Ibrutinib (Oral)

Overview

Ibrutinib is an antineoplastic agent (cancer medicine) used in the treatment of chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), Waldenström macroglobulinemia (WM) and small lymphocytic lymphoma (SLL). It works by interfering with the growth of cancer cells, which are then destroyed eventually by the body. Ibrutinib is an antineoplastic agent (cancer medicine).

You cannot obtain this medication on your own, it is only available via prescription from your doctor. It is available in the dosage form of a capsule.

Conditions treated

  • Incompatibility Reaction Following Bone Marrow Transplant

Type of medication

  • Oral capsule

Side effects

Alongside its intended effects, the consumption of this drug can produce some unwanted side effects. Not all of these side effects need to be present, but if any do occur, you may need to seek medical advice.

Inform your doctor or healthcare professional right away if you suffer from any of the following side effects whilst taking Ibrutinib.

More common

  • Confusion

Less common

  • Shiny skin bump

Some of the side effects that can occur with this drug usually don't require any specific medical attention due to their low severity. You usually find that these side effects begin to disappear as your body begins adjusting to the medication. However, if you are finding these side effects bothersome, you can contact your local pharmacist or doctor for advice on various ways to reduce the severity of these side effects or even avoid them altogether. You should check with your doctor or healthcare professional if any of the following side effects listed below become persistent or bothersome.

More common

  • Swelling or inflammation of the mouth

You may suffer from other side effects that are not listed above, you should seek advice from your doctor if you notice anything strange or unusual. Remember to report all side effects to the FDA if necessary on 1-800-FDA-1088.

Dosage

The final dose of any medication you will receive is dependent on individual factors including specifics surrounding the medication itself. Your doctor will take into account things such as your age, weight and height, any other medical conditions you suffer from and corresponding drugs you are taking for treatment. They will also consider what condition you are being treated for, how often you are receiving the medication and how your body reacts to the first dose. Do not take more of this medication than has been prescribed to you. To do so could increase your risk of serious interactions or increased side effects.

For oral dosage form (capsules):

For chronic lymphocytic leukemia, small lymphocytic lymphoma, or Waldenström macroglobulinemia:

Adults should take 420 milligrams once daily.

Children: the use and dose will be determined by your doctor.

For mantle cell lymphoma:

Adults should take 560 milligrams once daily.

Children: the use and dose will be determined by your doctor.

Missed Dose

If you forget to take a dose of this medication, you need to take it as soon as you remember. The exception is if it's almost time for your next dose. In this case, you should skip the dose you have missed and go back to your regular schedule. Don't double your doses.

Only take the missed dose if it is the same day as the scheduled dose.

Proper use

This medication comes with a patient information leaflet. You need to read this carefully and follow all instructions. Seek advice from your doctor if you have questions.

Take this medication at the same time each day.

Swallow the capsule alongside a glass of water. Do not crush, open, chew or break it.

Ensure you consume plenty of water each day to help avoid dehydration caused by diarrhea.

Don't eat products containing grapefruit or Seville oranges with this medication.

Interactions

This consumption of this drug can interact with a variety of other drugs which could produce severe side effects or even reduce the effectiveness of either drug you are taking. In some cases, your doctor may avoid treating you with this drug, but in other cases, interactions may be unavoidable. To help limit the risk of interactions occurring, it's a good idea to give your doctor a complete list of all the current and past medications you have taken. This should include all over the counter products, prescription and non-prescription drugs, herbal products/remedies and any vitamin supplements. It's also important to make your doctor aware of any other health conditions you may suffer from.

The use of this medication alongside any of the following medications is not typically recommended, but in some cases, it may be necessary. If you are prescribed both medications at the one time, your doctor may alter the dose or frequency in which you use either medication.

  • Aprepitant

There are over 400 drugs that can interact with this medication. The following are listed in moderate severity. You should let your doctor know if you are taking any of the following drugs. However, this list is not complete, so it's important to consult with your doctor about any medication you are taking.

  • Nepafenac ophthalmic

Other conditions

Other interactions

In some cases, you can't eat certain foods, drink alcohol or use tobacco whilst using medication. You should speak with your doctor about possible interactions and usage.

The use of this medication is not recommended with any of the following, however, in some cases, it may be unavoided. If given together, your doctor may alter the dose or how often you use this medication or give you special instructions about the use of alcohol, food, and tobacco.

  • Grapefruit Juice

Warnings

Before deciding to take a drug, it's important that you consider both the potential benefits and risks alongside other factors.

Allergies

Let your doctor know if you have ever suffered from an unusual or allergic reaction to this medication or similar medications. You should also make them aware of any of allergies you may suffer from including to animals, foods, dyes, and preservatives.

Pediatric population

Appropriate studies have not yet been conducted on the relationship of age to the effects of this drug in the pediatric population. Therefore efficacy and safety have not been established.

Geriatric population

Appropriate studies conducted to date have not indicated a geriatric-specific problem that could limit the useful nature of ibrutinib in the elderly population.

Use in pregnancy and breastfeeding

The use of this drug can potentially harm an unborn child. You may need to prove you are not pregnant before you start treatment with this drug. You should use effective forms of birth control to prevent pregnancy whilst you are using this medication, whether you are a woman or man. The use by either parent can cause birth defects.

Keep using birth control for at least one month after your last dose of this medication and inform your doctor immediately if you fall pregnant whilst either the mother or father was using this drug.

It is unknown whether ibrutinib can pass into breast milk or affect a breastfeeding baby. You should avoid breastfeeding while using this medication.

It's very important that your doctor monitors your progress with regular appointments whilst taking this drug. This will allow them to ensure the medication is working properly and to test for any side effects via blood and urine tests.

This medication can cause bleeding problems. You should check with your doctor immediately if you notice any of the following symptoms:

  • Red or dark brown urine

Ensure that any dentist or doctor who is treating you is aware that you are taking this medication. You may need to stop this medication if you have to have surgery.

This medication can increase your risk of developing infections, including a serious infection of the brain known as progressive multifocal leukoencephalopathy. Seek medical attention immediately if you suffer from any of the following signs:

  • Weight loss

Ibrutinib can lower the number of white blood cells in your blood temporarily which can increase your risk of obtaining an infection. It can also lower the number of platelets, which are needed for proper blood clotting. There are certain precautions you can take if this occurs to reduce the risk of bleeding or infection.

If you can, try to avoid people with infections and check with your healthcare professional or doctor right away if you think you are getting an infection.

Be careful when using dental floss, a regular toothbrush, or toothpick. Your healthcare professional may recommend other ways to clean your gums and teeth. You should consult with your doctor before committing to dental work.

Don't touch the inside of your nose or your eyes unless you have just washed your hands. Be careful not to cut yourself when you are using sharp objects such as toenail or fingernail cutters or a safety razor. Avoid situations or contact sports where injury or bruising could occur.

This medication could cause a heart condition known as atrial flutter. You should seek advice from a doctor right away if you suffer from a fast or irregular heartbeat, lightheadedness, trouble breathing, fainting or dizziness.

The use of this medication can increase your risk of obtaining new cancers, such as skin cancer. You should discuss the risks with your doctor.

This medication can cause a serious reaction known as tumor lysis syndrome. You can be given a medication to prevent this. Let your doctor know if you suffer from any of the following side effects:

  • Unusual weakness or tiredness

Storage

This medication should be stored in a closed container and kept at room temperature. It's also important to keep it away from moisture, heat, and light. Do not let this medication freeze. Make sure you keep it out of the reach of small children. Do not keep any medication that has passed its expiry date or you no longer need. You should ask your local pharmacist or healthcare professional for specific advice on the best way to dispose of this medication after you no longer need it.

Summary

When used correctly, this drug is successful in the treatment of various cancers such as chronic lymphocytic leukemia, mantle cell lymphoma, and Waldenstrom's macroglobulinemia. Due to a large number of interactions possible with this medication, it is important that you give your physician a full list of all the current and past medications you are taking. Do not take this medication for longer than has been prescribed. Your condition will not improve faster, and you increase your risk of obtaining serious side effects.

The safety and efficacy have not been established in the use of children. You should not use this medication whilst pregnant and take the necessary precautions to avoid falling pregnant. You should avoid falling pregnant for at least one month after you have stopped taking this medication. This includes use for both mother and father. You should also avoid breastfeeding whilst using this medication as it can pass into breast milk. This drug can increase your risk of obtaining other cancers so it's important you weigh up the pros and cons of receiving this medication. If you require any further information about the practical uses of this medication or have any other questions, you should contact your local healthcare professional or doctor for advice.