacaine. |
Butacaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Butacaine. |
Butamben | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Butamben. |
Cabazitaxel | The serum concentration of Cabazitaxel can be increased when it is combined with Enfortumab vedotin. |
Cabergoline | The serum concentration of Cabergoline can be increased when it is combined with Enfortumab vedotin. |
Canagliflozin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Canagliflozin. |
Capmatinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Capmatinib. |
Capsaicin | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Capsaicin. |
Carbamazepine | The metabolism of Enfortumab vedotin can be increased when combined with Carbamazepine. |
Carfilzomib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Carfilzomib. |
Carvedilol | The serum concentration of Enfortumab vedotin can be increased when it is combined with Carvedilol. |
Cenobamate | The serum concentration of Enfortumab vedotin can be decreased when it is combined with Cenobamate. |
Ceritinib | The serum concentration of Ceritinib can be increased when it is combined with Enfortumab vedotin. |
Chloroprocaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Chloroprocaine. |
Cinchocaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Cinchocaine. |
Ciprofloxacin | The metabolism of Enfortumab vedotin can be decreased when combined with Ciprofloxacin. |
Clarithromycin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Clarithromycin. |
Clobazam | The serum concentration of Enfortumab vedotin can be increased when it is combined with Clobazam. |
Clofazimine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Clofazimine. |
Clomifene | The serum concentration of Enfortumab vedotin can be increased when it is combined with Clomifene. |
Clozapine | The metabolism of Enfortumab vedotin can be decreased when combined with Clozapine. |
Cobicistat | The serum concentration of Enfortumab vedotin can be increased when it is combined with Cobicistat. |
Cobimetinib | The serum concentration of Cobimetinib can be increased when it is combined with Enfortumab vedotin. |
Cocaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Cocaine. |
Colchicine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Colchicine. |
Conivaptan | The serum concentration of Enfortumab vedotin can be increased when it is combined with Conivaptan. |
Copanlisib | The serum concentration of Copanlisib can be increased when it is combined with Enfortumab vedotin. |
Crizotinib | The metabolism of Enfortumab vedotin can be decreased when combined with Crizotinib. |
Curcumin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Curcumin. |
Cyclosporine | The metabolism of Enfortumab vedotin can be decreased when combined with Cyclosporine. |
Dabigatran etexilate | The serum concentration of Enfortumab vedotin can be increased when it is combined with Dabigatran etexilate. |
Dabrafenib | The serum concentration of Enfortumab vedotin can be decreased when it is combined with Dabrafenib. |
Daclatasvir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Daclatasvir. |
Dacomitinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Dacomitinib. |
Dactinomycin | The serum concentration of Dactinomycin can be increased when it is combined with Enfortumab vedotin. |
Danazol | The serum concentration of Enfortumab vedotin can be increased when it is combined with Danazol. |
Daptomycin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Daptomycin. |
Darbepoetin alfa | The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Enfortumab vedotin. |
Darolutamide | The serum concentration of Enfortumab vedotin can be increased when it is combined with Darolutamide. |
Darunavir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Darunavir. |
Dasabuvir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Dasabuvir. |
Dasatinib | The serum concentration of Dasatinib can be increased when it is combined with Enfortumab vedotin. |
Delavirdine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Delavirdine. |
Desvenlafaxine | The metabolism of Enfortumab vedotin can be decreased when combined with Desvenlafaxine. |
Dexamethasone | The metabolism of Enfortumab vedotin can be increased when combined with Dexamethasone. |
Digitoxin | The serum concentration of Digitoxin can be increased when it is combined with Enfortumab vedotin. |
Digoxin | The serum concentration of Digoxin can be increased when it is combined with Enfortumab vedotin. |
Diltiazem | The metabolism of Enfortumab vedotin can be decreased when combined with Diltiazem. |
Diosmin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Diosmin. |
Diphenhydramine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Diphenhydramine. |
Dolutegravir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Dolutegravir. |
Dronedarone | The metabolism of Enfortumab vedotin can be decreased when combined with Dronedarone. |
Duvelisib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Duvelisib. |
Dyclonine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Dyclonine. |
Econazole | The serum concentration of Enfortumab vedotin can be increased when it is combined with Econazole. |
Edoxaban | The serum concentration of Enfortumab vedotin can be increased when it is combined with Edoxaban. |
Efavirenz | The serum concentration of Enfortumab vedotin can be increased when it is combined with Efavirenz. |
Elagolix | The serum concentration of Enfortumab vedotin can be increased when it is combined with Elagolix. |
Elbasvir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Elbasvir. |
Eliglustat | The serum concentration of Enfortumab vedotin can be increased when it is combined with Eliglustat. |
Elvitegravir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Elvitegravir. |
Enasidenib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Enasidenib. |
Entrectinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Entrectinib. |
Enzalutamide | The serum concentration of Enfortumab vedotin can be decreased when it is combined with Enzalutamide. |
Erdafitinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Erdafitinib. |
Ergotamine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ergotamine. |
Ertugliflozin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ertugliflozin. |
Erythromycin | The metabolism of Enfortumab vedotin can be decreased when combined with Erythromycin. |
Erythropoietin | The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Enfortumab vedotin. |
Ethyl chloride | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Ethyl chloride. |
Etidocaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Etidocaine. |
Etoposide | The serum concentration of Etoposide can be increased when it is combined with Enfortumab vedotin. |
Everolimus | The serum concentration of Enfortumab vedotin can be increased when it is combined with Everolimus. |
Favipiravir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Favipiravir. |
Fedratinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Fedratinib. |
Fexofenadine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Fexofenadine. |
Flibanserin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Flibanserin. |
Fluconazole | The metabolism of Enfortumab vedotin can be decreased when combined with Fluconazole. |
Fluvoxamine | The metabolism of Enfortumab vedotin can be decreased when combined with Fluvoxamine. |
Fosnetupitant | The metabolism of Enfortumab vedotin can be decreased when combined with Fosnetupitant. |
Fosphenytoin | The metabolism of Enfortumab vedotin can be increased when combined with Fosphenytoin. |
Fostemsavir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Fostemsavir. |
Fusidic acid | The metabolism of Enfortumab vedotin can be decreased when combined with Fusidic acid. |
Futibatinib | The serum concentration of Futibatinib can be increased when it is combined with Enfortumab vedotin. |
Gemcitabine | The serum concentration of Gemcitabine can be increased when it is combined with Enfortumab vedotin. |
Gilteritinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Gilteritinib. |
Glasdegib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Glasdegib. |
Glecaprevir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Glecaprevir. |
Grazoprevir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Grazoprevir. |
Haloperidol | The serum concentration of Haloperidol can be increased when it is combined with Enfortumab vedotin. |
Idelalisib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Idelalisib. |
Imipramine | The serum concentration of Imipramine can be increased when it is combined with Enfortumab vedotin. |
Indacaterol | The serum concentration of Enfortumab vedotin can be increased when it is combined with Indacaterol. |
Indinavir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Indinavir. |
Inotuzumab | The serum concentration of Inotuzumab ozogamicin can be increased when it is combined with Enfortumab vedotin. |
Isavuconazole | The serum concentration of Enfortumab vedotin can be increased when it is combined with Isavuconazole. |
Isavuconazonium | The serum concentration of Enfortumab vedotin can be increased when it is combined with Isavuconazonium. |
Isoniazid | The metabolism of Enfortumab vedotin can be decreased when combined with Isoniazid. |
Isradipine | The metabolism of Enfortumab vedotin can be decreased when combined with Isradipine. |
Istradefylline | The serum concentration of Enfortumab vedotin can be increased when it is combined with Istradefylline. |
Itraconazole | The serum concentration of Enfortumab vedotin can be increased when it is combined with Itraconazole. |
Ivacaftor | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ivacaftor. |
Ivosidenib | The metabolism of Enfortumab vedotin can be increased when combined with Ivosidenib. |
Ixabepilone | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ixabepilone. |
Ketoconazole | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ketoconazole. |
Lapatinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Lapatinib. |
Larotrectinib | The serum concentration of Larotrectinib can be increased when it is combined with Enfortumab vedotin. |
Lasmiditan | The serum concentration of Enfortumab vedotin can be increased when it is combined with Lasmiditan. |
Ledipasvir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ledipasvir. |
Lefamulin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Lefamulin. |
Lemborexant | The serum concentration of Enfortumab vedotin can be increased when it is combined with Lemborexant. |
Lenvatinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Lenvatinib. |
Levobupivacaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Levobupivacaine. |
Levoketocona | The serum concentration of Enfortumab vedotin can be increased when it is combined with Levoketoconazole. |
Lidocaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Lidocaine. |
Linagliptin | The metabolism of Enfortumab vedotin can be decreased when combined with Linagliptin. |
Lomitapide | The serum concentration of Enfortumab vedotin can be increased when it is combined with Lomitapide. |
Lonafarnib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Lonafarnib. |
Loncastuximab | The serum concentration of Loncastuximab tesirine can be increased when it is combined with Enfortumab vedotin. |
Loperamide | The serum concentration of Enfortumab vedotin can be increased when it is combined with Loperamide. |
Lopinavir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Lopinavir. |
Lovastatin | The metabolism of Enfortumab vedotin can be decreased when combined with Lovastatin. |
Loxapine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Loxapine. |
Lumacaftor | The serum concentration of Enfortumab vedotin can be decreased when it is combined with Lumacaftor. |
Lusutrombopag | The serum concentration of Lusutrombopag can be increased when it is combined with Enfortumab vedotin. |
Mannitol | The serum concentration of Enfortumab vedotin can be increased when it is combined with Mannitol. |
Maribavir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Maribavir. |
Mavacamten | The serum concentration of Enfortumab vedotin can be decreased when it is combined with Mavacamten. |
Mefloquine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Mefloquine. |
Meloxicam | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Meloxicam. |
Mepivacaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Mepivacaine. |
Methimazole | The serum concentration of Enfortumab vedotin can be increased when it is combined with Methimazole. |
Methoxy | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Enfortumab vedotin. |
Methylene blue | The serum concentration of Enfortumab vedotin can be increased when it is combined with Methylene blue. |
Metreleptin | The metabolism of Enfortumab vedotin can be increased when combined with Metreleptin. |
Miconazole | The metabolism of Enfortumab vedotin can be decreased when combined with Miconazole. |
Midostaurin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Midostaurin. |
Mifepristone | The serum concentration of Enfortumab vedotin can be increased when it is combined with Mifepristone. |
Milnacipran | The metabolism of Enfortumab vedotin can be decreased when combined with Milnacipran. |
Mirabegron | The serum concentration of Enfortumab vedotin can be increased when it is combined with Mirabegron. |
Mitapivat | The serum concentration of Enfortumab vedotin can be increased when it is combined with Mitapivat. |
Mitotane | The metabolism of Enfortumab vedotin can be increased when combined with Mitotane. |
Morphine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Morphine. |
Naloxone | The serum concentration of Enfortumab vedotin can be increased when it is combined with Naloxone. |
Nefazodone | The serum concentration of Enfortumab vedotin can be increased when it is combined with Nefazodone. |
Nelfinavir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Nelfinavir. |
Neratinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Neratinib. |
Netupitant | The metabolism of Enfortumab vedotin can be decreased when combined with Netupitant. |
Nicardipine | The metabolism of Enfortumab vedotin can be decreased when combined with Nicardipine. |
Nilotinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Nilotinib. |
Nilvadipine | The metabolism of Enfortumab vedotin can be decreased when combined with Nilvadipine. |
Nintedanib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Nintedanib. |
Norgestimate | The serum concentration of Enfortumab vedotin can be increased when it is combined with Norgestimate. |
Nortriptyline | The serum concentration of Nortriptyline can be increased when it is combined with Enfortumab vedotin. |
Omadacycline | The serum concentration of Enfortumab vedotin can be increased when it is combined with Omadacycline. |
Ombitasvir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ombitasvir. |
Osimertinib | The serum concentration of Osimertinib can be increased when it is combined with Enfortumab vedotin. |
Oxetacaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Oxetacaine. |
Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Oxybuprocaine. |
Pacritinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Pacritinib. |
Palbociclib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Palbociclib. |
Paliperidone | The serum concentration of Enfortumab vedotin can be increased when it is combined with Paliperidone. |
Panobinostat | The serum concentration of Panobinostat can be increased when it is combined with Enfortumab vedotin. |
Paritaprevir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Paritaprevir. |
Pazopanib | The serum concentration of Pazopanib can be increased when it is combined with Enfortumab vedotin. |
Peginesatide | The risk or severity of Thrombosis can be increased when Peginesatide is combined with Enfortumab vedotin. |
Pentobarbital | The metabolism of Enfortumab vedotin can be increased when combined with Pentobarbital. |
Phenobarbital | The metabolism of Enfortumab vedotin can be increased when combined with Phenobarbital. |
Phenol | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Phenol. |
Phenytoin | The metabolism of Enfortumab vedotin can be increased when combined with Phenytoin. |
Pibrentasvir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Pibrentasvir. |
Pitolisant | The serum concentration of Enfortumab vedotin can be decreased when it is combined with Pitolisant. |
Pomalidomide | The serum concentration of Pomalidomide can be increased when it is combined with Enfortumab vedotin. |
Ponatinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ponatinib. |
Posaconazole | The serum concentration of Enfortumab vedotin can be increased when it is combined with Posaconazole. |
Pralsetinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Pralsetinib. |
Pramocaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Pramocaine. |
Pravastatin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Pravastatin. |
Prednisolone | The serum concentration of Prednisolone phosphate can be increased when it is combined with Enfortumab vedotin. |
Prilocaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Prilocaine. |
Primaquine | The metabolism of Enfortumab vedotin can be decreased when combined with Primaquine. |
Primidone | The metabolism of Enfortumab vedotin can be increased when combined with Primidone. |
Procaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Procaine. |
Propafenone | The serum concentration of Enfortumab vedotin can be increased when it is combined with Propafenone. |
Proparacaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Proparacaine. |
Propoxycaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Propoxycaine. |
Quinidine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Quinidine. |
Quinine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Quinine. |
Ranolazine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ranolazine. |
Regorafenib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Regorafenib. |
Relugolix | The serum concentration of Enfortumab vedotin can be increased when it is combined with Relugolix. |
Reserpine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Reserpine. |
Revefenacin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Revefenacin. |
Ribociclib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ribociclib. |
Rifampicin | The metabolism of Enfortumab vedotin can be increased when combined with Rifampicin. |
Rifamycin | The metabolism of Enfortumab vedotin can be increased when combined with Rifamycin. |
Rifapentine | The metabolism of Enfortumab vedotin can be increased when combined with Rifapentine. |
Rimegepant | The serum concentration of Enfortumab vedotin can be increased when it is combined with Rimegepant. |
Riociguat | The serum concentration of Enfortumab vedotin can be increased when it is combined with Riociguat. |
Ripretinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ripretinib. |
Ritonavir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ritonavir. |
Rivaroxaban | The serum concentration of Enfortumab vedotin can be increased when it is combined with Rivaroxaban. |
Rolapitant | The serum concentration of Enfortumab vedotin can be increased when it is combined with Rolapitant. |
Romidepsin | The serum concentration of Romidepsin can be increased when it is combined with Enfortumab vedotin. |
Ropivacaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Ropivacaine. |
Sapropterin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Sapropterin. |
Saquinavir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Saquinavir. |
Sarecycline | The serum concentration of Enfortumab vedotin can be increased when it is combined with Sarecycline. |
Satralizumab | The serum concentration of Enfortumab vedotin can be decreased when it is combined with Satralizumab. |
Selexipag | The serum concentration of Enfortumab vedotin can be increased when it is combined with Selexipag. |
Selumetinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Selumetinib. |
Sildenafil | The serum concentration of Enfortumab vedotin can be increased when it is combined with Sildenafil. |
Silodosin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Silodosin. |
Simeprevir | The metabolism of Enfortumab vedotin can be decreased when combined with Simeprevir. |
Simvastatin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Simvastatin. |
Sirolimus | The serum concentration of Sirolimus can be increased when it is combined with Enfortumab vedotin. |
Sitagliptin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Sitagliptin. |
Sofosbuvir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Sofosbuvir. |
Somatrogon | The metabolism of Enfortumab vedotin can be increased when combined with Somatrogon. |
Sorafenib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Sorafenib. |
Sotagliflozin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Sotagliflozin. |
Sotorasib | The serum concentration of Enfortumab vedotin can be decreased when it is combined with Sotorasib. |
St. John’s Wort | The metabolism of Enfortumab vedotin can be increased when combined with St. John’s Wort. |
Stiripentol | The serum concentration of Enfortumab vedotin can be increased when it is combined with Stiripentol. |
Suvorexant | The serum concentration of Enfortumab vedotin can be increased when it is combined with Suvorexant. |
Tacrolimus | The serum concentration of Enfortumab vedotin can be increased when it is combined with Tacrolimus. |
Talazoparib | The serum concentration of Talazoparib can be increased when it is combined with Enfortumab vedotin. |
Tamoxifen | The serum concentration of Enfortumab vedotin can be increased when it is combined with Tamoxifen. |
Tazemetostat | The serum concentration of Enfortumab vedotin can be increased when it is combined with Tazemetostat. |
Technetium | The serum concentration of Enfortumab vedotin can be increased when it is combined with Technetium Tc-99m sestamibi. |
Tegaserod | The serum concentration of Enfortumab vedotin can be increased when it is combined with Tegaserod. |
Telaprevir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Telaprevir. |
Telithromycin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Telithromycin. |
Telotristat ethyl | The serum concentration of Enfortumab vedotin can be decreased when it is combined with Telotristat ethyl. |
Temsirolimus | The serum concentration of Enfortumab vedotin can be increased when it is combined with Temsirolimus. |
Tenofovir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Tenofovir disoproxil. |
Tepotinib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Tepotinib. |
Terfenadine | The serum concentration of Enfortumab vedotin can be increased when it is combined with Terfenadine. |
Tetracaine | The risk or severity of methemoglobinemia can be increased when Enfortumab vedotin is combined with Tetracaine. |
Tezacaftor | The serum concentration of Enfortumab vedotin can be increased when it is combined with Tezacaftor. |
Ticagrelor | The serum concentration of Enfortumab vedotin can be increased when it is combined with Ticagrelor. |
Tipranavir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Tipranavir. |
Tivozanib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Tivozanib. |
Tolvaptan | The serum concentration of Tolvaptan can be increased when it is combined with Enfortumab vedotin. |
Topotecan | The serum concentration of Topotecan can be increased when it is combined with Enfortumab vedotin. |
Toremifene | The serum concentration of Enfortumab vedotin can be increased when it is combined with Toremifene. |
Trastuzumab | The serum concentration of Trastuzumab emtansine can be increased when it is combined with Enfortumab vedotin. |
Trilaciclib | The serum concentration of Trilaciclib can be increased when it is combined with Enfortumab vedotin. |
Trimipramine | The serum concentration of Trimipramine can be increased when it is combined with Enfortumab vedotin. |
Troleandomycin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Troleandomycin. |
Tucatinib | Tucatinib may decrease the excretion rate of Enfortumab vedotin which could result in a higher serum level. |
Ubrogepant | The serum concentration of Ubrogepant can be increased when it is combined with Enfortumab vedotin. |
Umbralisib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Umbralisib. |
Umeclidinium | The serum concentration of Enfortumab vedotin can be increased when it is combined with Umeclidinium. |
Vandetanib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Vandetanib. |
Vardenafil | The serum concentration of Enfortumab vedotin can be increased when it is combined with Vardenafil. |
Velpatasvir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Velpatasvir. |
Vemurafenib | The serum concentration of Enfortumab vedotin can be increased when it is combined with Vemurafenib. |
Venetoclax | The metabolism of Enfortumab vedotin can be decreased when combined with Venetoclax. |
Verapamil | The metabolism of Enfortumab vedotin can be decreased when combined with Verapamil. |
Viloxazine | The metabolism of Enfortumab vedotin can be decreased when combined with Viloxazine. |
Vinblastine | The serum concentration of Vinblastine can be increased when it is combined with Enfortumab vedotin. |
Vincristine | The serum concentration of Vincristine can be increased when it is combined with Enfortumab vedotin. |
Vinflunine | The serum concentration of Vinflunine can be increased when it is combined with Enfortumab vedotin. |
Voclosporin | The serum concentration of Enfortumab vedotin can be increased when it is combined with Voclosporin. |
Vorapaxar | The serum concentration of Enfortumab vedotin can be increased when it is combined with Vorapaxar. |
Voriconazole | The serum concentration of Enfortumab vedotin can be increased when it is combined with Voriconazole. |
Voxilaprevir | The serum concentration of Enfortumab vedotin can be increased when it is combined with Voxilaprevir. |
Zimelidine | The metabolism of Enfortumab vedotin can be decreased when combined with Zimelidine. |
Ziprasidone | The metabolism of Enfortumab vedotin can be decreased when combined with Ziprasidone. |
Zonisamide | The serum concentration of Enfortumab vedotin can be increased when it is combined with Zonisamide. |
Pregnancy and Lactation
US FDA pregnancy category Not Assigned
Pregnancy
This drug can harm a developing fetus. Adequate methods of contraception should be encouraged. Verify negative pregnancy status in females of reproductive potential prior to initiating therapy. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential harm to the fetus. Advise females of reproductive potential to use effective contraception during therapy and for 2 months after. Advise male patients with female partners of reproductive potential to use effective contraception during therapy and for 4 months after. This drug may impair male fertility.
Lactation
Use should be avoided. Excreted into human milk: Unknown Excreted into animal milk. Because of the potential for serious adverse reactions in a breastfed child, advise lactating women not to breastfeed during therapy and for at least 3 weeks after.
How should this medicine be used?
Enfortumab vedotin-ejfv injection comes as a powder to be mixed with liquid and injected intravenously (into a vein) over 30 minutes by a doctor or nurse in a hospital or medical facility. It is usually injected on days 1, 8, and 15 of a 28-day cycle for as long as your doctor recommends that you receive treatment.
Your doctor may delay or stop your treatment with enfortumab vedotin-ejfv injection, or treat you with additional medications, depending on your response to the medication and any side effects that you experience. Talk to your doctor about how you are feeling during your treatment. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
What special precautions should I follow?
Before receiving enfortumab vedotin-ejfv injection,
- tell your doctor and pharmacist if you are allergic to enfortumab vedotin-ejfv injection, any other medications, or any of the ingredients in enfortumab vedotin-ejfv injection. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: clarithromycin (Biaxin); idelalisib (Zydelig); indinavir (Crixivan); ketoconazole (Nizoral); nefazodone; nelfinavir (Viracept); ritonavir (Norvir, in Kaletra); or saquinavir (Invirase); and rifampin (Rimactane). Many other medications may also interact with enfortumab vedotin-ejfv, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had peripheral neuropathy (a type of nerve damage that causes tingling, numbness, and pain in the hands and feet), diabetes or high blood sugar, lung problems, or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or if you plan to father a child. You or your partner should not become pregnant while you are receiving enfortumab vedotin-ejfv injection. Your doctor may perform a pregnancy test to be sure that you are not pregnant before you receive enfortumab vedotin-ejfv injection. If you are female, you should use birth control during your treatment and for 2 months after your final dose. If you are male, you and your female partner should use birth control during your treatment and for 4 months after your final dose. Talk to your doctor about birth control methods that will work for you. If you or your partner become pregnant while receiving enfortumab vedotin-ejfv injection, call your doctor. Enfortumab vedotin-ejfv injection may harm the fetus.
- tell your doctor if you are breastfeeding. You should not breastfeed while you are receiving enfortumab vedotin-ejfv injection and for at least 3 weeks after your final dose.
- you should know that this medication may decrease fertility in men. Talk to your doctor about the risks of receiving enfortumab vedotin-ejfv injection.
- you should know that you may experience hyperglycemia (increases in your blood sugar) while you are receiving this medication, even if you do not already have diabetes. Tell your doctor immediately if you have any of the following symptoms while you are receiving enfortumab vedotin-ejfv injection: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. It is very important to call your doctor as soon as you have any of these symptoms because high blood sugar that is not treated can cause a serious condition called ketoacidosis. Ketoacidosis may become life-threatening if it is not treated at an early stage. Symptoms of ketoacidosis include dry mouth, nausea and vomiting, shortness of breath, breath that smells fruity, and decreased consciousness.
- you should know that this medication may cause dry eyes and other eye problems, which may be serious. Your doctor may tell you to use artificial tears or lubricant eye drops during your treatment with enfortumab vedotin-ejfv.
References