Imbruvica Ibrutinib 140 Mg Capsules

Q1: What is Imbruvica (Ibrutinib) used for?

Imbruvica treats chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), Waldenström's macroglobulinemia, marginal zone lymphoma, and chronic graft-versus-host disease — multiple B-cell malignancies and immune conditions.

Q2: How does Ibrutinib work against blood cancers?

Ibrutinib is the first BTK (Bruton's tyrosine kinase) inhibitor. It irreversibly binds to BTK, blocking B-cell receptor signaling that malignant B-cells depend on for survival, proliferation, and migration — causing cell death and suppression of tumor growth.

Q3: How is Imbruvica 140mg administered?

Take 420mg (3 capsules) to 560mg (4 capsules) once daily at the same time each day, with water. Swallow capsules whole. Do not open or crush them.

Q4: What dose is used for CLL versus MCL?

For CLL and marginal zone lymphoma: 420mg (3 capsules) once daily. For MCL and Waldenström's macroglobulinemia: 560mg (4 capsules) once daily. For cGvHD: 420mg once daily.

Q5: Should I avoid grapefruit with Ibrutinib?

Yes. Grapefruit and Seville oranges inhibit CYP3A4, which metabolises Ibrutinib. Consuming these can raise Ibrutinib blood levels significantly and increase side effect risk. Avoid them throughout treatment.

Q6: What are the most common side effects?

Common side effects include diarrhea, bruising, fatigue, musculoskeletal pain (arthralgia/myalgia), skin rash, and nausea. These are usually manageable and often improve with continued treatment.

Q7: What serious side effects require emergency care?

Seek immediate care for: severe uncontrolled bleeding, atrial fibrillation (irregular, rapid heartbeat), serious infections with fever, severe skin reactions, or signs of second malignancy.

Q8: What bleeding risk does Ibrutinib carry?

Ibrutinib inhibits platelet aggregation and increases bleeding risk. Hold Ibrutinib for at least 3–7 days before and after surgery. Avoid anticoagulants and antiplatelet agents unless clearly necessary.

Q9: Does Ibrutinib cause heart rhythm problems?

Atrial fibrillation (AF) occurs in 6–9% of patients on Ibrutinib and is more common with longer treatment duration and in older patients. Report any palpitations, shortness of breath, or irregular heartbeat to your doctor promptly.

Q10: What drugs interact with Imbruvica?

Strong and moderate CYP3A4 inhibitors (ketoconazole, clarithromycin, diltiazem) significantly increase Ibrutinib levels. Strong inducers (rifampicin, carbamazepine) reduce efficacy. Avoid anticoagulants and antiplatelet agents unless benefits clearly outweigh risks.

Q11: Is Ibrutinib safe during pregnancy?

No. Ibrutinib can cause fetal harm. Women of childbearing potential must use effective contraception during treatment and for 1 month after stopping. Male patients should use contraception during and for 3 months after treatment.

Q12: Is a prescription required for Imbruvica?

Yes. Imbruvica is a prescription-only specialist haematology/oncology drug requiring specialist prescribing, genetic typing of the cancer, and close monitoring for bleeding, arrhythmia, and infection throughout treatment.