If you’re looking at treatment options for a kind of cancer called acute myeloid leukemia (AML), your doctor might prescribe Idhifa for you. It’s a prescription medication that’s used in adults with certain types of AML.

Idhifa comes as tablets that you swallow. The active ingredient in Idhifa is enasidenib. (An active ingredient is what makes a drug work.)

This article mainly focuses on Idhifa’s side effects. For more information about Idhifa, including dosages and how it’s used, see this in-depth article on the drug.

Like other drugs, Idhifa can cause mild to serious side effects. Keep reading to learn more.

Like other drugs, Idhifa can cause side effects. Examples of Idhifa’s commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below.

The following sections contain more information about Idhifa’s side effects.

Some people may experience mild to serious side effects during their Idhifa treatment. Examples of mild side effects that have been reported with Idhifa include:

In most cases, some of these side effects are easily managed and should be temporary. But if you have symptoms that are bothersome or ongoing, talk with your doctor or pharmacist. And don’t stop using Idhifa unless your doctor recommends it.

Idhifa may cause mild side effects other than the ones listed above. See the Idhifa prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Idhifa, visit MedWatch.

* To learn more about this side effect, see the “Side effects explained” section below.

Some side effects of Idhifa can be serious. Serious side effects that have been reported with Idhifa include:

If you develop serious side effects while taking Idhifa, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* Idhifa has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.
† To learn more about this side effect, see the “Side effects explained” section below.
‡ An allergic reaction is possible after using Idhifa. But this side effect wasn’t reported in studies.

Get answers to some frequently asked questions about Idhifa’s side effects.

Is Idhifa treatment sometimes stopped due to side effects?

It’s possible. Your doctor will likely stop your Idhifa treatment temporarily if you have serious side effects such as differentiation syndrome, leukocytosis, or a large increase in your level of bilirubin (a byproduct of red blood cells breaking down).

In studies, some people taking Idhifa stopped their treatment due to side effects. The most common side effect that led to permanently stopping Idhifa was leukocytosis. (This serious condition occurs when your white blood cell count rises.)

After your serious side effects have been treated, you’ll likely be able to restart your Idhifa treatment. Your doctor may lower your dose to help prevent serious side effects from returning. If your serious side effects do return, your doctor will likely have you stop taking Idhifa permanently. They can suggest other drugs that may be better options for you.

Talk with your doctor right away if you have symptoms of serious side effects during your Idhifa treatment. See the “Side effects explained” section below for more information on some of Idhifa’s serious side effects and symptoms to watch for.

Should I take another dose of Idhifa if I vomit shortly after taking the drug?

Yes, then take your dose the next day as usual. But if you aren’t feeling well enough to take another dose of Idhifa soon after vomiting, you can wait until your next scheduled dose the following day.

If you’re unsure when to take another Idhifa dose after vomiting, call your doctor or pharmacist.

Vomiting is common side effect of Idhifa. If your vomiting doesn’t away or if you’re regularly vomiting shortly after taking a dose of Idhifa, talk with your doctor right away.

Does Idhifa cause long-term side effects?

It isn’t known if Idhifa causes long-term side effects. But the drug does cause some serious side effects that may cause long-term problems such as organ damage if not treated right away. In some cases, these serious side effects could even be fatal.

Some examples of these serious side effects include:

  • differentiation syndrome (a condition that happens when cancer cells release certain proteins into your blood)
  • high levels of bilirubin (a byproduct of red blood cells breaking down)
  • tumor lysis syndrome (a condition caused by rapidly dying cancer cells releasing their contents into your body)

If you’re concerned about your risk of serious side effects with Idhifa, talk with your doctor. And see the “Side effects explained” section below for more information on some of Idhifa’s serious side effects.

Does Idhifa affect fertility?

It’s possible that Idhifa could reduce fertility (the ability to conceive a child) in both males and females.* It’s not known whether fertility problems caused by this drug are reversible after you stop treatment.

If you have questions or concerns about your fertility while taking Idhifa, talk with your doctor before starting treatment.

* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Learn more about some of the side effects Idhifa may cause.

Differentiation syndrome (DS)

Idhifa has a boxed warning for DS. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

DS is a condition that happens when leukemia cells release certain proteins into your blood. These proteins cause a reaction in your body that lead to the symptoms of DS. These symptoms may include:

DS typically occurs from 1 day up to 5 months after your first dose of Idhifa. This is a serious common side effect that can lead to severe problems, such as acute (sudden) kidney failure. DS can be fatal if not treated quickly. If you’re concerned about your risk of DS from Idhifa, talk with your doctor.

What might help

While taking Idhifa, tell your doctor right away if you have any symptoms of DS. During your treatment, you may also have certain lab tests done to check for any problems that could occur with DS. For example, you may have kidney function tests done to check for acute kidney failure.

If you develop DS, your doctor will treat it with a corticosteroid drug such as dexamethasone. You may need to stay in a hospital, depending on how severe your condition is. When your symptoms have been relieved to a certain degree, you may be able to restart your Idhifa treatment.

If you have concerns about developing differentiation syndrome while taking Idhifa, talk with your doctor.

Nausea and vomiting

Nausea and vomiting can occur during Idhifa treatment. In studies, digestive side effects (such as nausea vomiting, and diarrhea) were the most commonly reported side effects in people taking Idhifa.

What might help

If you experience nausea and vomiting while taking Idhifa, talk with your doctor. To ease your symptoms and prevent dehydration, they may recommend you slowly sip certain liquids and eat non-greasy, low-sugar meals. Eating small meals and drinking liquids such as peppermint tea, ginger drinks, and water may help your nausea and vomiting.

If your nausea or vomiting gets worse or becomes too bothersome, talk with your doctor.

Leukocytosis

Leukocytosis is a possible side effect of Idhifa. This serious condition occurs when your white blood cell count rises. This happens because of the way Idhifa works to treat acute myeloid leukemia (AML).

Leukocytosis may not cause symptoms. For this reason, your doctor will order blood tests to check for this side effect. You’ll also have your white blood cell count tested before you start taking Idhifa to compare with your later tests.

What might help

Because leukocytosis may not cause any symptoms, you’ll have blood tests done during your Idhifa treatment to check for this condition.

If you develop leukocytosis while taking Idhifa, you may need to take hydroxyurea (Droxia, Hydrea, Siklos) to help lower your white blood cell count. Your doctor may have you stop taking Idhifa temporarily if hydroxyurea doesn’t lower your levels enough.

Once your white blood cell count returns to a normal range, your doctor may have you restart your Idhifa treatment at the same dose you took before.

Tumor lysis syndrome (TLS)

TLS can occur with Idhifa use. See Idhifa’s prescribing information for how often this side effect occurred in people taking the drug.

With TLS, a large number of tumor cells quickly die and release their contents into the blood as they break apart. This can lead to high blood levels of uric acid and certain electrolytes, such as potassium, phosphate, and calcium. And if left untreated, TLS could damage organs such as the heart, kidney, and liver.

Symptoms of TLS may include:

  • nausea, vomiting, or diarrhea
  • lower amounts of urine than normal
  • muscle cramps, spasms, or weakness
  • tiredness
  • feeling irritable or restless
  • tingling or numbness

What might help

While you’re taking Idhifa, tell your doctor right away if you have symptoms of TLS. Your doctor will likely stop your Idhifa treatment if you develop this condition. You may need to receive treatment in a hospital, where you’ll be given intravenous (IV) fluids or other medications. Once your TLS has been treated, you may be able to restart your Idhifa treatment at a lower dose.

You’ll have blood tests done to check your levels of uric acid and electrolytes before you start Idhifa. You’ll have them checked again about every 2 weeks for the first 3 months of your treatment. These tests allow your doctor to watch for possible signs of TLS.

Also, you should drink plenty of liquids during your treatment. Staying hydrated can help lower your risk of TLS.

If you have concerns about your risk of tumor lysis syndrome, talk with your doctor.

High levels of bilirubin

Taking Idhifa can cause increased levels of bilirubin. This was a common side effect of Idhifa seen in studies of the drug.

Bilirubin is a byproduct of red blood cells breaking down. Having high levels may mean there’s a problem with your liver. Or it may be caused by red blood cells being destroyed more quickly than usual. In studies, most people taking Idhifa who had high bilirubin did not show signs of liver problems.

What might help

You’ll have blood tests done regularly during your Idhifa treatment to check for high levels of bilirubin.

If your test results show your levels are too high, your doctor may decrease your Idhifa dose. In some cases, they may have you stop taking Idhifa until your bilirubin levels return to a safe level.

The main symptom of high bilirubin levels is jaundice (yellowing of your skin or the whites of your eyes). If you have jaundice, your doctor may order a blood test to see if your bilirubin level has risen. And they may adjust your Idhifa dose, depending on your level of bilirubin.

To learn more about your risk of high bilirubin levels from Idhifa, talk with your doctor.

Allergic reaction

Like most drugs, Idhifa can cause an allergic reaction in some people. But this side effect wasn’t reported in studies.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an over-the-counter oral antihistamine, such as Benadryl (diphenhydramine)
  • a topical product, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Idhifa, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Idhifa, they may have you switch to a different treatment.

Keeping track of side effects

During your Idhifa treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Idhifa affects you. They can then use this information to adjust your treatment plan if needed.

Idhifa has some serious warnings. Discuss your health history and these warnings with your doctor before you start taking Idhifa.

Boxed warning: Risk of differentiation syndrome

Idhifa has a boxed warning for the risk of differentiation syndrome. This condition happens when cancer cells release certain proteins into your blood. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

To learn more about this warning, see the “Side effects explained” section above.

Other warnings

Idhifa may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before starting Idhifa. Below are factors to consider.

Allergic reaction. If you’ve had an allergic reaction to Idhifa or any of its ingredients, your doctor will likely not prescribe Idhifa. Allergic reaction wasn’t reported in studies, but it can happen. Ask your doctor what other medications are better options for you.

Alcohol use and Idhifa

It should be safe to drink alcohol while taking Idhifa. But alcohol may make certain side effects of the drug worse. These include nausea, vomiting, and diarrhea.

If you drink alcohol, talk with your doctor about an amount that may be safe for you to drink during your Idhifa treatment.

Pregnancy and breastfeeding while taking Idhifa

Idhifa is not safe to take during pregnancy. This is because the drug could cause harm to a fetus.

If you’re able to become pregnant, your doctor will have you take a pregnancy test before you start taking Idhifa. You’ll also need to use birth control during your Idhifa treatment and for at least 2 months after your last dose. If you’re pregnant or planning to become pregnant, talk with your doctor before taking Idhifa.

It’s not known whether it’s safe to take Idhifa while breastfeeding. But taking the drug while breastfeeding could cause side effects in a breastfed child. Due to this risk, your doctor will likely recommend that you do not breastfeed during your Idhifa treatment and for up to 2 months after your last dose. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.

Like other drugs, Idhifa causes side effects. The common side effects are mostly mild and are usually temporary or go away over time. To feel confident about your Idhifa treatment, ask your doctor questions about possible side effects. Below are some questions to help get the conversation started.

  • Will my side effects worsen if I don’t take Idhifa with food?
  • Could other drugs worsen my side effects if taken with Idhifa?
  • Does the risk for Idhifa’s side effects increase with age?
  • If I also have other health conditions, does that raise my risk of side effects from Idhifa?

Q:

Does Idhifa have different side effects than chemotherapy drugs?

Anonymous

A:

Yes, different types of cancer treatments can cause different side effects.

Idhifa is a kind of targeted cancer therapy. This means that it works by targeting certain parts of cancer cells to stop them from growing. Targeted therapies are less likely than chemotherapy drugs to damage healthy cells, which also means they can cause fewer side effects.

Common side effects of Idhifa include:

  • nausea and vomiting
  • diarrhea
  • decreased appetite
  • increased level of bilirubin (a byproduct of red blood cells breaking down)

Some common side effects of chemotherapy drugs include:

To learn more about the differences between targeted cancer therapy and chemotherapy, talk with your doctor.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.