Understanding Revumenib Side Effects

If you or a loved one is starting Revumenib (brand name Revuforj), knowing what side effects to expect — and which ones need immediate medical attention — can help you feel more prepared and in control of your treatment.

Revumenib is a powerful targeted therapy for acute leukemia, and like most cancer treatments, it comes with side effects. Some are mild and manageable. Others are serious and require quick action. This guide covers both, based on FDA labeling and clinical trial data.

What Is Revumenib?

Revumenib is a menin inhibitor made by Syndax Pharmaceuticals and sold under the brand name Revuforj. It is approved for the treatment of relapsed or refractory acute leukemia with a KMT2A translocation (in adults and children 1 year and older) and for relapsed or refractory acute myeloid leukemia (AML) with a susceptible NPM1 mutation.

For a deeper look at how it works, see our guide on Revumenib's mechanism of action. For dosing details, check out What Is Revumenib?

Common Side Effects

The following side effects were reported frequently in clinical trials. Many are manageable with supportive care, but you should always tell your doctor about any new or worsening symptoms.

• Nausea — One of the most commonly reported side effects. Eating small, frequent meals and avoiding strong smells may help.
• Diarrhea — Stay hydrated and let your doctor know if it becomes severe or persistent.
• Constipation — Increasing fluids and fiber can help. Your doctor may recommend a stool softener.
• Decreased appetite — Try eating smaller portions more frequently throughout the day.
• Fatigue — Rest when you need to and pace your activities. This is very common with cancer treatment.
• Musculoskeletal pain — Bone, joint, or muscle pain may occur. Over-the-counter pain relievers may help, but check with your doctor first.
• Edema (swelling) — Swelling in the hands, feet, or face. Report significant swelling to your doctor.
• Hemorrhage/bleeding — This can range from minor nosebleeds to more serious bleeding events. Report any unusual bleeding immediately.
• Infection — Your immune system may be weakened. Watch for fever, chills, or signs of illness.
• Febrile neutropenia — Fever combined with low white blood cell counts. This is a medical emergency — call your doctor right away.

Lab Abnormalities

Your doctor will monitor your blood work regularly. Common lab changes include:

• Increased phosphate levels
• Increased liver enzymes (AST, ALT)
• Increased parathyroid hormone
• Increased triglycerides
• Decreased potassium

You may not feel these changes, which is why regular blood tests are so important during treatment.

Serious Side Effects

Revumenib carries two boxed warnings — the most serious type of warning the FDA can require. These are:

Differentiation Syndrome

This is a potentially fatal condition that can occur when leukemia cells begin to mature rapidly in response to treatment. Symptoms include:

• Fever
• Difficulty breathing or shortness of breath
• Rapid weight gain
• Swelling in the lungs or around the heart
• Low blood pressure
• Kidney problems

What to do: If you experience any combination of these symptoms, contact your doctor immediately or go to the emergency room. Differentiation syndrome is treatable when caught early, usually with corticosteroids.

QTc Prolongation and Torsades de Pointes

Revumenib can affect the electrical activity of your heart, causing a condition called QTc prolongation. In rare cases, this can lead to a dangerous heart rhythm called Torsades de Pointes. Symptoms may include:

• Dizziness or lightheadedness
• Fainting or near-fainting
• Rapid or irregular heartbeat
• Shortness of breath

What to do: Call your doctor or go to the ER immediately if you experience any of these. Your doctor will monitor your heart with ECGs — weekly for the first 4 weeks and monthly after that.

Other Serious Side Effects

• Severe hemorrhage — Heavy or uncontrolled bleeding requires immediate medical attention.
• Severe infections — Including bacterial and viral infections that can become life-threatening in immunocompromised patients.
• Embryo-fetal toxicity — Revumenib can cause harm to an unborn baby. See the section below on specific populations.

Specific Populations

Pregnancy and Fertility

Revumenib can cause fetal harm. If you are pregnant or could become pregnant, this is critical information:

• A pregnancy test is required within 7 days before starting treatment.
• Women must use effective birth control during treatment and for 4 months after the last dose.
• Men with female partners of reproductive potential must also use effective contraception during treatment and for 4 months after the last dose.
• Revumenib may affect fertility in both men and women.

Breastfeeding

Do not breastfeed during treatment with Revumenib or for 1 week after the last dose.

Children

Revumenib is approved for pediatric patients aged 1 year and older with confirmed KMT2A-rearranged acute leukemia. It has not been studied in children under 1 year of age.

How to Manage Side Effects

Here are some general tips for managing common side effects while on Revumenib:

1. Keep all monitoring appointments. ECGs and blood work are essential for catching problems early.
2. Stay hydrated. This helps with nausea, diarrhea, and overall well-being.
3. Report symptoms early. Do not wait for side effects to become severe before calling your doctor.
4. Follow dietary guidelines. Take Revumenib fasting or with a low-fat meal (no more than 400 calories, no more than 25% fat). High-fat meals can affect how the drug works.
5. Avoid medications that interact. Tell your doctor about all medications, supplements, and over-the-counter drugs you take. Check our drug interactions guide for details.
6. Watch for signs of infection. Fever, chills, sore throat, or cough should be reported to your doctor right away.
7. Ask about supportive medications. Anti-nausea drugs, stool softeners, and pain relievers may help. Always ask your doctor before adding anything to your regimen.

Final Thoughts

Every medication has side effects, and Revumenib is no exception. The important thing is to be informed, stay in close contact with your medical team, and report any new symptoms promptly. Many side effects are manageable, and early detection of serious ones like differentiation syndrome and QTc prolongation can be life-saving.

If you are having trouble finding or affording Revumenib, Medfinder can help you locate it in stock near you. You can also learn about savings programs and patient assistance to reduce your costs.