Pemigatinib
About Pemigatinib
Pemigatinib — FGFR1-3 tyrosine kinase inhibitor
Pemigatinib is an oral targeted cancer medicine for bile duct cancer (cholangiocarcinoma) whose tumour carries a specific FGFR2 fusion or rearrangement. It is only used where that genetic change has been confirmed by testing.
How Pemigatinib works
It blocks fibroblast growth factor receptors 1, 2 and 3. In tumours driven by an FGFR2 fusion, that receptor is stuck in the "on" position and drives cell growth; inhibiting it removes the signal the tumour depends on. Because the target is the fusion rather than the tissue, tumour genotyping comes before treatment.
What it is licensed for
Locally advanced or metastatic cholangiocarcinoma with a confirmed FGFR2 fusion or rearrangement, in patients who have had at least one prior line of therapy.
How it is taken
An oral tablet in 21-day cycles — taken for 14 consecutive days, then 7 days off. The break is part of the schedule, not a pause for side effects. Dosage must be determined by a qualified healthcare provider.
What your prescriber monitors
Serum phosphate, because FGFR inhibition raises it; regular eye examinations for serous retinal detachment and dry eye; and liver function. Phosphate is measured before every cycle and mid-cycle where it has run high. Serum calcium is followed alongside, since correcting phosphate can disturb it. Ophthalmology review is scheduled at two months and six-monthly thereafter.
Important cautions and interactions
Hyperphosphataemia is common enough that a phosphate-lowering plan is often set up in advance. Eye changes can appear without symptoms, so scheduled ophthalmic review matters. Strong CYP3A4 inhibitors and inducers alter blood levels significantly. It can harm a developing baby, so contraception is required.
Where Pemigatinib sits in its class
Pemigatinib is one of several FGFR inhibitors developed for biliary tract cancer, alongside infigratinib and futibatinib, and all of them require an FGFR2 alteration to be identified first. The hyperphosphataemia and retinal effects are class effects rather than peculiar to this medicine, which is why the same monitoring pattern follows the whole class.
What to expect in the first weeks
Phosphate usually climbs within the first cycle, so a blood test is taken early and a phosphate binder or a low-phosphate diet may be introduced. Dry eye, altered taste, hair thinning, sore mouth and nail changes are typical and manageable. Fatigue often peaks in the fortnight of dosing and lifts during the week off, which is one reason the schedule is structured that way.
Before you start Pemigatinib
Bring the report confirming your tumour's FGFR2 fusion or rearrangement, since treatment depends on it. Tell the team about any eye condition, dry eye or change in vision, and about kidney problems, which affect how phosphate is handled. List everything you take including St John's wort and grapefruit products, because strong CYP3A4 inhibitors and inducers change blood levels substantially.
Generic Pemigatinib and Pemazyre
Generic Pemigatinib contains the same active ingredient as Pemazyre®, produced by licensed pharmaceutical manufacturers. The brand name and the price differ, not the molecule.
Pemigatinib is a prescription-only medicine. A valid prescription is required and every order is reviewed by a licensed pharmacist before dispatch. Used as prescribed by a licensed medical professional.
Frequently asked questions
Why does pemigatinib need a genetic test first?
It is licensed only for cholangiocarcinoma carrying an FGFR2 fusion or rearrangement. Without that change the target it blocks is not what is driving the tumour, so tumour testing decides whether the medicine is appropriate at all.
Why is pemigatinib taken 14 days on and 7 days off?
That 21-day cycle is how the medicine is licensed and studied. The week off is part of the schedule itself rather than a break taken because of side effects.
Why are eye checks part of pemigatinib treatment?
FGFR inhibitors can cause retinal changes and dry eye, and these can develop before you notice anything. Scheduled eye examinations are there to find them early — report blurred vision or any change in sight without waiting for the next appointment.
Do I need a prescription to order Pemigatinib?
Yes. Pemigatinib is a prescription-only medicine. Upload a valid prescription at checkout — every order is reviewed by a licensed pharmacist before dispatch.
Browse by condition
Last updated: October 3, 2026
Medically reviewed by
Henry Thomas
Henry Thomas is a licensed clinical pharmacist with 15 years of experience. He holds a B.Pharm and M.Pharm from Mahatma Gandhi University. At OnlineMeds, he reviews medicine and health content to help ensure it is accurate, evidence-based, and easy to understand.