Microbiome–Nutrition Interactions in Early Life and Their Association With Childhood Systolic Blood Pressure
February 17, 2026
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Brand Name :
Rytelo
Synonyms :
imetelstat
Class :
Telomerase inhibitors
Brand Name :
Rytelo
Synonyms :
imetelstat
Class :
Telomerase inhibitors
Dosage forms and strengths
Lyophilized powder for injection
Single dose vial/188 mg
Single dose vial/47 mg
Administer a dose of 7.1 mg/kg through intravenous route every 4 weeks and infuse over 2 hours
Stop the dose if RBC transfusion does not decrease after 24 weeks of treatment
Safety and efficacy are not established in pediatrics
Actions and Spectrum:
Actions:
Tumor cells are known to exhibit high levels of telomerase activity, which is necessary to divide and replicate cells indefinitely and maintain telomere size and structure.
Imetelstat interferes with this process by inhibiting telomerase, leading to progressive shortening of telomeres, cellular aging, and cell death with a focus on the affected malignant cells.
Frequency defined
>10%
All grades
PTT prolonged (26%)
Fatigue (29%)
ALT increased (43%)
ALP increased (48%)
AST increased (53%)
Neutrophil count decreased (92%)
WBC count decreased (94%)
Platelet count decreased (97%)
Grades 3-4
Neutrophil count decreased (72%)
WBC count decreased (53%)
Platelet count decreased (65%)
1-10%
All grades
Pruritus (6%)
Hematoma (6%)
Epistaxis (7%)
Syncope (7%)
Infusion-related reactions (8%)
Urinary tract infection (9%)
Grades 3-4
Urinary tract infection (2.5%)
Arthralgia/myalgia (2.5%)
Fractures (3.4%)
ALT increased (3.4%)
Other clinically relevant adverse reactions (<5%)
Sepsis
Gastrointestinal hemorrhage
Febrile neutropenia
<1%
Grades 3-4
Headache (0.8%)
AST increased (0.8%)
Black Box Warning
None
Contraindication/Caution:
Contraindication:
None
Caution:
Embryo-fetal toxicity
Infusion-related reactions
Neutropenia
Thrombocytopenia
Pregnancy & breastfeeding:
Pregnancy consideration:
No data is available regarding the administration of the drug during pregnancy.
Breastfeeding warnings:
No data is available regarding the excretion of drugs in breast milk.
Pregnancy category:
Category A: well-controlled and satisfactory studies show no risk to the fetus in the first or later trimester.
Category B: There was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: There was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: Adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence, these categories of drugs need to be avoided by pregnant women.
Category N: No data for the drug under this category is available.
Pharmacology:
Imetelstat is a selective small-molecule inhibitor of telomerase.
Pharmacodynamics:
The pharmacodynamics profile reveals imetelstat’s ability to reduce telomere length and telomerase activity, contributing to anticancer attributes. Based on this mechanism, imetelstat maybe a useful therapy for several types of hematologic malignancies including myelofibrosis and several subtypes of MDS.
Pharmacokinetics:
Absorption
The drug has a peak plasma concentration of 18.3 μM.
Distribution
Imetelstat is highly bound to proteins in the blood (>94%). The volume of distribution of the drug is 14.1 L.
Metabolism
Anticipated to be broken down into nucleotides of different lengths by nucleases
Excretion and elimination
The elimination half-life of the drug is 4.9 hr.
Administration:
The route of administration is intravenous.
Patient information leaflet
Generic Name: imetelstat
Why do we use imetelstat?
Based on the current evaluations, the use of imetelstat has been considered effective as it relieves symptoms through shrinking the size of the spleen in patients diagnosed with myelofibrosis.
It is currently explored in its ability to enhance the hematologic outcomes, as well as decrease the frequency of RBC transfusions for myelodysplastic syndromes; especially in lower risk MDS.
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