Tryptophan hydroxylase inhibitor
Telotristat ethyl
Brand names: Xermelo
Adult dose
Dose: 250mg PO TDS with meals
Route: PO
Frequency: TDS
Clinical pearls
- Carcinoid syndrome diarrhoea inadequately controlled by somatostatin analogues
- Specialist endocrine
Contraindications
- Hypersensitivity
- Severe hepatic impairment
Side effects
- GI upset
- Constipation
- Depression
- Pyrexia
- LFT elevation
Interactions
- CYP3A4 substrates
- Octreotide (separate by 30 min)
Monitoring
- LFTs
- Bowel symptoms
- Mood
Reference: BNF; NICE TA487; SmPC; https://bnf.nice.org.uk/drugs/telotristat-ethyl/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016