Ripretinib (Specialist drug)

Take a missed dose only if less than 8 hours have passed since the missed scheduled dose. If vomiting occurs after taking a dose, do not take an additional dose — continue with the next scheduled dose. Dose reduction for adverse reactions is 100 mg orally once daily; permanently discontinue in patients unable to tolerate 100 mg once daily. Grade 2 palmar-plantar erythrodysaesthesia syndrome (PPES), arthralgia or myalgia: withhold until Grade <=1 or baseline — if recovered within 7 days resume at the same dose, otherwise resume at a reduced dose; on recurrence resume at a reduced dose regardless of time to improvement. Grade 3 PPES, arthralgia or myalgia: withhold for at least 7 days or until Grade <=1 or baseline (maximum 28 days), then resume at a reduced dose. Grade 3 hypertension: if symptomatic withhold until symptoms resolve and blood pressure is controlled, then resume at the same dose if controlled to Grade <=1 or baseline, otherwise at a reduced dose; permanently discontinue for Grade 4. Permanently discontinue for Grade 3 or 4 left ventricular systolic dysfunction. Other Grade 3 or 4 adverse reactions: withhold until Grade <=1 or baseline (maximum 28 days) then resume at a reduced dose, otherwise permanently discontinue; permanently discontinue if Grade 3 or 4 recurs. Re-escalation may be considered if maintained at Grade <=1 or baseline for at least 28 days. Moderate CYP3A inducers: avoid; if unavoidable, increase the dosing frequency from 150 mg once daily to 150 mg twice daily during co-administration, and resume 150 mg once daily 14 days after the inducer is discontinued (for patients on twice-daily dosing who miss a dose: take it if less than 4 hours have passed, otherwise skip it). Withhold for at least 1 week prior to elective surgery and do not administer for at least 2 weeks after major surgery and until adequate wound healing. Paediatric: safety and effectiveness in paediatric patients have not been established. CLINICIAN CHECK: this draft is from the US FDA prescribing information (QINLOCK, Deciphera Pharmaceuticals, label date 2025-05-12) — no UK SPC posology was fetched; verify against the UK SPC.