[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Antibody-drug conjugates (ADCs)](https://durgical.com/en/pharmacology/classes/antibody-drug-conjugates/) › Enfortumab vedotin

# Enfortumab vedotin

## ADCs?

Antibody-drug conjugates (ADCs)

## High alert?

An error with this medicine can cause serious harm: double checks and protocols are used.

Anti-Nectin-4 antibody carrying MMAE, for advanced urothelial (bladder) cancer, often with pembrolizumab. Watch skin, blood sugar, nerves and eyes.

Updated Nov 1, 2026

## Quick facts

**Group**
[Antibody-drug conjugates (ADCs)](https://durgical.com/en/pharmacology/classes/antibody-drug-conjugates/)

**Target**
Nectin-4, a cell adhesion protein on urothelial cancer cells

**Used for**
Locally advanced

**Key effects**
Fatigue · Hair loss · Peripheral neuropathy

**Monitor**
Skin at every visit · Blood glucose before each dose

**ATC**
L01FX13

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Clinical What the labels mean

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

The fully human antibody binds Nectin-4, an adhesion molecule highly expressed in urothelial carcinoma. The conjugate is internalised and releases monomethyl auristatin E (MMAE), which disrupts microtubules, stops mitosis and kills the cell.

- The antibody binds Nectin-4 on the urothelial cancer cell
- The conjugate enters the cell
- MMAE is released and disrupts microtubules
- Mitotic arrest and cell death

## Indications

- Locally advanced or metastatic urothelial cancer: with pembrolizumab, or alone after platinum chemotherapy and immunotherapy or when cisplatin cannot be used. [Bladder cancer →](https://durgical.com/en/conditions/bladder-cancer/)

## Adverse effects

### Common

- Fatigue, decreased appetite, weight loss
- Hair loss, dry skin, rash
- Peripheral neuropathy
- Taste changes, nausea, diarrhoea
- Dry eyes

### Serious (rare, important)

- Severe skin reactions, including blistering and peeling (boxed warning)
- Hyperglycaemia and diabetic ketoacidosis, even without prior diabetes
- Pneumonitis
- Peripheral neuropathy with weakness
- Eye disorders (dry eyes, eye pain, vision changes)
- Skin reactions at the infusion site

## Contraindications

- Allergy to the drug
- Caution in diabetes or high blood glucose, pre-existing neuropathy and liver disease

## Key interactions

**Strong CYP3A4 inhibitors**
May raise MMAE exposure and its toxicity.

**Pembrolizumab (combination use)**
Used together on purpose; skin and lung reactions are watched for both drugs.

## What is monitored

- Skin at every visit, especially in the first cycles
- Blood glucose before each dose
- Neuropathy symptoms
- Eye symptoms and dry eyes
- Breathing symptoms (pneumonitis)
- Liver tests

## Administration and safety

- Intravenous infusion only; the infusion site is watched for skin reactions.
- Hazardous drug: prepared and handled with chemotherapy precautions.
- Artificial tears may be recommended to prevent dry eyes.

## Pregnancy and breastfeeding

Can harm the fetus; effective contraception is used during and after treatment, and breastfeeding is avoided.

## Nursing care

- Inspect the skin and mouth before each dose; report rash, blisters or sores.
- Check blood glucose; report thirst, frequent urination or blurred vision.
- Ask about numbness or weakness in the hands and feet, and about eye pain or vision changes.
- Teaching: report any new rash early, use effective contraception, avoid breastfeeding.

## Pharmacokinetics

**Absorption**
Intravenous infusion in cycles.

**Metabolism**
The released MMAE is metabolised mainly by CYP3A4.

## Memory aid

«Enfortumab = Nectin-4 + vedotin»: think «4 S's»: Skin, Sugar, Sensory nerves, Sight.

## Test yourself

Think of the answer, then tap the question to see it.

## Which antigen does enfortumab vedotin bind?

Nectin-4, an adhesion protein highly expressed in urothelial cancer.

## What is the boxed warning of enfortumab vedotin?

Serious, potentially fatal skin reactions.

## Which metabolic problem can enfortumab vedotin cause even in people without diabetes?

Hyperglycaemia, which can progress to diabetic ketoacidosis.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/enfortumab-vedotin/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## What the labels mean

**High alert**
An error with this medicine can cause serious harm: double checks and protocols are used.

## Connections

## Related drugs 2

- [Brentuximab vedotin](https://durgical.com/en/pharmacology/brentuximab-vedotin/)
- [Pembrolizumab](https://durgical.com/en/pharmacology/pembrolizumab/)

## Related conditions 1

- [Bladder cancer](https://durgical.com/en/conditions/bladder-cancer/)

[← Back to the class: Antibody-drug conjugates (ADCs)](https://durgical.com/en/pharmacology/classes/antibody-drug-conjugates/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Enfortumab vedotin-ejfv Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a620005.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Enfortumab Vedotin-ejfv - NCI](https://www.cancer.gov/about-cancer/treatment/drugs/enfortumabvedotin-ejfv) (National Cancer Institute, 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01FX13) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/enfortumab-vedotin/