Axulta

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Axulta

Method of action: Laxative

Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Axulta

Quick Facts

Property Description
Active ingredient Linaclotide (INN)
Form Hard Gelatin Capsule (Oral)
Pharmacological class Guanylate Cyclase-C (GC-C) Agonist
Origin Synthetic Peptide
Rx/OTC Status Prescription Only (Rx)

What Type of Medicine is Axulta?

Linaclotide, the active ingredient in Axulta, is a prescription medicine classified as a Guanylate Cyclase-C (GC-C) agonist. This represents a specialized grouping of gastrointestinal agents, distinct from non-specific laxatives. The active substance is a synthetic 14-amino acid peptide designed to interact with specific receptors on the intestinal surface. This classification is a key differentiating factor, establishing its mechanism as modulating an endogenous cellular signaling pathway in the gut. Its specialized role in providing targeted relief for chronic functional bowel symptoms is confirmed by clinical recognition.

Composition and General Purpose

The drug is administered orally as a hard gelatin capsule. The composition is defined by its minimal absorption characteristic; due to its peptide structure, Linaclotide is classified as minimally absorbed and functions almost exclusively within the intestinal lumen with negligible systemic exposure. This property ensures the therapeutic effect is concentrated locally.

The general therapeutic purpose of Linaclotide is to address two core symptoms often present in chronic bowel issues: impaired gut motility and chronic discomfort. It functions as a secretagogue, stimulating the secretion of fluid into the intestines, which softens the stool and facilitates accelerated gut transit. This local action also utilizes signaling pathways to modulate pain-sensing nerves, helping to mitigate the sensation of chronic abdominal discomfort frequently reported in these persistent functional disorders.

Regulatory References

  1. NIH Reference

What side effects are possible with Axulta?

Possible Side Effects and Safety Information

This section details the officially documented adverse effects and safety characteristics of olutasidenib (Axulta), derived from government regulatory sources. Safety classifications and terminology reflect those utilized in official labeling for this medicine.


Serious Adverse Reactions

Official regulatory labeling includes a Boxed Warning regarding the risk of Differentiation Syndrome, a condition that may be life-threatening or fatal. This syndrome was documented to occur as early as one day and up to 18 months after starting treatment. Symptoms listed in the labeling include fever, difficulty breathing (dyspnea), swelling (edema), and signs of kidney injury.

Another serious adverse reaction documented is Hepatotoxicity (liver injury), which can be severe. The median time to the onset of liver injury was 1.2 months after starting treatment. Due to this risk, the regulatory text specifies the need to monitor liver function tests frequently during the course of treatment.


Very Common Adverse Reactions (ge 20%)

Adverse reactions occurring in at least 20% of patients are classified as very common. These often include:

System-Organ Class Very Common Adverse Reactions
General Fatigue/Malaise, Pyrexia (Fever)
Gastrointestinal Nausea, Constipation, Mucositis, Diarrhea
Musculoskeletal Arthralgia (Joint Pain)
Respiratory Dyspnea

Very common laboratory abnormalities include increases in liver enzymes (AST/ALT) and decreases in electrolytes (Potassium and Sodium).


Safety Considerations in Specific Populations

Regulatory documents state that the recommended dose has not been established for individuals with severe hepatic impairment (severe liver problems) or severe renal impairment (severe kidney problems) or those on dialysis. Furthermore, the safety and effectiveness of olutasidenib have not been established in children (pediatric use).

Overdose and Emergency Response

Overdose and When to Seek Help

The official regulatory documents define the overdose profile of Axulta (Linaclotide) based on its localized action in the gut, with the primary presentation being an exaggeration of the drug’s effect, resulting in severe diarrhea. Overdose management is limited to symptomatic and supportive treatment, as no specific antidote is available.

The principal hazard is the development of serious systemic complications secondary to the fluid loss. Officially documented severe outcomes requiring intervention include severe dehydration and potentially life-threatening electrolyte abnormalities, such as hypokalemia (low potassium) and hypotension (low blood pressure), which have been associated with reports of syncope (fainting).

Action Type Regulator-Mandated Action for Overdose or Severe Reaction
Immediate Response If severe diarrhea occurs, suspend dosing and begin rehydration; severe cases may require hospitalization
Urgent Care Trigger Seek immediate medical attention for unusual or severe abdominal pain, bloody stools, or black, tarry stools

Furthermore, a specific Boxed Warning exists regarding a critical population-specific risk: the drug is formally contraindicated in pediatric patients under two years of age due to the documented risk of serious dehydration and associated mortality in nonclinical studies. All individuals showing signs of a severe reaction should contact emergency services.

Therapeutic Uses of Axulta

Quick Facts

  • Relapsed or Refractory Acute Myeloid Leukemia (AML): May be used for adults who have this specific type of AML.
  • IDH1 Mutation: Intended for patients whose AML cells have a susceptible IDH1 mutation, as detected by a laboratory test.

Axulta: Main Uses and Benefits

Axulta is a treatment option intended for use in adult patients who have been diagnosed with relapsed or refractory Acute Myeloid Leukemia (AML) that carries a susceptible isocitrate dehydrogenase 1 (IDH1) mutation. Relapsed means the condition has returned after a period of remission, and refractory means the condition did not respond to prior treatment attempts.

Its function is to address the underlying condition in this specific patient population. In clinical studies, the medication was associated with a change in the need for transfusions, and it may promote a complete response or a complete response with partial blood count recovery. The approval for this indication is based on data that support its therapeutic effect in patients with this rare and challenging diagnosis. The goal of treatment may include achieving a remission state in affected individuals.

Eligibility and Restrictions for Use

The eligibility for Axulta (brexpiprazole) is strictly defined by regulatory guidelines, excluding certain populations due to heightened risk or lack of established data.

Eligibility Status Patient Population
Contraindicated Patients with a known hypersensitivity reaction to brexpiprazole or any of its components.
Not Approved Elderly patients with dementia-related psychosis (due to increased mortality risk, a Boxed Warning).
Restricted Use Patients with moderate to severe hepatic impairment (Child-Pugh score ge 7) or moderate, severe, or end-stage renal impairment (CrCl < 60 mL/min).

Age-Related Eligibility:

Axulta is approved for adults across all indications. For schizophrenia, it is approved for patients mathbf13 years of age and older. Use in children under 13 years old is not established for safety and efficacy. Additionally, patients 24 years of age and younger being treated for Major Depressive Disorder must be closely monitored for suicidal thoughts and behaviors.

Pregnancy and Lactation:

Use during the third trimester of pregnancy carries a documented risk of abnormal muscle movements or withdrawal symptoms in the neonate. Brexpiprazole is excreted in human milk, requiring a decision to discontinue nursing or the medicine. Maximum recommended dosages are restricted for those with organ impairment.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The interaction profile for Axulta is primarily defined by its susceptibility to drug-drug interactions involving metabolic enzymes and transport proteins, as documented in official regulatory labeling. These constraints are categorized as pharmacokinetic or pharmacodynamic interactions, which necessitate specific management requirements or restrictions.

Official Interaction Classifications and Constraints

Classification Interacting Agents (Category) Regulatory Constraint/Requirement
Pharmacokinetic Strong CYP3A4 Inhibitors Requires mandatory dose reduction or close monitoring of Axulta exposure.
Pharmacokinetic Strong CYP3A4 Inducers Contraindicated due to risk of significantly decreased Axulta systemic exposure.
Pharmacokinetic Acid-Reducing Agents (e.g., Proton Pump Inhibitors) Requires timing separation of administration (e.g., administer Axulta [X] hours before or after the agent) to prevent impaired absorption.
Pharmacodynamic Drugs that Prolong the QTc Interval Coadministration is restricted or requires additional cardiac monitoring and caution due to potential additive effects on cardiac repolarization.

Co-administration with P-glycoprotein (P-gp) Inhibitors is also documented to increase Axulta exposure and requires increased patient monitoring. The overall regulatory structure mandates caution and specific procedural adjustments to maintain a safe and consistent drug exposure profile, strictly defining combinations that are not permitted and those that require monitoring.

Mechanism of Action

Linaclotide, the active ingredient, operates through a dual, localized mechanism within the gastrointestinal tract, initiated by binding to a single primary target: the Guanylate Cyclase-C (GC-C) receptor on the intestinal surface. The drug functions as a selective agonist of the GC-C receptor, which initiates a molecular cascade by increasing the cellular concentration of cyclic Guanosine Monophosphate (cGMP). This cGMP then activates ion channels, facilitating the transmembrane transport of chloride, bicarbonate, and subsequent water into the intestinal lumen. This mechanism contributes to increased intestinal fluid volume, which physiologically results in modulation of fecal water content and acceleration of colonic transit. The same GC-C receptor activation also produces an anti-nociceptive effect by releasing extracellular cGMP into the submucosal space. This cGMP directly interacts with and inhibits the activity of peripheral afferent nociceptors (pain-sensing nerves) located in the gut wall. This action modulates the neurosensory signaling, leading to a physiological decrease in the excitability of peripheral afferent nociceptors.

Dosage and Administration Information

How Axulta is Used

Axulta (olutasidenib) is administered according to a precise schedule for the treatment of relapsed or refractory Acute Myeloid Leukemia (AML) with a susceptible IDH1 mutation. The core usage protocol focuses on the route, specific timing, and duration requirements.


Official Administration Protocol

The medicine is supplied as a 150 mg hard gelatin capsule and is taken orally. The standard regimen for adults is 150 mg twice daily.

Usage Constraint Instruction Detail
Timing with Meals Must be taken on an empty stomach: at least 1 hour before or 2 hours after a meal.
Physical Handling Capsules must be swallowed whole. They must not be broken, chewed, or opened.
Dose Interval Two doses must not be administered within an 8-hour interval

Duration and Special Populations

The treatment course is typically continued until disease progression or the patient experiences unacceptable toxicity. Treatment should be maintained for a minimum of 6 months to provide sufficient time for a complete clinical response.

Regarding dose adjustments, no dosage modification is necessary for patients with mild or moderate hepatic (liver) or renal (kidney) impairment. If a dose is missed, it should be taken as soon as possible, provided the interval until the next scheduled dose remains at least 8 hours.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Axulta

The available research for Axulta (Olutasidenib) primarily comes from clinical trials that research examined its activity in a specific group of adult patients with Acute Myeloid Leukemia (AML). This evidence describes group patterns and helps show what has been observed so far in this highly targeted treatment setting.

Evidence for Use in Relapsed or Refractory AML with an extitIDH1 Mutation

Research exploring this drug was evaluated in adult patients diagnosed with AML that is relapsed (the condition has returned) or refractory (the condition did not respond to prior treatment) and has the susceptible extitIDH1 mutation.

Researchers primarily conducted single-arm clinical trials, which means the treatment was evaluated in a group of patients without a separate control group. The studies monitored several key endpoints, including the rate at which patients had a Complete Remission (CR) or a Complete Remission with Partial Hematologic Recovery (CRh) measured. They also research examined outcomes related to physiological strain or stress by monitoring changes in the need for red blood cell and platelet transfusions.

Studies report how symptoms evolved in the observed populations, noting that a remission state was measured in a number of patients in the trial cohort. The research provides context on outcomes monitoring physiological strain or stress, particularly in the blood counts, but research does not determine whether an individual will respond similarly.

Long-Term Studies and Follow-Up

Data show patterns related to the duration of remission in patients who responded; studies monitored this persistence, sometimes tracked over two years. However, long-term effects are not fully established for all patients, and continued monitoring may be needed to fully characterize the persistence of response over many years.

What is Still Uncertain About Axulta

While studies contribute to the broader evidence landscape, certainty remains low and comparative evidence is lacking in several areas. Evidence is limited for certain patient subgroups, and these subgroup findings are uncertain due to sample sizes were modest in these smaller patient groups.

Frequently Asked Questions (FAQ)

Common questions about Axulta (FAQ)

Q: What is the main reason Axulta is prescribed?

According to official product information, Axulta is indicated for the treatment of adult patients who have relapsed or refractory Acute Myeloid Leukemia (AML). This means the condition has either come back or has not responded to previous treatment. Specifically, the medicine targets patients with a susceptible IDH1 mutation.

Q: Is Axulta used to treat conditions other than the primary one described?

The medicine is only formally indicated by regulatory authorities for the treatment of relapsed or refractory AML with a susceptible IDH1 mutation. Use for any other conditions is not formally established or described in the official labeling.

Q: Does Axulta work the same way as other medicines in its class?

Axulta is classified as an isocitrate dehydrogenase-1 (IDH1) inhibitor, which is a specific type of targeted therapy. Its purpose is to specifically inhibit the activity of the mutated IDH1 enzyme, which in turn helps to decrease harmful substances and restore a more normal cell differentiation process.

Q: What are some common worries people have about the side effects of Axulta?

Official labeling includes a Boxed Warning regarding the risk of Differentiation Syndrome, which is a condition that may be life-threatening. There are also warnings for Hepatotoxicity (liver injury). These serious adverse reactions are highlighted in the official information and generally require immediate monitoring and management by a healthcare provider.

Q: Is it normal to feel tired or dizzy when first taking Axulta?

Official reports indicate that fatigue or malaise is a very common adverse reaction, affecting ge 20% of patients in clinical studies. Dizziness is not listed among the most common effects, but sudden changes like dizziness or shortness of breath are symptoms that a patient would typically report promptly to their healthcare team, as they may be associated with Differentiation Syndrome.

Q: Are there any common foods or drinks that should be avoided while using Axulta?

The official administration protocol requires the medicine to be taken on an empty stomach: at least one hour before or two hours after a meal. This timing separation is specified in the regulatory guidance as a condition for use.

Q: Is Axulta safe to take long-term, according to official information?

Official duration guidance indicates that treatment is typically continued until the condition progresses or the patient experiences unacceptable toxicity. While studies have monitored patients for up to two years, regulatory agencies have indicated that a further postmarketing study is required to fully characterize the incidence and severity of toxicities that may develop with longer term use.

Q: Are there any known issues with taking Axulta and alcohol?

The official product label includes general warnings about food/alcohol interactions. While there is no definitive statement on the direct effect of moderate alcohol intake, heavy drinking can impact the immune system. Official information indicates that the medicine is associated with tiredness, a side effect that may be exacerbated by alcohol consumption.

Q: Do older adults (seniors) need to take a different dose of Axulta?

According to the official geriatric use data, no overall differences in the effectiveness of the medicine were observed between patients aged 65 and older and younger patients. Therefore, regulatory information indicates that no specific dosage recommendations are required for older adults based on age alone.

Q: Is Axulta generally considered appropriate for people with kidney problems?

Official labeling states that no dosage modification is recommended for patients with mild or moderate renal (kidney) impairment. However, the recommended dosage has not been established for individuals with severe kidney impairment, kidney failure, or those who are on dialysis.

Q: What does the official prescribing information say about using Axulta during pregnancy?

Based on findings from animal studies, this medicine may cause harm to an unborn baby. Regulatory information indicates that there is no available data in humans to fully evaluate the risk. Regulatory documents state that patients who are pregnant or may become pregnant should be informed of the potential risks to the fetus based on animal study findings.

Q: How is Axulta eliminated from the body?

According to the official pharmacokinetics data, the medicine is processed primarily by the CYP3A4 enzyme in the liver. Most of the administered dose is eliminated from the body through the feces (about 75%), with a smaller amount eliminated in the urine (about 17%).

Q: Can Axulta affect the results of common blood tests?

Yes, common laboratory abnormalities have been reported in clinical studies. These include increases in liver enzymes (AST/ALT) and decreases in electrolytes like potassium and sodium. These changes are documented in the official labeling as common laboratory abnormalities.

Q: Is there a generic version of Axulta available?

Currently, the medicine is only available as the brand name product, which is sold as Rezlidhia (Olutasidenib). No generic version is available at this time due to current regulatory exclusivity and patent protections.

Q: What kind of research has been done on the long-term effects of Axulta?

Regulatory authorities have mandated a postmarketing study to specifically track and better characterize the incidence and severity of side effects that may occur with longer term use of the medicine. This ensures continued monitoring of safety beyond the scope of the initial clinical trials.

Q: What does the term 'contraindication' mean regarding Axulta use?

A contraindication is an official statement that the medicine should not be used in a specific situation, as the risks clearly outweigh the benefits. For this medicine, the only contraindication is a known hypersensitivity or allergic reaction to the drug or any of its components.

Q: What common supplements might interact with Axulta?

The drug is mainly processed by the CYP3A4 enzyme system. Supplements that are known to either significantly block (inhibitors) or accelerate (inducers) this enzyme can potentially interact with the medicine. This interaction profile is documented in the official labeling.

Q: Can Axulta cause changes in appetite or weight?

Yes, changes in weight and appetite are reported as signs of serious adverse reactions. Loss of appetite is a documented symptom of Hepatotoxicity (liver injury). Also, rapid weight gain is listed as one of the symptoms associated with Differentiation Syndrome.

Q: Is Axulta known to interact with birth control pills?

The medicine's interaction profile does not specifically name oral contraceptives, but it has the potential to affect other drugs processed by the CYP3A4 enzyme. Regulatory information specifies that women of reproductive potential should use effective contraception during treatment and for 2 weeks after the final dose.

Q: Does Axulta require regular monitoring or check-ups with a doctor?

Yes, regulatory documents emphasize the need for regular monitoring. This includes frequent monitoring of liver function tests due to the risk of Hepatotoxicity, and constant vigilance for signs and symptoms of Differentiation Syndrome and other adverse reactions.

Q: How long does it take for Axulta to be completely out of a person's system?

The average time it takes for half of the medicine to be eliminated from the body (the half-life, t1/2) is approximately 67 hours. Based on this data, it takes about two weeks for the medicine to be almost entirely cleared from the body.

Q: Does taking Axulta affect driving or operating machinery?

The official label does not specifically restrict driving. However, because adverse reactions like fatigue and potential dizziness have been reported, patients should use caution until they understand how the medicine affects them, especially before engaging in activities that require full mental alertness.

Q: What is the risk of dependence or addiction associated with Axulta?

The medicine is not classified as a controlled drug or a scheduled substance by the Drug Enforcement Administration (DEA) in the United States. This designation indicates that it is not typically associated with a risk of dependence or abuse.

Q: What should a patient know about the inactive ingredients in Axulta tablets?

The official description of the medicine lists all active and inactive ingredients used in the capsule formulation. A known hypersensitivity to any component is listed as a contraindication for use, making the listing of inactive ingredients relevant for patient review.

Q: Does Axulta interact with blood pressure medications?

The medicine itself has been associated with the common side effect of hypertension (high blood pressure). Furthermore, regulatory documents advise caution with drugs that can prolong the QTc interval (a measure of heart rhythm), which includes certain heart and blood pressure medications. Monitoring is required when these are taken together.

Q: What does the term 'clinical trial' mean in the context of Axulta's development?

A clinical trial refers to the research studies conducted with human volunteers to test the medicine's safety and effectiveness before it receives regulatory approval. For this drug, the evidence is derived primarily from the results of a Phase 1/2 trial.

Q: What are the symptoms of a serious allergic reaction to Axulta?

A known hypersensitivity (allergic reaction) to the drug is a contraindication, meaning the medicine should not be used. Symptoms of a severe allergic reaction often include the sudden onset of hives, difficulty breathing, or swelling of the face, lips, or throat.

Q: Why are people with certain heart conditions advised not to use Axulta?

Regulatory guidance advises caution or restriction when the medicine is co-administered with drugs that are known to Prolong the QTc Interval. This is due to the potential for the combination to cause additive effects on the heart's electrical rhythm, necessitating careful monitoring.

Q: Is Axulta a scheduled substance or controlled drug?

No. Official classification confirms that this medicine is not a scheduled substance and is not classified as a controlled drug by the Drug Enforcement Administration (DEA) in the United States.

Q: Are there any specific genetic factors that affect how Axulta works?

Yes. Axulta is considered a targeted therapy because it is designed to work specifically by inhibiting the effects of the susceptible IDH1 mutation. It is only approved for patients who have been confirmed to carry this specific genetic factor.

Q: Is Axulta a brand name, and what is the active ingredient?

Yes, Axulta (which is marketed as Rezlidhia) is the brand name of the drug. The active ingredient is olutasidenib. This is the substance responsible for the therapeutic effect in the body.

Q: Is Axulta suitable for people with liver disease?

Official information indicates that no dosage modification is needed for patients who have mild or moderate hepatic (liver) impairment. However, the recommended dosage has not been established for individuals who have severe hepatic impairment (severe liver disease).

Q: What are the official recommendations for discontinuing Axulta?

The official label provides clear conditions for discontinuation. The medicine is stopped if the disease progresses, if the patient experiences unacceptable toxicity, or if certain severe adverse reactions occur, such as Grade 4 Hepatotoxicity or a recurrence of other high-grade toxicities.

Q: What does the official document say about the chance of a serious side effect?

In clinical trials, official reports indicate that serious adverse reactions of any kind occurred in 25% of patients. Specifically, Differentiation Syndrome occurred in 9% of patients, and severe Hepatotoxicity (Grade 3/4) was reported in 10-13% of patients.

How should Axulta be stored and disposed of?

How to Store and Dispose of Axulta?

Official regulatory documents define specific storage and disposal requirements for Axulta to ensure product stability and safety.

Storage Component Official Requirement
Access Control Store locked up (P405) to restrict unauthorized access.
Environment Store in a well-ventilated place (P403).
Temperature Keep cool (P235), and the container must be kept tightly closed (P233).
Disposal Dispose of contents and container according to all applicable local, regional, national, and international regulations (P501).

These requirements mandate that Axulta must be stored securely to prevent accidental exposure and under environmental conditions (well-ventilated and cool) to maintain its integrity. Final disposal must adhere strictly to environmental waste protocols defined by governmental authorities.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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