A targeted tablet for some types of acute myeloid leukaemia
Glasdegib
A targeted daily tablet used, with low-dose chemotherapy, for some adults with acute myeloid leukaemia.
What is Glasdegib?
Glasdegib is a specialist cancer tablet used for some adults with acute myeloid leukaemia (a cancer of the white blood cells), usually for people who cannot have intensive chemotherapy. It works by blocking a signalling pathway called the hedgehog pathway that helps leukaemia cells survive and grow, and it is taken together with low-dose chemotherapy. Important safety points are that it can affect the heart's electrical rhythm (the QT interval), it commonly causes muscle spasms, and it can seriously harm an unborn baby, so reliable contraception is essential and men must not donate blood or semen during treatment and for a time afterwards.
Education and reference only. This is a plain-language guide to Glasdegib — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Glasdegib is a targeted cancer medicine, taken by mouth, used for some adults with acute myeloid leukaemia, a cancer of the blood and bone marrow. It is mainly used for people who are not able to have intensive chemotherapy, and it is given together with a low-dose chemotherapy medicine. It belongs to a group of treatments that block the hedgehog signalling pathway, which leukaemia cells can use to keep themselves alive. It is prescribed and supervised by a haematology team, with regular checks of blood tests and the heart.
How it works
Leukaemia cells can switch on a set of signals called the hedgehog pathway, which helps them survive and resist treatment. Glasdegib blocks a key part of this pathway, making it harder for the leukaemia cells to keep going. It is used alongside low-dose chemotherapy so the two work together against the cancer. Because the hedgehog pathway is also important in healthy tissues, including in a developing baby and in muscle, this explains some of its main effects, such as muscle spasms and the serious risk it poses in pregnancy.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist oral medicine used in UK cancer centres for some adults with acute myeloid leukaemia who cannot have intensive chemotherapy.
Practical use
How to take Glasdegib
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth once a day, at about the same time, swallowing the tablet whole as your team advises.
- Take it together with the low-dose chemotherapy and on the schedule your haematology team has planned.
- Use reliable contraception during treatment and for as long as advised; men should use condoms and must not donate blood or semen.
- Tell your team about any heart-rhythm problems and any other medicines that can affect the heart's rhythm.
- Report muscle spasms that are troublesome, and any fever, unusual bruising or bleeding, to your team.
Weighing it up
Advantages & disadvantages of Glasdegib
Advantages
- A targeted oral option, taken with low-dose chemotherapy, for some people who cannot have intensive chemotherapy.
- Blocks a signalling pathway that leukaemia cells rely on.
- Taken as a once-daily tablet at home, with specialist monitoring.
Disadvantages
- Can affect the heart's rhythm (the QT interval), needing heart and blood-salt monitoring.
- Commonly causes muscle spasms, taste changes, hair thinning and tiredness.
- Can seriously harm an unborn baby, with strict contraception rules and restrictions on donating blood and semen.
Practical use
Good to know
Two safety points stand out with glasdegib. First, it can affect the heart's electrical rhythm by lengthening the QT interval, which can rarely cause dangerous heartbeats, so the heart's tracing and blood salts such as potassium are checked, and care is taken with other medicines that do the same. Second, it can seriously harm an unborn baby, so reliable contraception is essential during treatment and for a time afterwards; importantly, because the medicine can pass into semen, men should use condoms and must not donate blood or semen during treatment and for a period after stopping. A very common day-to-day effect is muscle spasms and aches, along with changes in taste, hair thinning and tiredness. As with other leukaemia treatments, blood counts can fall, so fevers, bruising or bleeding should be reported. The team will explain how to take it consistently and what to watch for.
Who should not take it / use with caution
- People who have had a serious allergic reaction to glasdegib should not take it.
- It must not be used in pregnancy because it can seriously harm the baby, and it is avoided while breastfeeding.
- It is used with great caution in people with heart-rhythm problems or those on other medicines that affect the QT interval.
Monitoring
- Heart tracing (ECG) and blood salts such as potassium, to watch the QT interval.
- Regular blood tests to check blood counts and general health.
- Reviewing muscle symptoms and how well the treatment is being tolerated.
Side effects
- Muscle spasms, muscle and joint aches, and tiredness.
- Changes in taste, reduced appetite, nausea and hair thinning.
- A fall in blood counts, leading to infections, bruising or bleeding.
- Less commonly, changes in the heart's rhythm (the QT interval), which monitoring is designed to catch.
Key interactions
- Other medicines that affect the heart's QT interval can add to the risk, so these are reviewed carefully.
- Some medicines can raise or lower glasdegib levels, so a full medicines list is important.
- Tell your team about all your medicines, including anything from a pharmacy or herbal products.
Available as: Tablets taken by mouth.
Answers
Glasdegib: frequently asked questions
What is glasdegib used for?
It is used, together with low-dose chemotherapy, for some adults with acute myeloid leukaemia who cannot have intensive chemotherapy, by blocking the hedgehog signalling pathway.
Why does it affect the heart?
It can lengthen the heart's QT interval, which can rarely cause dangerous rhythms, so your heart tracing and blood salts are checked and other QT-affecting medicines are reviewed.
Why can't men donate blood or semen?
The medicine can pass into semen and seriously harm an unborn baby, so men must use condoms and must not donate blood or semen during treatment and for a time afterwards.
Why do I get muscle spasms?
Muscle spasms and aches are a very common effect because the pathway it blocks is also active in muscle; tell your team if they become troublesome.
Can I take it in pregnancy?
No. It can seriously harm an unborn baby, so it must not be used in pregnancy and reliable contraception is essential during treatment and for a time afterwards.
Authoritative sources
- BNF
- NICE CKS
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