What is Ivosidenib used for?

acute myeloid leukemia (AML) with an IDH1 gene change; myelodysplastic syndrome (a bone marrow disorder) with an IDH1 gene change that came back; bile duct cancer (cholangiocarcinoma) with an IDH1 gene change.

What are the common side effects of Ivosidenib?

Feeling tired. Joint pain. Diarrhea or nausea. Swelling in the legs or feet. Mouth sores. Cough or shortness of breath. Less appetite or belly pain.

When should I call my care team while taking Ivosidenib?

Fever, trouble breathing, cough, chest pain, fast weight gain, swelling, dizziness, or urinating less, which can be signs of differentiation syndrome; A fast, pounding or uneven heartbeat, dizziness, fainting, or chest discomfort; Weakness, numbness or tingling in the legs or arms that spreads, or trouble breathing or swallowing; A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills.

Ivosidenib

Say it: eye-voe-SID-e-nib · Brand names: Tibsovo

Ivosidenib is a targeted pill that blocks a faulty enzyme in some leukemias and bile duct cancers.

What it is

Some cancers have a change in a gene called IDH1 (isocitrate dehydrogenase 1). The faulty enzyme makes a substance that keeps blood cells from maturing normally. Ivosidenib blocks this enzyme, which helps blood cells grow up normally again and slows some cancers.

Often used for

acute myeloid leukemia (AML) with an IDH1 gene change
myelodysplastic syndrome (a bone marrow disorder) with an IDH1 gene change that came back
bile duct cancer (cholangiocarcinoma) with an IDH1 gene change

How you get it

Ivosidenib is a tablet you take by mouth once a day. For acute myeloid leukemia it is sometimes given with another medicine called azacitidine. It may take a few months to see the full effect. Your schedule may be different.

Common side effects and what helps

Feeling tired. Rest and short walks can help.
Joint pain. Gentle movement and warm baths may help.
Diarrhea or nausea. Eat small meals and drink plenty of fluids.
Swelling in the legs or feet. Raise your legs when you sit.
Mouth sores. Rinse with a mild salt and baking soda mouthwash.
Cough or shortness of breath. Tell your team if it is new or getting worse.
Less appetite or belly pain. Try small meals through the day.

Call your care team right away if you have

Fever, trouble breathing, cough, chest pain, fast weight gain, swelling, dizziness, or urinating less, which can be signs of differentiation syndrome
A fast, pounding or uneven heartbeat, dizziness, fainting, or chest discomfort
Weakness, numbness or tingling in the legs or arms that spreads, or trouble breathing or swallowing
A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills

Before you start, tell your team

If you have heart problems, including a heart rhythm problem called long QT
If you have low potassium or magnesium
If you are pregnant, may become pregnant, or are breastfeeding
All the medicines you take, including vitamins, herbs and supplements

Good to know

In people with AML or myelodysplastic syndrome, ivosidenib can cause differentiation syndrome, a serious reaction where leukemia cells mature quickly. It can be life threatening, but it is treatable if caught early.
It can affect the heart rhythm. You will have heart tracings (ECG) and blood salt tests.
Rarely, it can cause a nerve problem called Guillain-Barre syndrome.
Many medicines can interact with it. Check with your team before starting anything new.

At home

Take it once a day at about the same time, with or without food. Do not take it with a high-fat meal, since this raises the amount in your body.
Swallow the tablets whole. Do not split, crush or chew them.
If you miss a dose, ask your care team what to do. Do not take two doses to make up for it.
Store at room temperature, away from children and pets.

Questions to ask

What warning signs of differentiation syndrome should I watch for?
How often will I need heart tracings?
How long until we know if it is working?
Which of my other medicines could interact with it?

Side effect guides

Sources

Quick answers

What is Ivosidenib?: Ivosidenib is a targeted pill that blocks a faulty enzyme in some leukemias and bile duct cancers. Brand names: Tibsovo.
What is Ivosidenib used for?: acute myeloid leukemia (AML) with an IDH1 gene change; myelodysplastic syndrome (a bone marrow disorder) with an IDH1 gene change that came back; bile duct cancer (cholangiocarcinoma) with an IDH1 gene change.
How is Ivosidenib given?: Ivosidenib is a tablet you take by mouth once a day. For acute myeloid leukemia it is sometimes given with another medicine called azacitidine. It may take a few months to see the full effect. Your schedule may be different.
What are the common side effects of Ivosidenib?: Feeling tired. Joint pain. Diarrhea or nausea. Swelling in the legs or feet. Mouth sores. Cough or shortness of breath. Less appetite or belly pain.
When should I call my care team while taking Ivosidenib?: Fever, trouble breathing, cough, chest pain, fast weight gain, swelling, dizziness, or urinating less, which can be signs of differentiation syndrome; A fast, pounding or uneven heartbeat, dizziness, fainting, or chest discomfort; Weakness, numbness or tingling in the legs or arms that spreads, or trouble breathing or swallowing; A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills.

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.