Glasdegib
Hedgehog pathway inhibitors
Hedgehog pathway inhibitorsHigh alert
An error with this medicine can cause serious harm: double checks and protocols are used.Pregnancy: avoid
Avoid in pregnancy. Glasdegib can cause embryo-fetal death or severe birth defects: a pregnancy test is done first, contraception is used during and for a month after treatment…
An oral Smoothened blocker used with low-dose cytarabine for newly diagnosed AML in older or unfit adults. Watch the QT interval.
Quick facts
- Group
- Hedgehog pathway inhibitors
- Target
- Smoothened (SMO) receptor
- Used for
- Newly diagnosed acute myeloid leukaemia
- Key effects
- Muscle spasms · Fatigue · Taste change
- Monitor
- ECG and electrolytes · Complete blood count
- ATC
- L01XJ03
No doses: the clinician sets them by the current guideline.
Mechanism of action
No structure with glasdegib was found. The figure shows vismodegib, another Smoothened inhibitor, in the same transmembrane pocket of human Smoothened.
Leukaemia stem cells use Hedgehog signalling to survive and resist chemotherapy. Glasdegib binds Smoothened and turns the pathway off, which makes the leukaemic cells more sensitive to low-dose cytarabine.
- Glasdegib binds Smoothened (SMO)
- Hedgehog signals in leukaemia stem cells stop
- Low-dose cytarabine kills them more easily
Indications
- Newly diagnosed acute myeloid leukaemia, with low-dose cytarabine, in adults aged 75 or older or who cannot receive intensive induction chemotherapy. Acute leukaemia (AML and ALL) →
Adverse effects
Common
- Muscle spasms, muscle, bone or joint pain
- Fatigue, nausea, constipation, abdominal pain
- Taste change, mouth sores, decreased appetite, weight loss
- Swelling, rash, hair loss
Contraindications
- Hypersensitivity to glasdegib
Key interactions
- St John's wort
- Can lower glasdegib levels; avoided.
- Low-dose cytarabine (given together)
- The combination is the approved use; blood counts are watched.
- Drugs that prolong the QT interval, low potassium or magnesium
- Add to QT risk; ECG and electrolytes are checked.
What is monitored
- ECG and electrolytes (potassium, magnesium)
- Complete blood count
- Kidney function
- Pregnancy test before starting
Administration and safety
- Oral tablets swallowed whole, not split, chewed or crushed.
- If vomiting follows a dose, no extra dose is taken.
- No blood donation during treatment and for a month after; men do not donate semen.
Pregnancy and breastfeeding
Avoid in pregnancy. Glasdegib can cause embryo-fetal death or severe birth defects: a pregnancy test is done first, contraception is used during and for a month after treatment, and men use condoms.
Nursing care
- Check ECG and electrolytes before and during treatment.
- Teach to report palpitations, fainting, dizziness, bleeding or fever.
- Confirm pregnancy test and contraception; men use condoms even after vasectomy.
- Support nutrition: taste change and mouth sores are common.
Pharmacokinetics
- Absorption
- Oral tablets once a day, with or without food.
Test yourself
Think of the answer, then tap the question to see it.
With which drug is glasdegib combined?
Low-dose cytarabine.
Which patients with AML receive glasdegib?
Newly diagnosed adults aged 75 or older or unfit for intensive chemotherapy.
Which cardiac test is followed?
The ECG for QT prolongation.
Connections
← Back to the class: Hedgehog pathway inhibitors
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Glasdegib: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2019); Glasdegib Maleate - NCI (National Cancer Institute, 2022); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.