Product image of Inaqovi (Decitabine, Cedazuridine) supplied by GNH India

Inaqovi

Active Ingredient:
Decitabine, Cedazuridine
Origin:
EU

Inaqovi (Decitabine, Cedazuridine)

Decitabine, the active ingredient in Inaqovi, is a DNA methyltransferase inhibitor presented as an oral tablet for oral use. It is indicated for the treatment of myelodysplastic syndromes and acute myeloid leukemia in adult patients.
GNH India supplies Inaqovi as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, oncology centres, pharmacies and clinics worldwide.

Manufacturer / TM Owner

Otsuka Pharmaceutical Netherlands B.V.

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Indications & Clinical Uses

  • Inaqovi is used in hematologic malignancies that involve abnormal DNA methylation.
  • Myelodysplastic syndromes (MDS): improves blood cell production and may delay progression to acute leukemia.
  • Acute myeloid leukemia (AML): provides disease control for patients unsuitable for intensive chemotherapy.

How It Works

  • Decitabine incorporates into DNA as a nucleoside analog and irreversibly inhibits DNA methyltransferase, leading to hypomethylation and re‑expression of silenced tumor‑suppressor genes. Cedazuridine blocks cytidine deaminase, preventing rapid degradation of decitabine and thereby enhancing its oral bioavailability, allowing effective systemic exposure from an oral tablet.

Side Effects

Inaqovi may cause a range of adverse reactions that vary in frequency and severity.

Common Side Effects

  • Nausea and vomiting
  • Fatigue or weakness
  • Low blood counts (anemia, neutropenia, thrombocytopenia)
  • Diarrhea or constipation
  • Fever or chills
  • Elevated liver enzymes

Serious or Rare Side Effects

  • Severe infections due to neutropenia
  • Bleeding complications from thrombocytopenia
  • Pulmonary toxicity (e.g., interstitial pneumonitis)
  • Cardiac arrhythmias or myocarditis
  • Severe skin reactions (e.g., Stevens‑Johnson syndrome)
  • Renal impairment or failure

Precautions & Warnings

  • Before initiating therapy, clinicians should evaluate baseline organ function and monitor patients regularly.
  • Baseline blood counts: obtain complete blood count with differential.
  • Renal function: assess serum creatinine and calculate eGFR.
  • Hepatic function: check liver enzymes and bilirubin levels.
  • Infection risk: monitor for signs of infection and manage promptly.
  • Pregnancy and lactation: avoid use unless benefits outweigh risks; discuss contraception.
  • Store at ambient temperature: keep below 25°C, retain in original packaging, protect from moisture and direct sunlight.

Avoid Interactions

Inaqovi can interact with other medicines that affect blood cell production or metabolism.

Major Interactions (Avoid)

  • Strong CYP3A4 inducers (e.g., rifampin, carbamazepine) that may reduce exposure to cedazuridine.
  • Concurrent use of other hypomethylating agents or cytotoxic chemotherapy that markedly increase myelosuppression.
  • Live vaccines: risk of infection due to immunosuppression.

Moderate Interactions (Monitor Closely)

  • Anticoagulants (warfarin, DOACs): monitor coagulation parameters.
  • Drugs that prolong QT interval: observe cardiac rhythm.
  • NSAIDs or other agents that can cause gastrointestinal bleeding: assess bleeding risk.

Frequently Asked Questions

Inaqovi is prescribed for adult patients with myelodysplastic syndromes (MDS) and for those with acute myeloid leukemia (AML) who are not candidates for intensive chemotherapy. It targets abnormal DNA methylation that contributes to disease progression in these hematologic cancers.

Decitabine integrates into DNA and blocks DNA methyltransferase, leading to hypomethylation and re‑activation of silenced genes that control cell growth. Cedazuridine inhibits the enzyme cytidine deaminase, which normally degrades decitabine, thereby increasing the drug’s oral bioavailability and allowing effective systemic exposure from a tablet.

The specific dose and dosing schedule of Inaqovi are determined by the prescribing clinician based on the patient’s disease characteristics, renal and hepatic function, and overall health status. Healthcare professionals should follow the approved prescribing information and adjust as needed.

The safety of Inaqovi in pregnancy or while breastfeeding has not been established. It should only be used if the potential benefit justifies the potential risk to the fetus or infant. Women of childbearing potential should use effective contraception during treatment and for a period after the last dose.

To place an order, submit an enquiry on the product page at gnhindia.com, specifying the required quantity. GNH India works with hospitals, pharmacies and procurement teams worldwide, verifies trade or institutional credentials, and then provides pricing, availability, shipping details (including any cold‑chain requirements) and necessary import documentation.

Inaqovi combines decitabine with cedazuridine to enable oral administration, whereas traditional hypomethylating agents such as decitabine alone require intravenous infusion. The oral formulation offers greater convenience and may improve patient adherence while delivering comparable pharmacologic exposure when taken as prescribed.

Inaqovi tablets should be stored at ambient temperature, below 25 °C. Keep them in the original blister pack, protect from moisture, heat and direct sunlight, and keep out of reach of children.

Inaqovi is taken orally, usually once daily on a scheduled treatment cycle as defined by the prescriber. The tablets should be swallowed whole with water and not crushed or chewed, unless otherwise directed by a healthcare professional.

The most serious risks include severe myelosuppression leading to infections, bleeding, or anemia; life‑threatening infections due to neutropenia; pulmonary toxicity such as interstitial pneumonitis; and rare severe skin reactions like Stevens‑Johnson syndrome. Patients should be monitored closely for these events.

Inaqovi is contraindicated in patients with known hypersensitivity to decitabine, cedazuridine, or any tablet excipients. It should also be avoided in individuals with uncontrolled infections, severe hepatic impairment, or those receiving live vaccines without appropriate clinical justification.

Published by

GNH India Pharmaceuticals Limited

Licensed pharmaceutical supplier

Last updated:

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