SCEMBLIX Film-coated tablet Ref.[50174] Active ingredients: Asciminib

Source: European Medicines Agency (EU)  Revision Year: 2026  Publisher: Novartis Europharm Limited, Vista Building, Elm Park, Merrion Road, Dublin 4, Ireland

4.1. Therapeutic indications

Scemblix is indicated for the treatment of adult patients with Philadelphia chromosome-positive chronic myeloid leukaemia in chronic phase (Ph+ CML-CP) (see section 5.1).

Scemblix is indicated for the treatment of adult patients with Ph+ CML-CP with the T315I mutation who are resistant to, intolerant to or ineligible for ponatinib (see section 5.1).

4.2. Posology and method of administration

Treatment should be initiated by a physician experienced in the diagnosis and treatment of patients with leukaemia.

Posology

Ph+ CML-CP

The recommended total daily dose of asciminib is 80 mg. Asciminib can be taken orally either as 80 mg once daily at approximately the same time each day, or as 40 mg twice daily at approximately 12-hour intervals (see section 4.4).

Patients switching from 40 mg twice daily to 80 mg once daily should start taking asciminib once daily approximately 12 hours after the last twice-daily dose, and then continue at 80 mg once daily.

Patients switching from 80 mg once daily to 40 mg twice daily should start taking asciminib twice daily approximately 24 hours after the last once-daily dose, and then continue at 40 mg twice daily at approximately 12-hour intervals.

The decision on the appropriate dosage regimen should be taken at the prescriber's discretion as necessary for the benefit of the patient.

Ph+ CML-CP with the T315I mutation in patients resistant to, intolerant to or ineligible for ponatinib

The recommended dose is 200 mg twice daily at approximately 12-hour intervals.

Use of the 100 mg film-coated tablets is restricted to patients with Ph+ CML-CP with the T315I mutation.

Missed dose

Once-daily dosage regimen

If a dose is missed by less than 12 hours, it should be taken and the next dose should be taken as scheduled.

If a dose is missed by more than approximately 12 hours, it should be skipped and the next dose should be taken as scheduled.

Twice-daily dosage regimen

If a dose is missed by less than 6 hours, it should be taken and the next dose should be taken as scheduled.

If a dose is missed by more than approximately 6 hours, it should be skipped and the next dose should be taken as scheduled.

Treatment duration

Treatment with asciminib should be continued as long as clinical benefit is observed or until unacceptable toxicity occurs.

Dose adjustments for adverse reactions

Ph+ CML-CP

The starting dose is 80 mg once daily or 40 mg twice daily, while the reduced dose is 40 mg once daily or 20 mg twice daily, respectively. The dose can be modified based on individual safety and tolerability as shown in Table 1. Asciminib should be permanently discontinued in patients unable to tolerate a dose of 40 mg once daily or 20 mg twice daily.

Ph+ CML-CP with the T315I mutation in patients resistant to, intolerant to or ineligible for ponatinib

The starting dose is 200 mg twice daily, while the reduced dose is 160 mg twice daily. The dose can be modified based on individual safety and tolerability as shown in Table 1. Asciminib should be permanently discontinued in patients unable to tolerate a dose of 160 mg twice daily.

Table 1. Asciminib dose modification schedule for the management of adverse reactions:

Adverse reactionDose modification
Thrombocytopenia and/or neutropenia
ANC <1.0 x 109/l and/or PLT
<50 x 109/l
Withhold asciminib until resolved to ANC ≥1 x 109/l
and/or PLT ≥50 x 109/l.
If resolved:
• Within 2 weeks: resume at starting dose.
• After more than 2 weeks: resume at reduced dose.
For recurrent severe thrombocytopenia and/or neutropenia,
withhold asciminib until resolved to ANC ≥1 x 109/l and
PLT ≥50 x 109/l, then resume at reduced dose.
Asymptomatic amylase and/or lipase elevation
Elevation >2.0 x ULNWithhold asciminib until resolved to <1.5 x ULN.
• If resolved: resume at reduced dose. If events reoccur at
reduced dose, permanently discontinue.
• If not resolved: permanently discontinue. Perform
diagnostic tests to exclude pancreatitis.
Non-haematological adverse reactions
Grade 3 or higher1 adverse reactionsWithhold asciminib until resolved to grade 1 or lower.
• If resolved: resume at a reduced dose.
• If not resolved: permanently discontinue.

ANC: absolute neutrophil count; PLT: platelets; ULN: upper limit of normal
1 Based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v 4.03.

Special populations

Elderly

No dose adjustment is required in patients aged 65 years or above.

Renal impairment

No starting dose adjustment is required in patients with mild or moderate renal impairment at all recommended doses and in patients with severe renal impairment at the 80 mg total daily dose. No clinical data are available in patients with severe renal impairment at the 200 mg asciminib twice daily dose. Therefore, no recommendations for dose adjustment can be given. Caution should be exercisedin patients with severe renal impairment receiving the 200 mg twice daily dose (see sections 4.4 and 5.2).

Hepatic impairment

No starting dose adjustment is required in patients with mild or moderate hepatic impairment at all recommended doses and in patients with severe hepatic impairment at the 80 mg total daily dose. No clinical data are available in patients with severe hepatic impairment at the 200 mg asciminib twice daily dose. Therefore, no recommendations for dose adjustment can be given. Caution should be exercised in patients with severe hepatic impairment receiving the 200 mg twice daily dose (see sections 4.4 and 5.2).

Paediatric population

The safety and efficacy of Scemblix in paediatric patients aged below 18 years have not been established. No data are available.

Method of administration

Scemblix is for oral use. The film-coated tablets should be swallowed whole with a glass of water and should not be broken, crushed or chewed.

The tablets should be taken orally without food. Food consumption should be avoided for at least 2 hours before and 1 hour after taking asciminib (see section 5.2).

4.9. Overdose

In clinical studies, asciminib has been administered at doses up to 280 mg twice daily with no evidence of increased toxicity.

General supportive measures and symptomatic treatment should be initiated in cases of suspected overdose.

6.3. Shelf life

Scemblix 20 mg and 40 mg film-coated tablets:

3 years.

Scemblix 100 mg film-coated tablets:

2 years.

6.4. Special precautions for storage

Do not store above 25°C.

Store in the original package in order to protect from moisture.

6.5. Nature and contents of container

Scemblix is supplied in PCTFE/PVC/alu (20 mg and 40 mg film-coated tablets) or PA/alu/PVC/alu
(100 mg film-coated tablets) blisters containing 10 film-coated tablets.

The following pack sizes are available:

Scemblix 20 mg film-coated tablets:

Packs containing 20 or 60 film-coated tablets.

Scemblix 40 mg film-coated tablets:

Packs containing 20 or 60 film-coated tablets.

Multipacks containing 180 (3 packs of 60) film-coated tablets.

Scemblix 100 mg film-coated tablets:

Packs containing 60 or 120 film-coated tablets.

Not all pack sizes may be marketed.

6.6. Special precautions for disposal and other handling

Any unused medicinal product or waste material should be disposed of in accordance with local requirements.

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