Belumosudil is used to treat chronic graft-versus-host disease after at least two other treatments did not work.

Belumosudil is for use in adults and children at least 12 years old.

Belumosudil may also be used for purposes not listed in this medication guide.

Use only as directed. Tell your doctor if you use other medicines or have other medical conditions or allergies.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Belumosudil is usually taken once per day with a meal. Follow your doctor's dosing instructions very carefully.

Take with a full glass of water, at the same time each day.

Swallow the tablet whole and do not crush, chew, or break it.

You will need frequent blood tests to check your liver function.

Store tightly closed at room temperature, away from moisture and heat.

Keep the tablets in their original container, along with the packet or canister of moisture-absorbing preservative.

Usual Adult Dose for Graft Versus Host Disease:

200 mg orally once a day until progression of chronic GVHD that requires new systemic therapy

Use: For the treatment of adults with chronic graft-versus-host disease (chronic GVHD) after failure of at least 2 prior lines of systemic therapy

Usual Pediatric Dose for Graft Versus Host Disease:

200 mg orally once a day until progression of chronic GVHD that requires new systemic therapy

Use: For the treatment of pediatric patients 12 years and older with chronic graft-versus-host disease (chronic GVHD) after failure of at least 2 prior lines of systemic therapy

Tell your doctor if you have ever had liver or kidney problems.

You may need to have a negative pregnancy test before starting this treatment.

Both men and women using belumosudil should use effective birth control to prevent pregnancy. Belumosudil can harm an unborn baby if the mother or father is using this medicine.

Keep using birth control for at least 1 week after your last dose. Tell your doctor right away if a pregnancy occurs.

Pregnancy may be less likely to occur while the mother or the father is using this medicine. Both men and women should still use birth control to prevent pregnancy because the medicine can harm an unborn baby.

Do not breastfeed while using this medicine, and for at least 1 week after your last dose.

Take the missed dose on the same day you remember it. Take your next dose at the regular time and stay on your once-daily schedule. Do not take two doses in one day.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not remove the desiccant (small packet included with medication to absorb moisture).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Unless your doctor tells you otherwise, continue your normal diet.

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Belumosudil may cause serious side effects. Call your doctor at once if you have:

• severe ongoing nausea, vomiting, or diarrhea;

• liver problems--loss of appetite, stomach pain (upper right side), dark urine, jaundice (yellowing of the skin or eyes); or

• signs of infection--fever, chills, sore throat, body aches, unusual tiredness, bruising or bleeding, painful urination, cough with mucus, chest pain, feeling short of breath.

Common side effects of belumosudil may include:

• stomach pain, nausea, diarrhea;

• infections, bleeding;

• high blood pressure;

• cough, shortness of breath;

• muscle or bone pain;

• swelling;

• headache; or

• feeling weak or tired.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your current medicines. Many drugs can affect belumosudil, especially:

• phenobarbital or other barbiturate medicine;

• St. John's wort;

• an antibiotic--rifabutin, rifampin, rifapentine;

• cancer medicine--apalutamide, enzalutamide, mitotane;

• HIV or AIDS medicine--efavirenz, nevirapine;

• a proton pump inhibitor stomach acid medicine--esomeprazole, lansoprazole, omeprazole, Nexium, Prevacid, Prilosec, Protonix, and others;

• seizure medicine--carbamazepine, oxcarbazepine, phenytoin, primidone; or

• steroid medicine--dexamethasone, prednisone.

This list is not complete and many other drugs may affect belumosudil. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to belumosudil.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.