Decnupaz (pivekimab sunirine-pvzy) is a targeted cancer medicine used to treat a rare blood cancer called blastic plasmacytoid dendritic cell neoplasm (BPDCN).
Like other cancer treatments, Decnupaz can cause side effects. Some are common and can be managed, while others can become serious and require medical treatment. Decnupaz can also interact with certain medicines.
Keep reading to learn about possible Decnupaz side effects, ways to manage them, and which medicines may interact with Decnupaz.
This article does not include every possible side effect or interaction. Tell your health care provider about any new or worsening symptoms during treatment, even if they are not listed here.
Decnupaz Side Effects
Common side effects
The most common side effects reported with Decnupaz include:
- Fluid buildup or swelling
- Tiredness
- Muscle, bone, or joint pain
- Bleeding
- Reactions during or after infusion
- Nausea
- Diarrhea
Serious side effects
Decnupaz can sometimes cause serious or life-threatening side effects, such as allergic reactions or severe reactions during or after infusion.
Also, Decnupaz has a boxed warning for serious liver problems, including a condition in which small blood vessels in the liver become blocked. This can be life-threatening. See below for more details.
If you think you may be having a serious side effect, contact your health care provider or seek medical care right away.
How to Manage Decnupaz Side Effects
The following information can help you identify and manage some of the possible side effects of Decnupaz.
1. Liver problems
Rarely, Decnupaz can cause liver damage, including a serious condition called veno-occlusive disease. With this condition, small blood vessels in the liver become blocked. Severe and fatal liver damage has occurred in people treated with Decnupaz, including some who later received a stem cell transplant.
Contact your health care provider right away if you notice possible signs of liver problems, such as:
- Yellowing of your skin or eyes
- Dark urine
- Pain or swelling in your abdomen
- Fast weight gain
- Fever
- Weakness or unusual tiredness
- Itching
- Loss of appetite
Your health care provider will check your liver with blood tests before each Decnupaz dose and during treatment. Keep all appointments for these tests. Your next dose may need to be delayed if your liver tests are abnormal. Decnupaz must be stopped if you have veno-occlusive disease.
2. Infusion reactions
Decnupaz can cause a reaction during or shortly after an infusion. In the main clinical trial, infusion reactions occurred in about 26% of people treated with Decnupaz. Most of these reactions happened during or after the first infusion.
Symptoms may include:
- Shortness of breath
- Flushing
- Fever or chills
- Nausea or vomiting
- Chest pain
- Feeling lightheaded or dizzy
- Fast heartbeat
To lower the chances of a reaction, you may receive medicines before each infusion. Your health care team will also watch you closely for any reactions during and after the infusion. You will be monitored for at least one to four hours after each infusion.
Tell your health care team if you notice symptoms during your infusion. They may pause the infusion, slow it down, or give you treatment for the reaction. A severe reaction may require you to stop taking Decnupaz.
3. Fluid buildup
Decnupaz can cause your body to hold extra fluid, also called fluid retention or edema. Fluid retention occurred in about half of people treated with Decnupaz in the clinical trial. Some cases were severe.
Contact your health care provider if you notice fluid retention. It may look like swelling or puffiness in your legs, ankles, or feet. Other symptoms may include unusual weight gain or shortness of breath.
Your health care provider may prescribe a water pill, also called a diuretic, to help your body get rid of extra fluid. Depending on how severe the swelling is, they may delay, lower, or stop your Decnupaz dose.
4. Nausea
In studies, nausea affected about 24% of people who took Decnupaz.
Nausea means feeling like you might throw up, but it doesn’t always lead to vomiting.
Tips to help prevent or ease nausea:
- Eat smaller meals more often instead of a few large meals.
- Choose bland, easy-to-digest foods such as crackers, toast, or broth.
- Avoid foods that are greasy, spicy, or have strong smells, as they may worsen nausea.
- Sip fluids throughout the day to help prevent dehydration.
Tell your health care provider if nausea is severe, does not improve, or makes it hard to eat and drink. They may prescribe medicine to help control nausea.
5. Diarrhea
Diarrhea occurred in about 21% of people treated with Decnupaz in studies. Symptoms may include loose or watery stools, stomach cramps, and an urgent need to use the bathroom.
Mild diarrhea often improves on its own within a short time, but these tips can help manage it:
- Drink plenty of fluids to help replace what you lose.
- Choose soft, bland foods, such as applesauce, bananas, or toast.
- Ask your health care provider if taking an over-the-counter medicine for diarrhea is safe for you.
Contact your health care provider if you have severe or ongoing diarrhea and signs of dehydration, such as dizziness or very little urine.
Decnupaz Interactions
Decnupaz can interact with certain medicines. An interaction happens when a substance changes how a medicine works or affects the body.
Decnupaz is an antibody-drug conjugate, which means it uses an antibody to carry an anticancer drug to BPDCN cells. The anticancer part, called FGN849, is broken down in the body by an enzyme called CYP3A. Some medicines can slow this process, causing more FGN849 to stay in the body, which may increase the risk of Decnupaz side effects.
Certain medicines, known as strong or moderate CYP3A inhibitors, can slow the CYP3A enzyme. This can result in higher-than-expected levels of FGN849 (the drug part of Decnupaz) in your body.
Some examples of medicines that may interact with Decnupaz in this way include:
- Erythromycin
- Diltiazem
- Fluconazole
- Itraconazole
- Ritonavir
- Verapamil
If you need to take one of these types of medicines, your health care provider may monitor you more closely for Decnupaz side effects. Or they may switch you to a different medicine that is less likely to interact with Decnupaz.
This is not a full list of interactions. Tell your health care provider and pharmacist about any prescription and over-the-counter medicines, vitamins, and supplements you use before you start Decnupaz. Do not start or stop a medicine or supplement during Decnupaz treatment without checking with your health care provider first.
FAQs: Decnupaz Interactions
Does Decnupaz interact with birth control pills?
Decnupaz isn’t known to interact with birth control. In fact, preventing pregnancy during treatment is especially important because Decnupaz can harm a fetus.
- If you can become pregnant, your health care provider will test you for pregnancy before you start Decnupaz. You should use effective birth control during treatment and for seven months after your last dose.
- If you are male and have a partner who can become pregnant, you should use effective birth control during treatment and for four months after your last dose.
Ask your health care provider which birth control methods are good options for you.
Does Decnupaz interact with supplements?
The labeling for Decnupaz does not list any specific interactions with supplements. However, some supplements can affect how medicines are broken down in the body.
Tell your health care provider and pharmacist about any vitamins, herbs, or other supplements you take. Check with them before starting a new supplement during Decnupaz treatment.
Reducing Your Risk of Side Effects and Interactions
You can help lower your risk of problems by following your Decnupaz treatment plan and keeping all follow-up appointments.
Helpful tips include:
- Tell your health care provider if you have liver or kidney problems, asthma, or an allergy to sulfites before starting treatment.
- Make sure your health care provider and pharmacist know about all prescription drugs, over-the-counter medicines, vitamins, and supplements you use.
- Keep all your appointments for blood tests and monitoring.
- Tell your health care provider about any new or worsening swelling, weight gain, stomach problems, or other symptoms that concern you.
Your health care provider may delay or lower your Decnupaz dose or stop treatment if you have certain side effects. They can also recommend treatments to help manage some side effects.
