A few things to help with some common side effects of GAVRETO® (pralsetinib)

We’ve provided some tips that may help if you have side effects while taking GAVRETO. However, make sure to discuss any changes in your diet or daily routine with your doctor.

See the full Patient Information for a full list of side effects here.

If you experience side effects or your symptoms worsen, call your doctor for medical advice. You may also report side effects to FDA MedWatch or call 1-800-FDA-1088.

Tip: Share your side effects with your doctor and use a journal to help keep track and remember.

How should I deal with constipation?¹

Drink more liquids, like water
Eat more fiber (whole grains, vegetables, fruits, beans, and nuts)
Move around more
Talk to your doctor about taking fiber supplements or laxatives

How can I fight tiredness and fatigue?²

Talk to your doctor about how to stay active
Practice mind-body strategies, like meditation
Work with a physical therapist
Talk with a counselor

What can I do if I have muscle and joint pain?^3,4

Get a massage or work with a physical therapist
Talk to your doctor about medicines to treat aches, relax muscles, and reduce pain
Apply heat or cold for joint pain
Try some light exercise
Try relaxation exercises (like deep breathing and meditation)

Is there something I can do about diarrhea?⁵

Avoid caffeine, alcohol, dairy, fatty foods, foods high in fiber, orange juice, prune juice, and spicy foods
Eat small meals and choose foods that are easy to digest, like bananas, rice, applesauce, and toast
Drink water and other clear liquids to prevent dehydration
If your diarrhea is more severe or does not improve, speak with your doctor

How can I manage high blood pressure?⁶

Follow a healthy diet:

Eat vegetables, fruits, white meat, and occasionally fish and low-fat dairy
Eat less red meat and salt
Get regular exercise (like walking, swimming, or riding a bike)
Talk to your doctor about medicines that help control your blood pressure

Though not a known side effect of GAVRETO, anxiety and depression are normal given the changes that are taking place in your life. It’s important to know you’re not alone. Learn more about support groups here.

NEXT: Important Safety Information

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WHAT IS GAVRETO® (pralsetinib)?

GAVRETO is a prescription medicine used to treat certain cancers caused by abnormal rearranged during transfection (RET) genes in:

adults with non-small cell lung cancer (NSCLC) that has spread
adults and children 12 years of age and older with advanced medullary thyroid cancer (MTC) or MTC that has spread who require a medicine by mouth or injection (systemic therapy)
adults and children 12 years of age and older with advanced thyroid cancer or thyroid cancer that has spread who require a medicine by mouth or injection (systemic therapy) and who have received radioactive iodine and it did not work or is no longer working

Your healthcare provider will perform a test to make sure that GAVRETO is right for you.

It is not known if GAVRETO is safe and effective in children younger than 12 years of age.

GAVRETO was approved based on the percentage of patients whose tumor size shrank or disappeared after treatment and how long that response lasted. There are ongoing studies to confirm the benefit of GAVRETO.

IMPORTANT SAFETY INFORMATION

GAVRETO may cause serious side effects, including

Lung Problems: GAVRETO may cause severe or life-threatening inflammation of the lungs during treatment, that can lead to death. Tell your healthcare provider right away if you have any new or worsening symptoms, including shortness of breath, cough, or fever.

High blood pressure (hypertension): High blood pressure is common with GAVRETO and may sometimes be severe. You should check your blood pressure regularly during treatment with GAVRETO. Tell your healthcare provider if you have increased blood pressure readings or get any symptoms of high blood pressure, including confusion, dizziness, headaches, chest pain or shortness of breath.

Liver problems: Liver problems (increased liver function blood test results) can happen during treatment with GAVRETO and may sometimes be serious. Your healthcare provider will do blood tests before and during treatment with GAVRETO to check you for liver problems. Tell your healthcare provider right away if you get any signs or symptoms of liver problem during treatment, including yellowing of your skin or the white part of your eyes (jaundice), loss of appetite, nausea or vomiting, dark “tea-colored” urine, pain on the upper right side of your stomach area, sleepiness, bleeding or bruising.

Bleeding problems: GAVRETO can cause bleeding which can be serious and cause death. Tell your healthcare provider if you have any signs or symptoms of bleeding during treatment, including vomiting blood or if your vomit looks like coffee-grounds, unusual vaginal bleeding, nose bleeds that happen often, pink or brown urine, drowsiness or difficulty being awakened, red or black (looks like tar) stools, confusion, coughing up blood or blood clots, headache, unusual bleeding or bruising of your skin, change in speech, or menstrual bleeding that is heavier than normal.

Tumor lysis syndrome (TLS): TLS is caused by a fast breakdown of cancer cells. TLS can cause you to have kidney failure and the need for dialysis treatment, an abnormal heartbeat, and may sometimes lead to hospitalization. Your healthcare provider may do blood tests to check you for TLS. You should stay well hydrated during treatment with GAVRETO. Call your healthcare provider or get emergency medical help right away if you develop any of these symptoms during treatment with GAVRETO: nausea, shortness of breath, vomiting, muscle cramps, weakness, seizures or swelling.

Risk of wound healing problems: Wounds may not heal properly during treatment with GAVRETO. Tell your healthcare provider if you plan to have any surgery before or during treatment with GAVRETO. You should not take GAVRETO for at least 5 days before surgery. Your healthcare provider should tell you when you may start taking GAVRETO again after surgery.

Before taking GAVRETO, tell your healthcare provider about all of your medical conditions, including if you:

have lung or breathing problems other than lung cancer.
have high blood pressure
have bleeding problems
plan to have surgery
are pregnant or plan to become pregnant. GAVRETO can harm your unborn baby.
Females who are able to become pregnant:
- Your healthcare provider will do a pregnancy test before you start GAVRETO.
- Should use an effective form of non-hormonal birth control (contraception) during treatment with GAVRETO and for 2 weeks after the final dose of GAVRETO.
- Birth control methods that contain hormones (such as birth control pills, injections or transdermal system patches) may not work as well during treatment with GAVRETO.
- Talk to your healthcare provider about birth control methods that may be right for you during this time.
- Tell your healthcare provider right away if you become pregnant or think you might be pregnant during treatment with GAVRETO.
Males with female partners who are able to become pregnant should use effective birth control (contraception) during treatment and for 1 week after your final dose of GAVRETO.
are breastfeeding or plan to breastfeed. It is not known if GAVRETO passes into your breast milk. Do not breastfeed during treatment and for 1 week after your last dose of GAVRETO.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. GAVRETO may affect the way other medicines work, and other medicines may affect how GAVRETO works.

The most common side effects of GAVRETO include: constipation, decreased levels of phosphate in the blood, high blood pressure, decreased levels of calcium in the blood, tiredness, decreased levels of body salt (sodium) in the blood, muscle and joint pain, diarrhea, abnormal liver function blood tests, and decreased white blood cell, red blood cell, and platelet counts.

GAVRETO may affect fertility in males and females, which may affect your ability to have children. Talk to your healthcare provider if this is a concern for you.

These are not all of the possible side effects of GAVRETO. Call your doctor for medical advice about side effects. You are encouraged to report side effects to the FDA. Visit FDA MedWatch or call 1-800-FDA-1088. You may also report side effects to Genentech at 1-888-835-2555.

Please see the full Prescribing Information and Patient Information for GAVRETO.

- American Society of Clinical Oncology. Constipation. https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/constipation. Accessed March 10, 2022.
  
  American Society of Clinical Oncology. Constipation. https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/constipation. Accessed March 10, 2022.
- American Society of Clinical Oncology. Fatigue. https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/fatigue. Accessed March 10, 2022.
  
  American Society of Clinical Oncology. Fatigue. https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/fatigue. Accessed March 10, 2022.
- American Society of Clinical Oncology. Muscle aches. https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/muscle-aches. Accessed March 10, 2022.
  
  American Society of Clinical Oncology. Muscle aches. https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/muscle-aches. Accessed March 10, 2022.
- American Society of Clinical Oncology. Joint pain. https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/joint-pain. Accessed March 10, 2022.
  
  American Society of Clinical Oncology. Joint pain. https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/joint-pain. Accessed March 10, 2022.
- American Society of Clinical Oncology. Diarrhea. https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/diarrhea. Accessed March 10, 2022.
  
  American Society of Clinical Oncology. Diarrhea. https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/diarrhea. Accessed March 10, 2022.
- Siteman Cancer Network. High blood pressure. https://siteman.wustl.edu/treatment/cardio-oncology/high-blood-pressure. Accessed March 10, 2022.
  
  Siteman Cancer Network. High blood pressure. https://siteman.wustl.edu/treatment/cardio-oncology/high-blood-pressure. Accessed March 10, 2022.

A type of cancer treatment that targets specific types of cancer cells.
The most common type of lung cancer, named after the way cancer cells look under a microscope.
A type of cancer that forms in the thyroid and is a less common type of thyroid cancer.
Thyroid cancer that has spread to nearby tissue or distant parts of the body.
A test performed by your healthcare provider to identify the gene(s) that may impact the way a tumor grows, spreads, or reacts to certain treatments.
RET stands for rearranged during transfection, and it’s a type of gene that everyone has within their cells. In specific types of cancer cells, the RET gene is abnormal.
The molecules inside cells that carry genetic information and pass it from one generation to the next.
May be in the form of fusions or mutations; these genes drive the uncontrolled growth of cells, leading to cancer.
RET positive (RET+) stands for rearranged during transfection positive, and the term RET+ is used to describe cancer caused by abnormal RET genes.
A molecule or gene measured in tissue, blood, or other bodily fluids that can help determine the type of disease you have, how aggressive it is, and the best treatment.
Biomarker testing that is performed by your doctor that includes testing for all of the biomarkers recommended by current guidelines.
Standard chemotherapy aims to stop the growth of cancer cells by blocking all rapidly dividing cells. Chemotherapy may be given by mouth, injection, or infusion, or put directly on the skin. This depends on the type and stage of cancer being treated.
A type of cancer treatment that helps your immune system fight cancer.
A type of lung cancer driven by abnormal RET genes that has spread to other parts of the body.
A butterfly-shaped organ that makes hormones to help regulate your heart rate, metabolism, blood pressure, and body temperature.
A substance produced by glands in the body that regulates the activities of different cells and organs.
A type of targeted therapy that targets multiple types of cancer cells.
A type of thyroid cancer driven by abnormal RET genes that has spread to nearby tissue or distant parts of the body.
A type of cancer that forms in the thyroid and is the most common type of thyroid cancer.
A treatment that shrinks or kills thyroid cells. It is used to treat certain types of thyroid cancer.
When cancer spreads to other parts of the body.
A piece of DNA that gives the cells in your body instructions to perform certain functions.
When a gene breaks off and reattaches to another gene.
Any change in a cell’s DNA sequence.
When cancer has spread to other parts of the body.
May be in the form of fusions or mutations; these genes drive the uncontrolled growth of cells that leads to cancer.
All tumors have responded to a treatment and completely disappeared. This does not mean the cancer has been cured.
Tumors have responded to a treatment and shrunk in size by at least 30%.