ivosidenib
Pronunciation:
EYE-voe-SID-e-nib
Other Name(s):
Tibsovo®
Appearance:
tablet
This handout gives general information about this cancer medication.
You will learn:
who to contact for help
what the medication is
how it is given
what to expect while on medication
This handout was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.
This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.
My cancer health care provider is: _____________________________________________
During the day I should contact: _______________________________________________
Evenings, weekends and holidays: _____________________________________________
This page gives general information about this cancer medication.
You will learn:
who to contact for help
what the medication is
how it is given
what to expect while on this medication
This information was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.
This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.
Ivosidenib is used to treat a certain type of blood cancer, called acute myeloid leukemia (AML), and bile duct cancer.
Tell your health care team if you have or had significant medical condition(s), especially if you have / had:
kidney or liver problems,
heart problems (including irregular heartbeat),
too much or too little salt in your body (such as sodium, potassium, calcium or magnesium), or
any allergies.
Ivosidenib tablets contain a small amount of lactose. Tell your health care team if you cannot have lactose.
Remember To:
Tell your health care team about all of the other medications you are taking.
Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
You will have a blood test to check for hepatitis B before starting treatment. See the Hepatitis B and Cancer Medications pamphlet for more information.
This medication is usually taken once a day by mouth. Talk to your health care team about how and when to take your medication.
Take ivosidenib whole, with a full glass of water on an empty stomach, at least one hour before or two hours after eating.
Do not eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. These may increase the quantity of the medication in your blood and increase the side effects.
If you forget to take a dose of your ivosidenib:
If it has been less than 12 hours from the missed dose, take the dose as usual. Then take your next dose at the normal scheduled time.
If it has been longer than 12 hours, do not take the dose. Take your next dose at the normal scheduled time. Do not take extra (double up) to make up for the missed dose.
If you vomit (throw up) after taking your medication, do not take an extra dose. Take your next dose at the normal scheduled time.
Warning: If you take too much of this medication by accident, or if you think a child or a pet may have swallowed your medication, you must call the Ontario Poison Control Center right away at: 1-800-268-9017.
DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.
DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs, or natural health products without checking with your health care team.
DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic medications, without checking with your health care team.
DO NOT use tobacco products (such as smoking cigarettes or vaping) or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
DO NOT drive, operate machinery or do any tasks that need you to be alert if you feel dizzy.
DO NOT eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. These may increase the quantity of the medication in your blood and increase the side effects.
DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.
DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs, or natural health products without checking with your health care team.
DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic medications, without checking with your health care team.
DO NOT use tobacco products (such as smoking cigarettes or vaping) or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
DO NOT drive, operate machinery or do any tasks that need you to be alert if you feel dizzy.
DO NOT eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. These may increase the quantity of the medication in your blood and increase the side effects.
Yes, this medication can interact with other medications, vitamins, foods, traditional medicines and natural health products. Interactions can make this medication not work as well or cause severe side effects.
Tell your health care team about all of your:
- prescription and over-the-counter (non-prescription) medications
- other drugs and substances, such as cannabis/marijuana (medical or recreational)
- natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements, or traditional medicines
Check with your health care team before starting or stopping any of them.
- Anti-inflammatory medications such as ibuprofen (Advil® or Motrin®), naproxen (Aleve®) or Aspirin®.
- Over-the-counter products such as dimenhydrinate (Gravol®)
- Natural health products such as St. John’s Wort
- Traditional medicines
- Supplements such as vitamin C
- Grapefruit juice
- Alcoholic drinks
- Tobacco
- All other drugs or substances, such as marijuana or cannabis (medical or recreational)
Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).
Fever can be a sign of infection that may need treatment right away.
If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.
How to check for fever:
Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain).
You have a fever if your temperature taken in your mouth (oral temperature) is:
38.3°C (100.9°F) or higher at any time
OR
38.0°C (100.4°F) or higher for at least one hour.
If you do have a fever:
Try to contact your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
Ask your health care team for the Fever pamphlet for more information.
If you do not have a fever but have mild symptoms such as headache or mild pain:
- Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
Talk to your health care team before you start taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.
Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.
Talk to your health care team about:
How this treatment may affect your sexual health
How this treatment may affect your ability to have a baby, if this applies to you
This treatment may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.
- If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time until at least 1 month after your last treatment dose. Talk to your health care team about which birth control options are best for you.
This treatment may make hormonal birth control, such as birth control pills, less effective (not work as well). If you choose to use a hormonal birth control, make sure you also use a barrier or non-hormonal birth control method (such as condoms). Talk to your health care team about the best birth control options for you.
Do not breastfeed while on this treatment and for at least 1 month after your last dose.
Keep ivosidenib tablets in the original packaging at room temperature in a dry place, away from heat and light.
Keep out of sight and reach of children and pets.
Do not throw out any unused ivosidenib tablets at home. Bring them to your pharmacy to be thrown away safely.
If you are a patient:
Wash your hands before and after touching your oral anti-cancer medication.
Swallow each pill whole. Do not crush or chew your pills.
If you are a caregiver:
Wear nitrile or latex gloves when touching tablets, capsules or liquids.
Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
Throw out your gloves after each use. Do not re-use gloves.
Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.
If medication gets on your skin:
Wash your skin with a lot of soap and water.
If your skin gets red or irritated, talk to your health care team.
If medication gets in your eyes:
Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.
The following table lists side effects that you may have when getting ivosidenib. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.
Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on ivosidenib.
| Less Common Side Effects (10 to 24 out of 100 people) | |
| Side effects and what to do | When to contact health care team |
Diarrhea What to look for?
What to do? If you have diarrhea:
| Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day). |
Nausea and vomiting (Generally mild) What to look for?
To help prevent nausea:
If you have nausea or vomiting:
| Contact your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours. |
Fatigue What to look for?
Ask your health care team for the Fatigue pamphlet for more information. | Talk to your health care team if it does not improve or if it is severe. |
Low neutrophils (white blood cells) in the blood (neutropenia) When neutrophils are low, you are at risk of getting an infection more easily. Ask your health care team for the Neutropenia (Low white blood cell count) pamphlet for more information. What to look for?
You have a fever if your temperature taken in your mouth (oral temperature) is:
What to do? If your health care team has told you that you have low neutrophils:
If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away. | If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you MUST get emergency medical help right away. |
Low platelets in the blood When platelets are low, you are at risk for bleeding and bruising. Ask your health care team for the Low Platelet Count pamphlet for more information. What to look for?
What to do? If your health care team has told you that you have low platelets:
If you have signs of bleeding:
If you have bleeding that does not stop or is severe (very heavy), you must get emergency medical help right away. | Talk to your health care team if you have any signs of bleeding. If you have bleeding that doesn’t stop or is severe, you MUST get emergency medical help right away. |
Differentiation syndrome What to look for?
What to do?
| If you have any symptoms of differentiation syndrome, try to contact your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away.
|
Pains or cramps in the belly What to look for?
What to do?
| Talk to your health care team if it does not improve or if it is severe. |
Higher than normal white blood cells in the blood
What to look for?
What to do?
Talk to your health care team right away if you have any severe symptoms. If you are unable to talk to the team for advice, you must get emergency medical help right away. | Talk to your health care team right away if you have any severe symptoms. If you are unable to talk to the team for advice, you must get emergency medical help right away. |
Other rare, but serious side effects are possible with this treatment.
If you have any of the following, talk to your cancer health care team or get emergency medical help right away:
irregular heartbeat, chest pain or fainting spells
new pain, numbness or tingling of your hands or feet; having trouble doing tasks (like doing up buttons, writing, walking)
bloating, feeling of fullness or swelling of the belly, unusual weight gain (seen in patients with bile duct cancer)
yellowish skin or eyes, unusually dark pee or pain on the right side of your belly (seen in patients with bile duct cancer)
For more information on how to manage your symptoms ask your health care provider, or visit: https://www.cancercareontario.ca/symptoms.
September 2025 New information sheet
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.