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Belzutifan (Welireg®) is used to treat renal cell carcinoma, central nervous system hemangioblastoma, or pancreatic neuroendocrine tumor caused by von Hippel-Lindau disease.

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Page 1 Name of your medication Generic name — Belzutifan (bel-ZOO-tih-fan) Brand name — Welireg® (WEL-ih-reg) Approved uses Belzutifan is used to treat renal cell carcinoma, central nervous system hemangioblastoma, or pancreatic neuroendocrine tumor caused by von Hippel-Lindau disease. Dose and schedule Taking belzutifan as instructed is important to allow your treatment to be as effective as possible, so here are some key points to remember. o Your dose may vary, but the usual dose of belzutifan is 120 milligrams (120 mg) to be taken by mouth at a scheduled time once a day. o Belzutifan can be taken with or without food, but at the same time each day. o Belzutifan should be taken whole and not crushed, cut, or dissolved. If you are unable to swallow belzutifan, talk to your care provider or pharmacist for possible options. o If you miss a dose of belzutifan, take it as soon as possible on the same day and resume the regular daily dose schedule the next day. Do not take an extra dose or two doses at one time. Be sure to write down if you miss a dose, and let your care provider know about any missed doses. o If vomiting occurs after taking belzutifan, do not retake the dose. Take the next dose on the next day at the regularly scheduled time. Drug and food interactions o Belzutifan has many drug interactions. Inform your care providers of all prescription medications, over-the-counter medications, vitamins, and herbal products. o Talk with your care provider or pharmacist before taking new medications or supplements, or receiving any vaccines. Storage and handling Handle belzutifan with care. Just like when chemotherapy is given into the vein, this drug can be toxic, and exposure of the drug to others should be limited. o Store belzutifan at room temperature (68°F–77°F) in a dry location away from light. o Keep belzutifan out of reach of children and pets. o Leave belzutifan in the provided packaging until it is ready to be taken. o Whenever possible, you should give belzutifan to yourself and follow the steps below. If a family member, friend, or caregiver needs to give the belzutifan to you, they also need to follow these steps: 1. Wash hands with soap and water. BELZUTIFAN ORAL CHEMOTHERAPY EDUCATION Page 2 Side Effects of Belzutifan Below are common side effects that have been known to happen in about one-third or more of patients taking belzutifan are listed on the left side of this table. You MAY NOT experience these side effects. Options to help manage any side effects that do occur are included on the right side of this table. These should be discussed with your care provider. If you experience any side effect you cannot manage or that is not listed here, contact your care provider. Possible Side Effect Management Decreased hemoglobin, part of the red blood cells that carry iron and oxygen Your hemoglobin should be monitored by a simple blood test. When your hemoglobin is low, you may notice that you get tired or fatigued more easily. • Try to get 7–8 hours of sleep per night. • Avoid operating heavy machinery if you feel too tired. • Find a balance between work and rest. • Stay as active as possible, but know that it is OK to rest as needed. • You might notice that you are more pale than usual. Let your healthcare provider know right away if you experience any of the following: • Shortness of breath • Dizziness • Palpitations Fatigue You may be more tired than usual or have less energy. • Stay as active as possible, but know it is OK to rest as needed. • Try to do some activity every day. • Plan your activities, and do them at a time of day when you feel a bit more energetic. Continued on the next page 2. Put on gloves to avoid touching the medication. (Gloves are not necessary if you give the drug to yourself.) 3. Gently transfer the belzutifan from its package to a small medicine or other disposable cup. 4. Administer the medicine immediately by mouth with water. 5. Remove gloves and do not use them for anything else. 6. Throw gloves and medicine cup in household trash. 7. Wash hands with soap and water. o If a daily pill box or pill reminder will be used, contact your care team before using: • The person filling the box or reminder should wear gloves (gloves are not necessary if you are filling the box or reminder). • When empty, the box or reminder should be washed with soap and water before refilling. Be sure to wash hands with soap and water after the task is complete, whether or not gloves are worn. Page 3 Serious side effects o Belzutifan can cause serious birth defects. Do not take belzutifan if you are pregnant or think you might be pregnant. o Belzutifan can lower your white blood cells and your platelets, increasing your risk of infection and bleeding. o Bone marrow suppression is a decrease in the number of white blood cells, red blood cells, and platelets that can be severe with belzutifan. Speak to your care provider to know when you need to have laboratory tests done to monitor your blood cell counts. You also may need to take a break, or hold, your medication for medical or dental procedures. Talk to your care provider or dentist before any scheduled procedures. If you experience ANY uncontrolled side effect, call your physician or healthcare center immediately: (INSTITUTIONAL CONTACT INFO) Handling body fluids and waste Because belzutifan remains in your body for several days after it is taken, some of the drug may be present in urine, stool, sweat, or vomit. Once you have started to take belzutifan, it is important to follow the instructions below every day for as long as your treatment lasts. This is to keep yourself, loved ones, and the environment as safe as possible. o Pregnant women should avoid touching anything that may be soiled with body fluids from the patient. o Toilet and septic systems • You may use the same toilet, septic tank, and/or sewer that you usually use. If you have a low-flow toilet, close the lid and flush twice to ensure all waste has been discarded. Headache Ask your provider what you may use to help with this discomfort. Contact your care provider right away if you headache has any of the following characteristics: • Follows a head injury • Is severe or starts suddenly • Does not go away after three days • Is associated with vomiting, visual disturbance, neck stiffness, drowsiness, confusion, rash, weakness in an arm or leg, or numbness, or is made worse by coughing or lowering the head Nausea • Eat and drink slowly. • Drink 8–10 glasses of water or fluid each day unless your care provider has instructed you to limit your fluid intake. • Eat small, frequent meals throughout the day rather than a few large meals. • Eat bland foods; avoid spicy, fried, and greasy foods. • Avoid vigorous exercise immediately after eating. • Don’t lie down immediately after eating. • Avoid strong odors. Let your provider know if you experience nausea or vomiting. Your provider may prescribe medication that can help. Page 4 • If the toilet or toilet seat becomes soiled with urine, stool, or vomit, clean the surfaces before other people use the toilet. • Wash hands with soap and water after using the toilet. o If you need a bedpan, be sure your caregiver knows to wear gloves to assist with cleanup and to wash the bedpan with soap and water every day. o If you do not have good control of bladder or bowels, use a disposable pad with a plastic back, a diaper, or a sheet to absorb body waste. o Wash any skin that has been exposed to body waste or belzutifan with soap and water. o Linens or clothing that are soiled with body fluids or body waste should be washed separately from other linens and clothing. If you do not have a washer, place the soiled linens in a plastic bag until they can be washed. o Wash hands with soap and water after touching linens or clothing that may be soiled with body fluids. Pregnancy, sexual activity, and contraception o Women should not become pregnant and men should not get a partner pregnant while taking belzutifan. Males and females of childbearing age and potential should use effective contraception during therapy and for a minimum of one week after the last dose of belzutifan. o Effective contraception could include one or more of the following: oral contraceptive, barrier methods, etc. o Do not breastfeed while taking belzutifan and for one week after the last dose of belzutifan. o Inform your care provider if you become pregnant. o It is safe to hug and kiss. Special precautions may be needed for sexual activity while on oral chemotherapy, and you are encouraged to ask your care provider. Obtaining medication o Talk with your care provider about the process for obtaining your belzutifan. (PHARMACY OR SPECIALTY PHARMACY CONTACT INFO) Additional resources Product website: Product prescribing information: Product resources: Updated – September 12, 2021 Page 5 Important notice: The Association of Community Cancer Centers (ACCC), Hematology/Oncology Pharmacy Association (HOPA), National Community Oncology Dispensing Association, Inc. (NCODA), and Oncology Nursing Society (ONS) have collaborated in gathering information for and developing this patient education guide. This guide represents a brief summary of the medication derived from information provided by the drug manufacturer and other resources. This guide does not cover all existing information related to the possible uses, directions, doses, precautions, warnings, interactions, adverse effects, or risks associated with this medication and should not substitute for the advice of a qualified healthcare professional. Provision of this guide is for informational purposes only and does not constitute or imply endorsement, recommendation, or favoring of this medication by ACCC, HOPA, NCODA, or ONS, who assume no liability for and cannot ensure the accuracy of the information presented. The collaborators are not making any representations with respect to the medications whatsoever, and any and all decisions, with respect to such medications, are at the sole risk of the individual consuming the medication. All decisions related to taking this medication should be made with the guidance and under the direction of a qualified healthcare professional. Permission: Oral Chemotherapy Education (OCE) sheets are provided as a free educational resource for patients with cancer in need of concise, easy-to-understand information about oral cancer drugs. Healthcare providers are permitted to copy and distribute the sheets to patients as well as direct patients to the OCE website for information. However, commercial reproduction or reuse, as well as rebranding or reposting of any type, are strictly prohibited without permission of the copyright holder. Please email permission requests and licensing inquiries to This email address is being protected from spambots. You need JavaScript enabled to view it.. Copyright © 2021 by Hematology/Oncology Pharmacy Association. All rights reserved. Additional instructions