[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [FGFR inhibitors](https://durgical.com/en/pharmacology/classes/fgfr-inhibitors/) › Pemigatinib # Pemigatinib ## FGFR inhibitors? FGFR inhibitors ## High 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. Updated Nov 12, 2026 ## Quick facts **Group** [FGFR inhibitors](https://durgical.com/en/pharmacology/classes/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. 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 ✂**Fibroblast growth factor receptor kinases (FGFR1–3)**Pemigatinib ⓘ 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. **Target in 3D:** Fibroblast growth factor receptor kinases (FGFR1–3). PDB structure 7WCL (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7WCL) · Drag to rotate · pinch to zoom 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) →](https://durgical.com/en/conditions/cholangiocarcinoma/) - 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 ### Serious (rare, important) - Retinal pigment epithelial detachment (blurred vision, floaters, flashes) - Hyperphosphataemia with soft-tissue mineralisation - Hand-foot skin reactions ## 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. ## Memory aid «Pemi for the bile duct, Erda for the bladder»: two FGFR inhibitors, two tumours, the same phosphate and eye warnings. ## 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). [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/pemigatinib/) [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. **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. ## Connections ## Related drugs 1 - [Erdafitinib](https://durgical.com/en/pharmacology/erdafitinib/) ## Related conditions 1 - [Cholangiocarcinoma (bile duct cancer)](https://durgical.com/en/conditions/cholangiocarcinoma/) [← Back to the class: FGFR inhibitors](https://durgical.com/en/pharmacology/classes/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](https://medlineplus.gov/druginfo/meds/a620028.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Pemigatinib - NCI](https://www.cancer.gov/about-cancer/treatment/drugs/pemigatinib) (National Cancer Institute, 2023); [RCSB PDB - 7WCL: Crystal structure of FGFR1 kinase domain with Pemigatinib](https://www.rcsb.org/structure/7WCL) (RCSB Protein Data Bank, 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01EN02) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/pemigatinib/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/pemigatinib/