Pemigatinib
FGFR inhibitors
FGFR inhibitorsHigh alert
An error with this medicine can cause serious harm: double checks and protocols are used.Pregnancy: avoid
Avoid in pregnancy. Pemigatinib may harm the fetus: a pregnancy test may be done first, contraception is used during treatment and for a week after, and breastfeeding is stopped.
An oral FGFR1–3 inhibitor for cholangiocarcinoma with FGFR2 fusions and for rare FGFR1-rearranged blood cancers. High phosphate and eye effects.
Quick facts
- Group
- FGFR inhibitors
- Target
- Fibroblast growth factor receptor kinases (FGFR1–3)
- Used for
- Previously treated unresectable
- Key effects
- High blood phosphate · Hair loss · Diarrhoea
- Monitor
- FGFR2 fusion · Serum phosphate · Skin and nails
- ATC
- L01EN02
No doses: the clinician sets them by the current guideline.
Mechanism of action
The crystal shows pemigatinib in the ATP site of the human FGFR1 kinase domain; in cholangiocarcinoma the target is fused FGFR2, whose site is very similar.
In some bile duct cancers a gene fusion joins FGFR2 to another protein and keeps the kinase permanently on. Pemigatinib fills the ATP site of FGFR1, 2 and 3 and blocks this signal, so the tumour stops growing. As with erdafitinib, FGFR inhibition raises blood phosphate.
- Pemigatinib fills the ATP site of FGFR1–3
- Fused FGFR2 or rearranged FGFR1 stops signalling
- Tumour growth stops; blood phosphate rises
Indications
- Previously treated unresectable or metastatic cholangiocarcinoma with an FGFR2 fusion or other rearrangement. Cholangiocarcinoma (bile duct cancer) →
- Relapsed or refractory myeloid or lymphoid neoplasms with an FGFR1 rearrangement.
Adverse effects
Common
- High blood phosphate
- Hair loss, nail changes, dry skin and mouth
- Diarrhoea, nausea, constipation, taste change, mouth sores
- Fatigue, joint or back pain
- Dry eyes
Contraindications
- Hypersensitivity to pemigatinib
Key interactions
- St John's wort
- Can lower pemigatinib levels; avoided.
- Grapefruit and its juice
- Can raise pemigatinib levels; avoided.
What is monitored
- FGFR2 fusion or FGFR1 rearrangement test before starting
- Serum phosphate
- Eye examinations including optical coherence tomography
- Skin and nails
Administration and safety
- Oral tablets swallowed whole, not split, crushed, chewed or dissolved.
- If vomiting follows a dose, no extra dose is taken.
- Artificial tears are often used for dry eyes.
Pregnancy and breastfeeding
Avoid in pregnancy. Pemigatinib may harm the fetus: a pregnancy test may be done first, contraception is used during treatment and for a week after, and breastfeeding is stopped.
Nursing care
- Teach to report blurred vision, floaters or flashes of light at once.
- Check phosphate results; explain the diet if ordered.
- Teach to avoid grapefruit and St John's wort.
- Contraception during treatment and for a week after; breastfeeding is stopped.
Pharmacokinetics
- Absorption
- Oral tablets once a day, with or without food.
Test yourself
Think of the answer, then tap the question to see it.
Which genetic change makes cholangiocarcinoma eligible for pemigatinib?
An FGFR2 fusion or other FGFR2 rearrangement.
Which electrolyte is monitored on pemigatinib?
Phosphate.
Which eye complication is typical?
Retinal pigment epithelial detachment (serous retinopathy).
Connections
← Back to the class: FGFR 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: Pemigatinib: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Pemigatinib - NCI (National Cancer Institute, 2023); RCSB PDB - 7WCL: Crystal structure of FGFR1 kinase domain with Pemigatinib (RCSB Protein Data Bank, 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.