futibatinib

20 mg orally daily
Continue till unacceptable toxicity or disease progression occurs

Dose Adjustments

Dosage Modifications
reductions of dose due to adverse effects
reduction of First dosage: 16 mg daily
reduction of Second dosage: 12 mg daily
12 mg/day not tolerated: discontinue permanently
Detachment of the Retinal pigment epithelium (RPED)
Continue at the current dosage and periodic ophthalmic testing
Continue at the current dosage if RPED resolves in less than 14 days.
Resuming at the prior or lower dose, once resolved; delay if f the condition does not resolve in less than 14 days
Hyperphosphatemia
Above 5.5 to below 7 mg/dL of Serum phosphate: Continue the existing dosage while beginning phosphate-lowering medication; monitor serum phosphate on a weekly basis.
Serum phosphate Above 7 to below 10 mg/dL
start or adjust the phosphate-lowering treatment; monitor the serum phosphate on a weekly basis
Reduce dosage to the next level
Continue at this lowered dose if the serum phosphate is below 7 mg/dL within two weeks of the dose reduction.
Reduce the dose even more to the next reduced level if the serum phosphate level is more than 7 mg/dL within two weeks.
If the serum phosphate is greater than 7 mg/dL within two weeks of the second dosage reduction, delay till serum phosphate is less than 7 mg/dL and then restart the prescribed dose.
serum phosphate above 10 mg/dL
Start or modify phosphate-reducing treatment and monitor the serum phosphate on weekly basis.
Restart at the next lower dose once the phosphate level is below 7 mg/dL.
If the serum phosphate is above 7 mg/dL in two weeks after 2 dosage interruptions and reductions, discontinue permanently.
Other adverse effects
Grade 3: delay till toxicity gets resolves to Grade 1 or to baseline
Before suspending, resume the hematologic toxicities that resolves less than a week.
resume for more adverse effects at the next reduced dosage
Grade 4: Discontinue permanently
Renal impairment
Mild and moderate (CrCl 30 to 89 mL/min): dosage adjustment is not necessary
Severe (CrCl 15 to 29 mL/min), renal dialysis in ESRD (CrCl below 15 mL/min): Not known
Hepatic impairment
Mild: dosage adjustment is not necessary
Moderate to severe: Not known