Imbruvica

Uses of Imbruvica

Imbruvica (ibrutinib) is used to treat Waldenström’s macroglobulinemia (WM), chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL) and chronic graft versus host disease (cGVHD) in certain patients. Imbruvica is used to help slow cancer or disease progression in WM, CLL, SLL and cGVHD. Imbruvica is taken once a day as a capsule, tablet or oral suspension.

Imbruvica works by blocking an enzyme called Bruton’s tyrosine kinase (BTK) which lowers the survival of cancerous B cells and slows the spread of CLL or SLL. In WM Imbruvica helps abnormal B cells move out of the nourishing environments in the lymph nodes, bone marrow, and other organs, and Imbruvica also inhibits specific immune cells that are involved in cGVHD.

Imbruvica’s mechanism of action is by directly inhibiting an enzyme, called Bruton’s tyrosine kinase (BTK). It forms a covalent bond with a cysteine residue on the enzyme, preventing its activity. BTK works as a signaling molecule for the B-cell antigen receptor (BCR) and cytokine receptor pathways. Activation of these pathways causes the proliferation of B cells and other interactions, and inhibition has been shown to reduce the growth and spread of malignant B cells. It belongs to the class of medicines known as BTK inhibitors.

Precautions and Warnings

Before taking ibrutinib, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood/bleeding problems, heart problems (such as fast/irregular heartbeat, previous heart attack), high blood pressure, kidney problems, liver problems, high levels of uric acid in the blood.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Ibrutinib can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.

Tell your health care professional that you are using ibrutinib before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Your doctor may tell you to temporarily stop treatment with this medication before certain medical, surgical, or dental procedures.

Older adults may be at greater risk for low red blood cell count, bleeding, fast/irregular heartbeat, and high blood pressure while using this drug.

Since this drug can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the capsules.

Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using ibrutinib. Ibrutinib may harm an unborn baby. Your doctor should order a pregnancy test before you start this medication. Men and women using this medication should ask about reliable forms of birth control during treatment and for 1 month after the last dose. If you or your partner becomes pregnant, talk to your doctor right away about the risks and benefits of this medication.

It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breastfeeding is not recommended while using this drug and for 1 week after the last dose. Consult your doctor before breastfeeding.

Dosage

The dose of Imbruvica varies depending on the condition being treated:

Imbruvica Dosage for Adults with CLL/SLL and WM

• 420mg once daily.

Imbruvica Dosage for cGVHD

• Patients 12 years and older: 420mg once daily
• Patients 1 year old to less than 12 years old: 240mg/m² once daily (up to a maximum dosage of 420mg once daily).

Side Effects

Common side effects:

• Upset stomach,
• diarrhea,
• nausea,
•  vomiting,
• decreased appetite,
• headache,
• joint/muscle pain,
• swelling of ankles/legs/feet,
• numbness/tingling of arms/legs,
• anxiety,
• constipation,
• dizziness,
• tiredness