IBRUTIX
IBRUTINIB · by HIMMEL
Composition
Cap: Ibrutinib 140 mg
Indications & Dosage
Mantle cell lymphoma (specialist use only): Adult: 560 mg once daily, for dose adjustments consult product literature. Chronic lymphocytic leukaemia, Waldenstrӧm’s macroglobulinaemia (specialist use only): Adult: 420 mg once daily, for dose adjustments consult product literature.
Precautions
History of congenital short QT syndrome, increased lymphocytes; increased risk of leukostasis, monitor closely, patients at risk from further shortening of QTc interval, personal history of congenital short QT syndrome, risk of haemorrhagic events, withhold treatment for at least 3 to 7 days before and after surgery depending on risk of bleeding.
Interactions
Antacids, Antiarrhythmics (dronedarone), Antiepileptics (carbamazepine, fosphenytoin, phenobarbital, phenytoin, primidone), Antifungals, azoles, Aprepitant, Bosentan, Calcium channel blockers (diltiazem, verapamil), Cobicistat, Anticoagulant, Crizotinib, Efavirenz, Enzalutamide, H2 receptor antagonists, HIV-protease inhibitors (atazanavir, darunavir, fosamprenavir, indinavir , lopinavir, ritonavir, saquinavir, tipranavir), Idelalisib, Imatinib, Macrolides (clarithromycin, erythromycin), netupitant, Nevirapine, Nilotinib, Proton pump inhibitors, Rifampicin, St Johns Wort.
Pregnancy
Avoid unless essential
Lactation
Avoid. Discontinue breast-feeding.
Side Effects
Arrhythmias, arthralgia, CNS haemorrhage, constipation, diarrhoea, dizziness, fever, haemorrhage, headache, hypertension, hyperuricaemia, increased leucocytes, increased risk of infection, interstitial lung disease, muscle spasms, musculoskeletal pain, nausea, neoplasms, neutropenia, peripheral neuropathy, peripheral oedema, sepsis, skin reactions, stomatitis, thrombocytopenia, tumour lysis syndrome, vision blurred, vomiting. Rare: Angioedema hepatitis B reactivation leukostasis syndrome, panniculitis, anaemia, hepatic failure,.progressive multifocal leukoencephalopathy (PML), Stevens-Johnson syndrome