What is Xermelo used for?

Xermelo is used to treat diarrhea in adults with carcinoid syndrome who are already taking somatostatin analog (SSA) therapy.

Can Xermelo cause constipation?

Yes, Xermelo can reduce bowel movement frequency and lead to constipation. You should stop the medicine and contact a doctor if you develop severe constipation or abdominal pain.

Should I take Xermelo with food?

Yes, it is recommended to take Xermelo with food.

What should I do if I miss a dose of Xermelo?

Take your missed dose at your regular time, but never take two doses at once to make up for a missed one.

Are there any drug interactions with Xermelo?

Xermelo may make certain drugs (like midazolam or bupropion) less effective. Also, wait 30 minutes after taking Xermelo before taking short-acting octreotide.

Who should not take Xermelo?

You should not take Xermelo if you have a history of allergic reactions to telotrisat, such as a rash or swelling.

Is Xermelo safe for people with liver problems?

Xermelo is not recommended for people with moderate or severe liver impairment.

What are the most common side effects of Xermelo?

Common side effects include nausea, headache, depression, flatulence, and decreased appetite.

telotristat | CAS 1033805-28-5 | NCLGDOBQAWBXRA

Loading compound...

Tryptophan hydroxylase inhibitor

Xermelo (telotrisat ethyl) is a prescription medicine used to treat diarrhea caused by carcinoid syndrome in adults. It is used alongside somatostatin analog (SSA) therapy when that therapy alone does not control the diarrhea well enough.

How it worksXermelo works as a tryptophan hydroxylase inhibitor to help manage symptoms of carcinoid syndrome.

Brand names:Xermelo

Used for

Carcinoid syndrome diarrhea

Conditions

Carcinoid syndrome

Class

Tryptophan hydroxylase inhibitorGastrointestinal

How to take

FormsOral

RoutesOral

The usual dose for adults is 250 mg taken three times every day.

You should take Xermelo with food. If you miss a dose, take it at your regular time, but do not take two doses at once to make up for a missed one.

Missed dose: Take the missed dose at your regular time. Do not take two doses at once.

Key warnings

·Xermelo can cause constipation and reduce how often you have bowel movements. You should monitor for severe constipation or worsening abdominal pain and stop taking the medicine if these occur.

Do not use if

·Do not use Xermelo if you have had an allergic reaction to telotrisat, such as a rash, itching, or swelling (angioedema).

Side effects

Common

NauseaHeadacheIncreased GGT (liver enzyme)DepressionFlatulenceDecreased appetiteSwelling in the limbs (peripheral edema)Fever (pyrexia)

Serious

·Constipation
·Severe or worsening abdominal pain
·Intestinal perforation
·Intestinal obstruction
·Fecaloma
·Allergic reactions (swelling, rash, or itching)

Seek help if

·Severe constipation
·Severe or worsening abdominal pain
·Allergic reaction symptoms like rash or swelling

Interactions

·Drugs that use the CYP3A4 pathway (like midazolam) may be less effective when taken with Xermelo.
·Drugs that use the CYP2B6 pathway (like bupropion or efavirans) may be less effective when taken with Xermelo.
·If you use short-acting octreotide, wait at least 30 minutes after taking Xermelo before taking the octreotide.

FoodTake Xermelo with food.

Special populations

PregnancyThere is no data on how Xermelo affects pregnant women. In animal studies, very high doses caused issues like pregnancy loss and reduced fetal weight, but the risks for humans are not yet known.

PediatricThe safety and effectiveness of Xermelo for children have not been studied.

GeriatricIn clinical trials, older adults (65 and older) used the drug similarly to younger adults, though older people might be more sensitive to some side effects.

Talk to your doctor

Monitor

·Bowel movement frequency
·Abdominal pain
·Liver enzymes (GGT)
·Signs of allergic reaction

Questions to ask

·Can I take Xermelo if I have liver or kidney issues?
·How will Xermelo interact with my other medications?
·What should I do if I experience severe constipation?
·Is it safe to take Xermelo with my current SSA therapy?

Pharmacokinetics

MetabolismSystemic exposure of telotrisat ethyl and its active metabolite, telotrisat, increases in patients with moderate or severe hepatic impairment.

Educational summary derived from FDA labeling, AI-assisted. Not medical advice — consult a healthcare professional. Updated 2026-04-26.