Brukinsa is a brand-name prescription drug that’s approved to treat mantel cell lymphoma (MCL) in adults. MCL is a type of blood cancer. Brukinsa is FDA-approved for use in people who’ve used at least one other treatment in the past for MCL.

Brukinsa contains the active drug zanubrutinib. It belongs to a class of drugs called BTK inhibitors. Brukinsa inhibits (blocks) the action of a protein called Bruton’s tyrosine kinase (BTK). By doing this, the drug can stop cancer cells from multiplying in your body. (Cells that multiply are making more cells.) And Brukinsa may also reduce tumor growth in some people.

Brukinsa is available in 80-mg capsules. It’s taken by mouth, usually once or twice daily.

FDA approval

In 2019, Brukinsa was approved by the Food and Drug Administration (FDA). It’s important to note that the drug received accelerated approval from the FDA.

Accelerated approval is based on information from early clinical trials of the drug. The FDA’s decision for full approval of Brukinsa will be made after additional clinical trials have been completed.

Typically, drugs receive approval from the FDA after extensive studies have been completed. But for some drugs, such as Brukinsa, a drug’s approval is granted before all of the studies have been done. Accelerated approval is granted for certain drugs that are used to treat conditions that don’t have a lot of successful treatment options.

For example, with MCL, there aren’t many treatment choices for people who’ve used at least one other treatment for the condition.

Effectiveness

In clinical trials, Brukinsa has been found effective in treating MCL. For information on Brukinsa’s effectiveness, see the section “Brukinsa uses” below.

Brukinsa is available only as a brand-name medication. It’s not currently available in generic form. (A generic drug is an exact copy of the active drug in a brand-name medication.)

Brukinsa contains the active drug ingredient zanubrutinib.

The Food and Drug Administration (FDA) approves prescription drugs such as Brukinsa to treat certain conditions. Brukinsa isn’t FDA-approved to treat chronic lymphocytic leukemia (CLL). However, Brukinsa is being studied as an off-label for the treatment of CLL.

With off-label use, a drug that’s approved to treat one condition is either prescribed or being tested to treat a different condition.

For information on the approved use of Brukinsa and other off-label uses of the drug, see the section “Brukinsa uses” below.

What CLL is

CLL is a blood cancer that typically starts in your bone marrow. With CLL, your body makes abnormal lymphocytes (a type of white blood cell).

Normally, lymphocytes help your body fight off infections. But with CLL, your body might not be able to fight off infections as easily as usual. This is because the abnormal lymphocytes don’t work with your immune system like healthy lymphocytes do.

Effectiveness for CLL

Brukinsa is currently being studied as a treatment option for types of cancer that it’s not approved to treat. And the types of cancer it’s being studied for include CLL.

In one study, researchers looked at Brukinsa as a treatment for either CLL or another cancer called small lymphocytic lymphoma (SLL). Brukinsa wasn’t compared with another medication or a placebo (drug with no active drug). At about 7 months of treatment, 92.2% of people taking Brukinsa responded to treatment. These people had lower levels of cancer cells in their body.

While some small studies have showed promising results of Brukinsa treatment for CLL, the studies still have to be evaluated by the FDA. The FDA will then decide whether Brukinsa is safe and effective enough to be used for CLL.

If you’d like to know more about Brukinsa’s effectiveness for CLL, talk with your doctor. And If you’re interested in participating in studies of Brukinsa for CLL, let your doctor know. They can let you know whether you’re eligible to take part in the studies.

The Food and Drug Administration (FDA) approves prescription drugs such as Brukinsa to treat certain conditions. Specifically, Brukinsa is approved to treat a type of blood cancer called mantle cell lymphoma (MCL).

Brukinsa may also be used off-label for other conditions. With off-label use, a drug that’s approved to treat one condition is used to treat a different condition.

For information on the off-label use of Brukinsa for chronic lymphocytic leukemia (CLL), see the section “Brukinsa for CLL” just above. And for information on other off-label uses of the drug, see the section “Brukinsa for other conditions” below.

Brukinsa for mantle cell lymphoma (MCL)

Brukinsa is FDA-approved to treat MCL. It’s approved for this use in adults who’ve used at least one other past treatment for the condition.

MCL is a form of cancer that affects certain white blood cells called B cells. With MCL, your B cells grow abnormally. The condition can also cause enlarged lymph nodes in certain areas of your body.

The abnormal B-cells caused by MCL can crowd out your healthy blood cells, which normally help your body fight off infections. This means that with MCL, you may be more prone to getting infections than are people who don’t have MCL.

Brukinsa works by inhibiting (blocking) the action of a protein called Bruton’s tyrosine kinase (BTK). This protein helps to signal B cells to grow and multiply. (Cells that multiply are making more cells.)

By stopping the abnormal B cells from multiplying, Brukinsa can reduce tumor growth in some people.

It’s important to note that Brukinsa received accelerated approval from the FDA to treat MCL. Accelerated approval is based on information from early clinical trials of the drug. The FDA’s decision for full approval of Brukinsa will be made after additional clinical trials have been completed.

Effectiveness for mantle cell lymphoma

Brukinsa was studied in two different clinical trials of adults with MCL. Everyone who participated in the trials had received at least one other past treatment for their MCL. And all of the people in the studies took Brukinsa. There weren’t any people in the studies who took a different drug or a placebo (treatment with no active drug).

The first study showed that:

  • 59% of people who took Brukinsa had a complete response to treatment. (With a complete response, their cancer completely went away with treatment.)
  • 24% of people had a partial response to treatment. (With a partial response, their cancer partially went away with treatment.)
  • Half of the people in the study kept these responses for at least 19.5 months.

In the second study, the following results were seen:

  • 22% of people taking Brukinsa had a complete response to treatment.
  • 62% of people taking Brukinsa had a partial response.
  • Half of the people in the study kept these responses for at least 18.5 months.

Brukinsa for other conditions

In addition to the use described above, Brukinsa may be used off-label for other purposes. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. And you may wonder if Brukinsa is used for certain other conditions. Below is information on other possible uses for Brukinsa.

For information on using Brukinsa off-label to treat chronic lymphocytic leukemia (CLL), see the section “Brukinsa for CLL” above.

Brukinsa for other forms of lymphoma (off-label use)

There are several ongoing trials testing Brukinsa as a treatment for different types of lymphomas than it’s approved to treat. (Lymphomas are types of cancers that affect certain blood cells.)

For example, Brukinsa is currently being studied as a treatment for CLL. And sometimes the drug is used off-label for this condition. For more information about using Brukinsa to treat CLL, see the section “Brukinsa for CLL” above.

In addition, Brukinsa is being studied as a treatment option for the following forms of lymphoma:

You can view a full list of current clinical trials of Brukinsa at ClinicalTrials.gov. And some of the trials listed on this website are recruiting people to join them.

If you have questions about using Brukinsa to treat certain forms of lymphoma, talk with your doctor. Also talk with your doctor if you’d like more information about participating in ongoing trials.

Brukinsa and children

Brukinsa hasn’t been studied in children. So it’s not known whether the drug is safe or effective for use in people younger than 18 years of age.

The Brukinsa dosage your doctor prescribes will depend on several factors. These include:

  • the severity of the condition you’re using Brukinsa to treat
  • your age
  • other medical conditions you may have
  • other medications you may be taking

Typically, your doctor will start you on a standard dosage of Brukinsa. Then they’ll adjust your dosage over time to reach the amount of drug that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect and the least number of side effects.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Brukinsa contains the active drug zanubrutinib. It’s available as 80-mg capsules.

Dosage for mantle cell lymphoma (MCL)

The usual dosage of Brukinsa for MCL is either of the following options:

  • 160 mg taken twice daily
  • 320 mg taken once daily

Your doctor may adjust your dosage of Brukinsa if needed. For example, they may do this depending on other medications you’re taking and how well you’re tolerating Brukinsa.

What if I miss a dose?

If you miss a dose of Brukinsa, take the missed dose as soon as possible that day. Then, on the following day, you can go back to your normal schedule for taking Brukinsa.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Brukinsa is meant to be used as a long-term treatment. If you and your doctor determine that Brukinsa is safe and effective for you, you might take the drug long term.

Typically, Brukinsa treatment is continued until either your disease gets worse or you have bothersome or severe side effects from the drug. Your doctor will recommend how long you should keep taking this drug based on your individual situation.

Brukinsa can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Brukinsa. These lists don’t include all possible side effects.

For more information on the possible side effects of Brukinsa, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Brukinsa, you can do so through MedWatch.

Mild side effects

Mild side effects of Brukinsa can include:*

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Brukinsa. To learn about other mild side effects, talk with your doctor or pharmacist, or see Brukinsa’s patient information.

Serious side effects

Serious side effects from Brukinsa aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Abnormal heart rhythm. Symptoms can include:
    • palpitations (feeling your heartbeat flutter or skip a beat)
    • dizziness
    • chest pain
    • shortness of breath
  • Low platelet count. Symptoms can include:
    • bruising more easily than usual
    • bleeding from your gums or nose
    • petechiae (tiny reddish-purple spots on your skin)
  • Anemia (low red blood cell count). Symptoms can include:
    • weakness
    • tiredness
    • shortness of breath
    • pale skin and fingertips
    • dizziness

Other serious side effects, explained in more detail below in “Side effect details,” include:

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Brukinsa. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Brukinsa. But call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Hemorrhage

Hemorrhage (bleeding) is a possible side effect of Brukinsa. And sometimes, this condition can be a medical emergency.

In clinical studies, hemorrhage occurred in 10% to 11% of people taking Brukinsa. But serious cases of hemorrhage occurred in just 5% of people taking the drug. In these studies, there weren’t any people taking a different drug or a placebo (treatment with no active drug).

Symptoms of hemorrhage can include:

It’s possible to have a hemorrhage either inside or outside of your body. If bleeding happens inside your body, you might not see the bleeding right away. But you may have some of the symptoms listed above.

If you see that you’re losing a large amount of blood or you’re having symptoms of hemorrhage, call your doctor right away. But if your situation feels life threatening, call 911.

Infections

People taking Brukinsa have had serious, and sometimes fatal, infections. For example, pneumonia was the most common serious infection reported in clinical studies of Brukinsa. (In these studies, there weren’t any people taking a different drug or a placebo. A placebo is a treatment with no active drug.)

In the studies, 15% to 18% of people taking the drug developed pneumonia. However, fatal cases of pneumonia were rare. In one study, fatal pneumonia was only reported in 1.7% of people taking Brukinsa.

Other serious infections were also reported in clinical studies of Brukinsa. These infections included:

* With reactivation of HBV, the virus is already inside your body, but it flares up and can cause symptoms.

Symptoms of infections

Symptoms of infection will vary, depending on the type of infection you have. But they can include:

  • fever
  • weakness
  • tiredness
  • confusion
  • cough
  • shortness of breath

What to do if you think you have an infection

It’s important to remember that both cancer and Brukinsa can lower your body’s ability to fight off infections. Because of this, make sure to tell your doctor right away if you think you have an infection. They’ll check to see if you have an infection, and they’ll prescribe medication for it if needed. And in some cases, your doctor may also recommend that you stop taking Brukinsa.

Other cancers

Even though Brukinsa is used to treat a type of blood cancer, it’s possible to develop other cancers while you’re using this drug. For example, in clinical studies, 9% of people taking Brukinsa developed a second primary type of cancer. (This means the second type of cancer wasn’t caused by their blood cancer spreading inside their body.)

In the studies, skin cancer was the most common type of second primary cancer that people had. Specifically, 6% of people taking Brukinsa developed either basal cell or squamous cell skin cancer. In these studies, there weren’t any people taking a different drug or a placebo (treatment with no active drug).

Because of this possible risk of skin cancer with Brukinsa, it’s recommended that you use sunscreen while you’re taking this drug.

It’s also important to watch for symptoms of skin cancer while you’re using Brukinsa. These symptoms can include:

  • spots on your skin that are painful and itch or burn
  • moles that change in size or color
  • new brown spots on your skin that have darker circles in them

If you have any symptoms of skin cancer, call your doctor. They may recommend seeing you right away to check your skin condition.

Low neutrophil count

Brukinsa works to treat a certain type of blood cancer by decreasing the amount of abnormal blood cells in your body. But the drug can also affect your level of healthy blood cells. For example, Brukinsa may lower your level of certain white blood cells called neutrophils. These blood cells are white blood cells that help fight infections.

Keep in mind that certain types of blood cancers can also lower your level of healthy blood cells. (This happens because the cancer cells crowd out your healthy blood cells.) In fact, low levels of healthy blood cells are seen in people with mantle cell lymphoma (MCL), which Brukinsa is used to treat.

In clinical studies, 38% to 53% of people had their neutrophil count lowered while using this drug. In the studies, there weren’t any people taking a different drug or a placebo (treatment with no active drug).

Having a decreased neutrophil count can lower your body’s ability to fight off infections. Because of this, it’s important to let your doctor know if you think you have an infection during treatment. For more information about infections during Brukinsa treatment, see the section “Infections” above.

While you’re taking Brukinsa, your doctor will routinely check your blood cell counts. And based on the results of these blood tests, your doctor may change your dosage of Brukinsa. Or in some cases, they may recommend that you use a medication other than Brukinsa for your condition.

Rash

It’s possible to have a rash while you’re taking Brukinsa. In fact, 25% to 36% of people taking Brukinsa had a rash during clinical studies. In the studies, there weren’t any people taking a different drug or a placebo (treatment with no active drug).

Keep in mind that in some cases, rash can be a sign of allergic reaction. But in other cases, a rash might not be related to an allergic reaction. And it may go away on its own, without any treatment. For more information on allergic reactions related to Brukinsa, see the section “Allergic reaction” above.

If you get a rash while you’re taking Brukinsa, call your doctor. They may prescribe a medication for you to treat the rash. Or they may recommend other ways to help reduce this side effect.

It’s not known whether or not Brukinsa interacts with alcohol. However, drinking alcohol can cause some of the same side effects as Brukinsa does, such as diarrhea. And it’s possible that drinking alcohol while you’re taking Brukinsa could worsen these side effects.

It’s important to talk with your doctor about whether it’s safe for you to drink alcohol while you’re taking Brukinsa.

Brukinsa can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Brukinsa and other medications

Below are lists of medications that can interact with Brukinsa. These lists don’t contain all the drugs that may interact with Brukinsa.

Before taking Brukinsa, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Brukinsa and certain antifungals

Taking Brukinsa with certain drugs used to treat fungal infections can increase the level of Brukinsa in your body. This interaction could increase your risk of side effects from Brukinsa. (For more information about side effects caused by Brukinsa, see the section “Brukinsa side effects” above.)

Examples of antifungals that can increase Brukinsa levels include:

  • fluconazole (Diflucan)
  • itraconazole (Onmel, Sporanox)
  • voriconazole (Vfend)

If you need to take an antifungal while you’re taking Brukinsa, make sure to talk with your doctor. They may recommend an antifungal that doesn’t interact with Brukinsa. Or in some cases, your doctor may lower your dosage of Brukinsa while you’re taking the antifungal.

Brukinsa and certain antibiotics

Taking Brukinsa with certain antibiotics can change the level of Brukinsa in your body.

In some cases, the level of Brukinsa may be increased. This interaction could increase your risk of side effects from Brukinsa. (For more information about side effects caused by Brukinsa, see the section “Brukinsa side effects” above.)

Examples of antibiotics that can increase Brukinsa levels include:

In other cases, the level of Brukinsa may be decreased. This interaction could affect how well Brukinsa is able to treat your condition. An example of an antibiotic that can decrease Brukinsa levels is rifampin (Rifadin).

If you need to take an antibiotic while you’re taking Brukinsa, make sure to talk with your doctor. They will likely recommend that you take an antibiotic that doesn’t interact with Brukinsa. However, if you need to take one of the antibiotics listed above, your doctor may adjust your Brukinsa dosage while you’re taking the antibiotic.

Brukinsa and efavirenz

Efavirenz (Sustiva) is an antiviral that’s mostly used for HIV treatment. But taking Brukinsa with efavirenz can decrease the level of Brukinsa in your body. This interaction could affect how well Brukinsa is able to treat your condition.

If your doctor prescribes efavirenz for you, make sure that they know you’re also taking Brukinsa. Your doctor may adjust your dosage of Brukinsa while you’re taking the drugs together. Or they may recommend that you take a different antiviral medication.

Brukinsa and omeprazole

Omeprazole (Prilosec) is a proton pump inhibitor that’s used to treat certain gastrointestinal conditions. These conditions include heartburn and peptic ulcer disease. But taking Brukinsa with omeprazole may lower the level of omeprazole in your body. This interaction could affect how well omeprazole is able to treat your condition.

Omeprazole is available both as a prescription drug and an over-the-counter (OTC) drug. If you purchase OTC omeprazole, you can do so without a prescription. But it’s still important to talk with your doctor before you take omeprazole with Brukinsa.

Your doctor can recommend whether it’s safe for you to take omeprazole with Brukinsa. In some cases, they may recommend a medication other than omeprazole for you.

Brukinsa and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Brukinsa. However, you should still check with your doctor or pharmacist before using any of these products while taking Brukinsa.

Brukinsa and foods

There aren’t any foods that have been specifically reported to interact with Brukinsa. If you have any questions about eating certain foods with Brukinsa, talk with your doctor.

Brukinsa and lab tests

It’s not known whether Brukinsa interacts with any lab tests. However, Brukinsa can affect your levels of certain blood cells that may be checked on lab tests. For more information about how Brukinsa can affect your blood cell levels, see the section “Brukinsa side effects” above.

As with all medications, the cost of Brukinsa can vary.

The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Brukinsa at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Your insurance plan may require you to get prior authorization before approving coverage for Brukinsa. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Brukinsa, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Brukinsa, or if you need help understanding your insurance coverage, help is available.

BeiGene, Ltd., the manufacturer of Brukinsa, offers a program called myBeiGene. Through this program, you may be eligible for cost savings for this drug. For more information and to find out if you’re eligible for support, call 833-BeiGene (833-234-4363) or visit the program website.

Generic version

Brukinsa isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Other drugs are available that can treat mantle cell lymphoma (MCL). Some may be a better fit for you than others. If you’re interested in finding an alternative to Brukinsa, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed below are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Examples of other drugs that may be used to treat MCL include:

  • BTK inhibitors* other than Brukinsa, such as:
    • acalabrutinib (Calquence)
  • proteasome inhibitors, such as:
    • bortezomib (Velcade)
  • combination treatments, such as:
    • R-CHOP, which contains rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone
    • VR-CAP, which contains rituximab, cyclophosphamide, doxorubicin, bortezomib, and prednisone
  • lenalidomide (Revlimid)
  • bendamustine (Treanda, Bendeka)

* Brukinsa belongs to a class of drugs called BTK inhibitors. (A class of drugs describes a group of medications that work in the same way.) These drugs work by inhibiting (blocking) the action of Bruton’s tyrosine kinase (BTK).

You may wonder how Brukinsa compares with other medications that are prescribed for similar uses. Here we look at how Brukinsa and Velcade are alike and different.

Ingredients

Brukinsa contains the active drug zanubrutinib. It belongs to a class of drugs called BTK inhibitors. (A class of drugs describes a group of medications that work in the same way.) Brukinsa works by inhibiting (blocking) the action of Bruton’s tyrosine kinase (BTK).

Velcade, on the other hand, contains the active drug bortezomib. It belongs to a class of drugs called proteasome inhibitors.

Uses

Brukinsa is approved to treat a type of blood cancer called mantle cell lymphoma (MCL). For this condition,* it can be given to adults who’ve used at least one other past treatment for their MCL. For more information about MCL, see the section “Brukinsa uses” above.

Velcade is also approved to treat MCL in adults. In addition, Velcade is approved for use in adults with multiple myeloma, which is another type of blood cancer.

* For MCL, Brukinsa received accelerated approval from the FDA. Accelerated approval is based on information from early clinical trials. The FDA’s decision for full approval will be made after additional clinical trials are completed.

Drug forms and administration

Brukinsa comes as capsules that are taken by mouth. It’s typically taken either once or twice daily, with or without food.

Velcade, on the other hand, is given as an injection by healthcare providers. Velcade can be given either subcutaneously (an injection under your skin) or intravenously (an injection into your vein). Velcade is generally given either once or twice weekly.

Side effects and risks

Brukinsa and Velcade both work in similar ways in your body. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Brukinsa, with Velcade, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Brukinsa, with Velcade, or with both drugs (when taken individually).

  • Can occur with Brukinsa:
    • developing other forms of cancer
    • anemia (low level of red blood cells)
  • Can occur with Velcade:
    • neurological issues, such as nerve damage and posterior reversible encephalopathy syndrome (a condition that causes brain swelling)
    • decreased blood pressure
    • problems with breathing
    • gastrointestinal issues, such as painful blockages in your digestive tract
    • liver damage
    • thrombotic microangiopathy (a rare blood disorder that affects small blood vessels)
    • tumor lysis syndrome (a condition that’s caused by the death of cancer cells in your body)
  • Can occur with both Brukinsa and Velcade:
    • allergic reaction

Effectiveness

These drugs haven’t been directly compared in clinical studies. But separate studies have found both Brukinsa and Velcade to be effective in treating MCL.

Costs

Brukinsa and Velcade are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

You can view cost estimates for both Brukinsa and Velcade on WellRx.com. But keep in mind that the actual price you’ll pay for either drug depends on your insurance plan, your location, and your prescribed dosage. Your cost will also vary depending on whether you get the drug from a pharmacy or you receive it from your doctor.

Like Velcade (discussed above), other medications are also prescribed for uses similar to those of Brukinsa. Here we look at how Brukinsa and Imbruvica are alike and different.

Ingredients

Brukinsa contains the active drug zanubrutinib. It belongs to a class of drugs called BTK inhibitors. (A class of drugs describes a group of medications that work in the same way.) Brukinsa works by inhibiting (blocking) the action of Bruton’s tyrosine kinase (BTK).

Imbruvica contains the active drug ibrutinib. Like Brukinsa, it’s also a BTK inhibitor.

Uses

Brukinsa is approved to treat a type of blood cancer called mantle cell lymphoma (MCL). For this condition,* it’s prescribed for adults who’ve used at least one other past treatment for their MCL. For more information about MCL, see the section “Brukinsa uses” above.

Imbruvica is also approved to treat MCL in adults who’ve used at least one other past treatment for the condition.

In addition, Imbruvica is approved to treat:

* For MCL, Brukinsa received accelerated approval from the FDA. Accelerated approval is based on information from early clinical trials. The FDA’s decision for full approval will be made after additional clinical trials are completed.

Drug forms and administration

Brukinsa comes as capsules that are taken by mouth. It’s typically taken either once or twice daily, with or without food.

Imbruvica comes as both capsules and tablets that are taken by mouth with a glass of water. Imbruvica is typically taken once daily.

Side effects and risks

Brukinsa and Imbruvica both belong to a class of drugs called BTK inhibitors. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Brukinsa, with Imbruvica, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Brukinsa, with Imbruvica, or with both drugs (when taken individually). Side effects also vary based on what condition you have.

Effectiveness

These drugs haven’t been directly compared in clinical studies. But separate studies have found both Brukinsa and Imbruvica to be effective in treating MCL.

Costs

Brukinsa and Imbruvica are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to cost estimates on WellRx.com, Imbruvica generally costs more than Brukinsa costs. But keep in mind that the actual price you’ll pay for either drug depends on your insurance plan, your location, and your prescribed dosage.

You should take Brukinsa according to your doctor’s or healthcare provider’s instructions. Brukinsa is taken by mouth, typically once or twice daily. It should be taken with a glass of water.

When to take

There’s no recommendation for an exact time of day that you should take Brukinsa.

However, if you’re taking Brukinsa once daily, try to be consistent in taking the drug at about the same time each day. And if you’re taking Brukinsa twice daily, try to keep your doses about 12 hours apart.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Brukinsa with food

Brukinsa can be taken with or without food. Sometimes taking the medication with food can help decrease certain side effects, such as nausea.

Can Brukinsa capsules be split, opened, or chewed?

It’s important that you swallow Brukinsa capsules whole. Don’t break, crush, open, or chew the capsules. Doing so can affect how your body absorbs the drug and may cause harmful effects.

Brukinsa is approved to treat a form of blood cancer called mantel cell lymphoma (MCL). With this condition, your B cells (a type of white blood cell) grow abnormally.

Brukinsa contains the active drug zanubrutinib. It belongs to a class of drugs called BTK inhibitors. (A class of drugs describes a group of medications that work in the same way.)

Brukinsa works by inhibiting (blocking) the action of Bruton’s tyrosine kinase (BTK). By targeting BTK, Brukinsa can stop abnormal B cells in your body from multiplying. (Cells that multiply are making more cells.) In some people, this action may lead to reduced tumor growth as well.

How long does it take to work?

How soon you notice Brukinsa working for you varies from person to person. But your doctor will monitor you during treatment to see when Brukinsa starts working and how well it works. To do this, your doctor may order certain blood tests for you.

There haven’t been any studies done to look at the safety or effectiveness of Brukinsa in pregnant women.

However, in animal studies, zanubrutinib (the active drug in Brukinsa) did cause harm to fetuses exposed to the drug. For example, pregnancies exposed to the drug had increased rates of:

Keep in mind that animal studies don’t always predict what will happen in people. But because of possible risks, it’s recommended that females of reproductive age have a negative pregnancy test before starting Brukinsa.

In addition, both males and females taking Brukinsa should use birth control to prevent pregnancy. For more information about this, see the following section, “Brukinsa and birth control.”

If you’re pregnant or planning to become pregnant, talk with your doctor before taking Brukinsa.

It’s not known if Brukinsa is safe to take during pregnancy. However, the drug has been shown to cause harm when given to pregnant animals. It’s important to remember that animal studies don’t always predict what will happen in humans. But because of possible risks with Brukinsa, it’s recommended that pregnancy be avoided while you’re using this drug.

For more information about the risks of taking Brukinsa during pregnancy, see the section “Brukinsa and pregnancy” above.

If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control options while you’re using Brukinsa. Below we describe recommendations for both women and men using Brukinsa.

Birth control in females using Brukinsa

If you’re a female of reproductive age, it’s recommended that you use effective birth control while you’re taking Brukinsa. And you should continue to use birth control for at least 1 week after stopping Brukinsa.

Birth control in males using Brukinsa

If you’re a male who’s sexually active with a female who can become pregnant, you should use effective birth control while you’re taking Brukinsa. And you should continue to use birth control for at least 1 week after stopping Brukinsa.

It’s not known whether Brukinsa is safe to use while breastfeeding. However, Brukinsa may possibly be harmful to children who are breastfed.

Because of this, it’s recommended that you don’t breastfeed while you’re taking Brukinsa. And you should continue to avoid breastfeeding for at least 2 weeks after stopping the drug.

If you have questions about the safety of breastfeeding while you’re using Brukinsa, talk with your doctor.

Here are answers to some frequently asked questions about Brukinsa.

Is Brukinsa a chemotherapy drug?

No, Brukinsa isn’t a chemotherapy drug. Chemotherapy describes traditional medications used to treat cancer. And chemotherapy works by killing rapidly multiplying cells in your body. (Cells that multiply are making more cells.)

Because cancer cells typically multiply quickly, chemotherapy affects cancer cells. But chemotherapy can also kill some of the body’s healthy cells that also multiply quickly.

Unlike chemotherapy, Brukinsa is called a targeted therapy. And it belongs to a class of drugs called BTK inhibitors. (A class of drugs describes a group of medications that work in the same way.)

Brukinsa works by inhibiting (blocking) the action of Bruton’s tyrosine kinase (BTK). By targeting BTK, Brukinsa can stop certain cancer cells in your body from multiplying. In some people, this may lead to reduced tumor growth as well.

If you’d like to know more about using chemotherapy versus targeted therapy for your condition, talk with your doctor.

Will Brukinsa cure my cancer?

No, unfortunately Brukinsa won’t cure your condition. In fact, there’s currently no known cure for cancer. However, Brukinsa may help slow your cancer from worsening. And in some people, the drug may help shrink cancer tumors.

For more information on Brukinsa’s effectiveness in treating cancer, see the section “Brukinsa uses” above.

Do I need to avoid sun exposure while I’m taking Brukinsa?

Yes, it’s recommended that you protect yourself from sunlight while you’re taking Brukinsa. This is because Brukinsa may increase your risk of certain types of skin cancer. And sun exposure can also increase this risk.

If you’re going to be out in the sun, it’s important that you use sunscreen with an SPF* of at least 30. Doing this will help to protect you from harmful light rays from the sun. You can also wear protective clothing to cover your skin from sunlight.

If you have questions about sun exposure while you’re using Brukinsa, talk with your doctor.

* SPF (sun protection factor) describes how much protection from sunlight a certain product provides.

If I’ve had hepatitis B in the past, is it safe for me to take Brukinsa?

Maybe. But certain infections, such as hepatitis B, may be reactivated while you’re taking Brukinsa. With reactivation, an infection that you’ve had in the past flares up inside your body and can cause symptoms.

In clinical studies, hepatitis B reactivation did occur in people taking Brukinsa. For example, in one study, 0.8% of people had reactivation of hepatitis B. And because of this, the people’s dose of Brukinsa had to be lowered.

Because of the risk of infection reactivation, it’s important that you share your entire medical history with your doctor before starting Brukinsa. Based on your history, your doctor can advise whether it’s safe for you to use Brukinsa.

In some cases, your doctor may prescribe medication for you to take with Brukinsa to reduce your risk of infection reactivation. Or your doctor may recommend treatment other than Brukinsa for you if your risk of infection reactivation is too high.

Is it safe for older people to use Brukinsa?

Yes, in general, it’s safe for older people to take Brukinsa. In fact, during clinical studies, no difference in safety was seen between younger and older people taking the drug.

In addition to younger people, clinical studies included:

  • 49% of people ages 65 years and older
  • 16% of people ages 75 years or older

If you have questions about the safety of using Brukinsa given your age, talk with your doctor. They can advise whether this drug is good treatment option for you.

How will my doctor monitor my health during Brukinsa treatment?

During Brukinsa treatment, your doctor will order certain lab tests to check and see how your condition is responding. For example, your doctor may order the following blood tests:

A CBC can help show how well your body is responding to Brukinsa treatment. For example, a CBC shows the levels of certain blood cells in your body, including both healthy and cancerous blood cells. If Brukinsa is working to treat your cancer, your blood cell levels may have improved with treatment.

In addition, a CBC can also show your doctor if you’re having certain side effects from Brukinsa. These side effects include low neutrophil count, low platelet count, and low red blood cell count. If your blood cell levels are too low with Brukinsa, your doctor may adjust your dosage of the drug.

If you have questions about the tests you’ll need to have done during Brukinsa treatment, talk with your doctor.

Before taking Brukinsa, talk with your doctor about your health history. Brukinsa may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Allergic reaction. If you’ve had an allergic reaction to Brukinsa or any of its ingredients, you shouldn’t take Brukinsa. Instead, talk with your doctor about other medications that are safer options for you.
  • Bleeding problems. Brukinsa can cause hemorrhage (bleeding). Before you start taking this drug, talk with your doctor. Let them know if you’ve ever had bleeding problems or if you have any planned surgeries. If you take Brukinsa, your doctor may monitor you more closely than usual. Or they may have you wait to start Brukinsa treatment until after your surgery.
  • Infections. If you have a fever or a current infection, tell your doctor before starting Brukinsa. In some cases, they may have you wait to start treatment with Brukinsa.
  • High blood pressure. Brukinsa may cause abnormal heart rhythms. And this risk may be increased if you have high blood pressure. Before you start taking Brukinsa, tell your doctor if you have a history of high blood pressure. They may monitor you more closely than usual during treatment with Brukinsa.
  • Heart rhythm problems. Brukinsa may cause abnormal heart rhythms. Before you start taking this drug, tell your doctor if you have a history of heart rhythm problems. Your doctor may monitor you more closely than usual during treatment with Brukinsa.
  • Liver problems. Brukinsa is metabolized (broken down) by your liver. Tell your doctor if you’ve had liver problems in the past. This includes having had the hepatitis B virus (HBV), which can affect your liver. (And if you’ve had HBV in the past, Brukinsa may cause the virus to reactivate in your body.) Before taking Brukinsa, talk with your doctor about any history of liver problems. Your doctor may monitor you more closely than usual during treatment. Or they may have you start taking a lower dose of Brukinsa than usual.
  • Pregnancy. Brukinsa can be harmful if used during pregnancy. For this reason, it’s recommended that the drug be avoided during pregnancy. For more information, please see the “Brukinsa and pregnancy” section above.
  • Breastfeeding. It’s not recommended that you breastfeed while taking Brukinsa. For more information, please see the “Brukinsa and breastfeeding” section above.

Note: For more information about the potential negative effects of Brukinsa, see the “Brukinsa side effects” section above.

Don’t use more Brukinsa than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Brukinsa

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Brukinsa from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Brukinsa tablets should be stored at room temperature (68°F to 77°F/20°C to 25°C) in a tightly sealed container. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.

Disposal

If you no longer need to take Brukinsa and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Brukinsa is approved to treat mantle cell lymphoma (MCL) in adults who have had previous treatment with at least one other therapy.

Brukinsa was granted approval for this indication under accelerated approval given its promising response rates in preliminary trials.

Administration

Brukinsa is available as 80-mg capsules. The capsules should be swallowed whole and not broken, opened, or chewed.

Brukinsa can be taken with or without food, with a full glass of water.

Mechanism of action

Brukinsa is a Bruton’s tyrosine kinase (BTK) inhibitor. It forms a covalent bond in the BTK active site and leads to inhibition of BTK activity. This leads to inhibition of cell signaling, proliferation, trafficking, and adhesion. In nonclinical studies, zanubrutinib inhibited B-cell proliferation and tumor growth.

Pharmacokinetics and metabolism

Brukinsa reaches its peak concentration 2 hours post-dose in most people. It is highly protein bound and primarily metabolized through CYP3A pathways.

Brukinsa is primarily (87%) excreted through the feces, with 38% of the drug being unchanged. Brukinsa has an elimination half-life of approximately 2 to 4 hours following a single dose of either 160 mg or 320 mg.

Contraindications

No specific contraindications have been cited for Brukinsa.

Storage

Brukinsa should be stored at controlled room temperature between 68°F to 77°F (20°C to 25°C).

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.