Cholangiocarcinoma, locally advanced or metastatic

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Cholangiocarcinoma, locally advanced or metastatic

• Oral: 13.5 mg daily on days 1 to 14 out of every 21 days until disease progression or unacceptable toxicity

Available as 4.5, 9, and 13.5 mg tablets. Tablets should NOT be crushed or broken. Store at room temperature.

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Fibroblast growth factor receptor (FGFR) kinase inhibitor

Take with or without food

If a dose is missed, patients should be instructed to take it as soon as they can if it is within 4 hours of the missed dose. If it is over 4 hours since the missed dose, patients should skip the missed dose and resume with the next scheduled dose.

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Common: Alopecia, Nail disease, Electrolyte imbalances (magnesium, phosphate, sodium, calcium, potassium), notably hyperphosphatemia, Constipation, Diarrhea, Decreased appetite, Nausea, Stomatitis, Taste alterations, Dry mouth, Skin rash, Dry skin, Decreased hemoglobin, Dry eyes, Fatigue, Increased serum creatinine.

Less Common: Abdominal pain, Peripheral edema, Hand-foot skin reaction, Weight loss, Vomiting, Dizziness, Headache, Urinary tract infections, Ocular toxicities, including Central serous retinopathy/retinal pigment epithelial detachment (CSR/RPED), Fever, Arthralgia, Nose bleeds.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC & differential, platelets, creatinine, sodium, potassium, magnesium, calcium, phosphate, hemoglobin, ophthalmological exam.

During treatment: CBC & differential, platelets, creatinine, sodium, potassium, magnesium, calcium, phosphate, hemoglobin, ophthalmological exam.

• Serum phosphate should be measured at baseline and then again 14 days after initiation, then every 2 cycles thereafter or as clinically indicated. Monitoring frequency may increase if hyperphosphatemia occurs.
• Ophthalmological exam should be performed at baseline, then every two months for the first 6 months, then every 3 months thereafter or as clinically indicated. Monitoring frequency may increase if ocular toxicity occurs.

• This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
• Avoid grapefruit, grapefruit juice, Seville oranges, or Seville orange juice.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Pemigatinib can significantly impact serum phosphate levels. Patients should be educated on lower phosphate dietary intake.
• Ocular toxicities can commonly occur with pemigatinib, and can range from severe (Central serous retinopathy/retinal pigment epithelial detachment (CSR/RPED)) to less severe (dry eyes, blurred vision).

Lexicomp. Pemazyre Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Accessed Nov 4th, 2025.

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Incyte Corporation. Pemazyre Product Monograph. In: Health Canada, Drug Product Database. Available at: /https://pdf.hres.ca/dpd_pm/00062968.PDF Updated September 8th, 2021. Accessed Nov 6th, 2025.

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