Does Fasting Fog Your Brain or Sharpen It? The Data Might Surprise You
November 5, 2025
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Brand Name :
Tibsovo
(United States) [Available]Synonyms :
Ivosidenib
Class :
Antineoplastics and IDH1 Inhibitor
Brand Name :
Tibsovo
(United States) [Available]Synonyms :
Ivosidenib
Class :
Antineoplastics and IDH1 Inhibitor
Dosage Forms & Strengths   Â
Tablet   Â
250mg   Â
500
mg
Orally
once a day
continue the treatment until disease progression or unacceptable toxicity occurs
patients without disease progression or unacceptable toxicity, given the treatment for up to a minimum of 6 months for clinical response
Safety and efficacy are not establishedÂ
when both drugs are combined, there may be a decreased effect of doravirine by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of fostemsavir by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of lonafarnib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of lorlatinib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of mavacamten by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of pacritinib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
ivosidenib: they may diminish the serum concentration of hormonal contraceptives
ivosidenib: they may diminish the serum concentration of hormonal contraceptives
ivosidenib: they may diminish the serum concentration of hormonal contraceptives
ivosidenib: they may diminish the serum concentration of hormonal contraceptives
when both drugs are combined, there may be an increase in qtc interval  
may enhance the serum concentration of CYP3A4 inhibitors
may diminish the serum concentration of CYP3A4 Inducers
may diminish the serum concentration of Hormonal Contraceptives
when both drugs are combined, there may be an increased effect of ivosidenib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of abemaciclib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of abiraterone by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of acalabrutinib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of ado-trastuzumab emtansine by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of alfentanil by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased QTC interval  
when both drugs are combined, there may be a decreased effect of alpelisib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of alprazolam by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased QTC interval  
when both drugs are combined, there may be a decreased effect of mestranol by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of metaxalone by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased QTC interval  
when both drugs are combined, there may be a decreased effect of methylergonovine by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of methylprednisolone by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased effect of ivosidenib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased effect of saxagliptin by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of ivosidenib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of simvastatin by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of siponimod by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of sirolimus by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased metabolism of ivosidenib    
the ivosidenib interacting with brentuximab has its effect decreased by altering the intestinal or hepatic CYP3A4 enzyme metabolism.
when both drugs are combined, there may be a decreased level of serum concentration of erlotinib  
ivosidenib decreases the effect of ixazomib by altering intestinal/hepatic CYP3A4 enzyme metabolism
both lapatinib and ivosidenib increase the QTc interval
CYP3A strong enhancers of the small intestine may reduce the bioavailability of ivosidenib
ivosidenib decreases the effect of gefitinib by altering the intestinal/ hepatic CYP3A4 enzyme metabolism
it will decrease the impact or level of regorafenib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
it increases the effect or level of ruxolitinib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
it reduces the concentration of CYP3A4 substrates in serum
it decreases the effect or level of dronabinol by altering the intestinal or hepatic metabolism
may decrease the level by affecting hepatic enzyme CYP2C9 metabolism
may decrease the level by affecting hepatic enzyme CYP2C9 metabolism
may decrease the level by affecting hepatic enzyme CYP2C9 metabolism
it decreases by affecting the hepatic enzyme CYP3A4 metabolism
when both drugs are combined, there may be an increased QTC interval  
when both drugs are combined, there may be an increased effect of ivosidenib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased effect of ivosidenib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be a decreased effect of ivosidenib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased effect of ivosidenib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased effect of ivosidenib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased effect of ivosidenib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased effect of ivosidenib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased effect of ivosidenib by affecting hepatic or intestinal enzyme cyp3a4 metabolism 
it may enhance the metabolism when combined with oxcarbazepine
it decreases the concentration of CYP3A4 inducers in serum
it decreases the concentration of CYP3A4 inducers in serum
it decreases the concentration of CYP3A4 inducers in serum
it decreases the concentration of CYP3A4 inducers in serum
it decreases the concentration of CYP3A4 inducers in serum
When acetohexamide is used together with ivosidenib, this lead to rise in acetohexamide’s metabolism
may increase the serum concentration of tamoxifen
the effect of ivosedinib is decreased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism
may reduce the serum levels of CYP3A4 substrates
may reduce the serum levels of CYP3A4 substrates
may reduce the serum levels of CYP3A4 substrates
may reduce the serum levels of CYP3A4 substrates
may reduce the serum concentration of CYP3A4 substrates
it reduces the concentration of CYP3A4 substrates in serum
May enhance the plasma concentration of CYP3A4 substrates
it decreases the concentration of hormonal contraceptives in serum
Actions and spectrum: Â
Ivosidenib inhibits IDH1 mutations, reducing 2-hydroxyglutarate levels and promoting myeloid differentiation in mice.Â
Frequency defined  Â
>10%   Â
Decreased hemoglobin   Â
Fatigue   Â
Edema   Â
Decreased appetite   Â
Leukocytosis  Â
Vomiting   Â
Headache   Â
Chest pain   Â
Increased bilirubin  Â
Increased alanine aminotransferase   Â
Dyspepsia   Â
Decreased weight   Â
<10%   Â
Constipation   Â
Mucositis   Â
Fatigue   Â
Chest pain   Â
Pleural effusion   Â
Diarrhea   Â
Edema   Â
Decreased phosphate   Â
Arthralgia   Â
Hypotension   Â
Rash   Â
Decreased appetite   Â
QT prolongation   Â
Dyspnea   Â
Tumor lysis syndrome  Â
Abdominal pain   Â
<1%  Â
Cough Â
Black box warningÂ
Symptoms of differentiation syndrome may occur that would be fatal if left untreated.Â
Contraindication/Caution: Â
Contraindication: Â
None Â
Caution: Â
Differentiation syndrome Â
Guillain-Barre syndrome Â
Liver disease Â
Pregnancy warnings:    Â
US FDA pregnancy category: Not assigned.  Â
Breastfeeding warnings: Â
The release of the drug into the human breastmilk is unknown  Â
The release of the drug into the animal milk is unknown Â
Pregnancy Categories:      Â
Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first trimester or the later trimester      Â
<b>Category B: No evidence shown of risk to the fetus found in animal reproduction studies, and there are not enough studies on pregnant women      Â
Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for a result in humans must take care of potential risks in pregnant women      Â
Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits      Â
Category X: Drugs listed in this category outweigh risks over benefits Hence these categories of drugs need to be avoided by pregnant women      Â
Category N: There is no data available for the drug under this category   Â
Pharmacology: Â
Ivosidenib is an anti-neoplastic agent that is indicated to treat AML and cholangiocarcinoma. Â
Pharmacodynamics: Â
Ivosidenib is effective against cancers susceptible to a mutation in IDH 1 (isocitrate dehydrogenase 1), which represents raised levels of D-2HG (D-2-hydroxyglutarate) oncometabolite.  Â
Pharmacokinetics: Â
Absorption Â
Ivosidenib is quickly absorbed when taken orally. Â
Distribution Â
In vitro studies suggest that 92-96% of ivosidenib is bound to proteins. Â
The volume of distribution is 234 L. Â
Metabolism Â
Ivosidenib undergoes extensive hepatic metabolism by CYP3A4 through oxidation. Â
Elimination and excretion Â
77% of the drug eliminated through feces, with 67% unchanged. 10% remains unchanged, while 17% is expelled in urine.Â
Half-lifeÂ
93 hours Â
Administration:Â
The medication is taken orally.Â
Patient Information Leaflet  Â
Generic Name: Ivosidenib (Rx) Â
Pronounced: I-voh-SIH-deh-nib Â
Why do we use Ivosidenib?  Â
The isocitrate dehydrogenase-1 (IDH1) inhibitor ivosidenib is authorized for usage in both the United States and Europe.Â
In combination with azacitidine, it is recommended for the treatment of newly diagnosed adult AML patients who have a susceptible IDH1 mutation.Â
It is also indicated to treat locally Advanced or Metastatic Cholangiocarcinoma in adults.Â
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