Calquence is a brand-name prescription medication. It’s FDA-approved to treat the following types of cancer:

Calquence drug class and form

Calquence contains the active ingredient acalabrutinib and belongs to a class of medications called kinase inhibitors. (A class of medications is a group of drugs that work in a similar way.) Calquence works by blocking the growth of cancer cells.

Calquence comes as a capsule that you swallow. It’s available in one strength: 100 mg. You’ll typically take Calquence once every 12 hours.

FDA approval

In 2019, the Food and Drug Administration (FDA) approved Calquence to treat CLL and SLL.

The FDA approved Calquence to treat MCL in 2017. The drug received accelerated approval from the FDA for this use based on the overall response rate. This rate is the percentage of people who had fewer or no signs of MCL after their treatment.

The FDA usually approves drugs after extensive studies have been done. But in certain cases, as with Calquence, the FDA gave approval before all the studies were completed.

Some conditions don’t have many proven treatments. So the FDA may give accelerated approval for certain medications to treat those conditions. In this case, people with MCL don’t have many treatment options if they’ve already tried at least one other medication for the condition.

After more clinical trials of Calquence for MCL have been done, the FDA may give the drug full approval.

Effectiveness

For information on the effectiveness of Calquence, see the “Calquence uses” section below.

Calquence 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. Generics usually cost less than brand-name drugs.

The Food and Drug Administration (FDA) approves prescription drugs such as Calquence to treat certain conditions.

Calquence for chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL)

Calquence is FDA-approved to treat chronic lymphocytic leukemia and small lymphocytic lymphoma.

CLL and SLL explained

CLL is a type of cancer that affects white blood cells in your bone marrow (the tissue inside bones). These cells begin to grow abnormally and don’t work as they should in your body. Eventually, the cancer cells move from your bone marrow into your blood. CLL is a very slow growing cancer. It’s the most common type of leukemia that occurs in adults.

SLL is very similar to CLL. But with SLL, the majority of the abnormal white blood cells are in your lymph nodes. Lymph nodes are part of your immune system, which helps you fight infections.

Effectiveness

Calquence was an effective medication in clinical trials to treat CLL or SLL. There were two different studies that tested Calquence in people with CLL or SLL.

CLL that hadn’t been treated before

The first study looked at people with CLL who had never been treated for their cancer before. Researchers tested Calquence alone, Calquence along with obinutuzumab (Gazyva), and obinutuzumab along with chlorambucil (Leukeran).

Researchers measured response to treatment, which means the cancer either got better or went away completely after treatment. Researchers found that:

  • 86% of people who took Calquence alone responded to treatment
  • 94% of people who took Calquence plus obinutuzumab responded to treatment
  • 79% of people who took obinutuzumab along with chlorambucil responded to treatment

CLL that had been treated before

A second study looked at people with CLL that came back or got worse after a different treatment. Some people took Calquence, and other people took idelalisib (Zydelig) or bendamustine (Treanda) along with rituximab (Rituxan). The results showed that:

  • Of the people who took Calquence, 81% responded to treatment. This means that their cancer either got better or went away completely after treatment.
  • In comparison, 75% of people who took either idelalisib or bendamustine along with rituximab also responded to treatment.

Calquence for mantle cell lymphoma (MCL)

Calquence is FDA-approved to treat mantle cell lymphoma (MCL). You must have already tried at least one other medication to treat your MCL.

Calquence received accelerated approval from the FDA for this use based on the overall response rate. This is the percentage of people who had fewer or no signs of MCL after their treatment. After more clinical trials of Calquence for MCL have been done, the FDA may give the drug full approval. To learn more, see the “FDA approval” section above.

MCL explained

MCL is a fast-growing type of cancer that affects your white blood cells. Specifically, it’s a kind of non-Hodgkin lymphoma. MCL occurs when your white blood cells begin to grow abnormally and reproduce quickly. These abnormal cells are usually found in your lymph nodes, bone marrow, digestive tract, and blood.

Effectiveness

Results from a clinical trial show that Calquence is an effective medication to treat MCL.

Before the study, people had tried at least one previous treatment for MCL. In the study, about 80% of people who took Calquence to treat their MCL had a response to the medication. This means that their cancer either got better or went away completely after treatment with Calquence.

Researchers didn’t compare Calquence with a different medication or a placebo (treatment with no active drug). So it’s not known how much better or worse people may have responded to other treatments.

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

For more information on the possible side effects of Calquence, 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 Calquence, you can do so through MedWatch.

Mild side effects

Mild side effects of Calquence 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 Calquence. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Calquence’s Patient Information.

Serious side effects

Serious side effects from Calquence 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:

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 some of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Calquence. It’s not known how many people had an allergic reaction to Calquence in clinical trials.

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 Calquence. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Blood disorders

Blood disorders may develop during Calquence use. These blood disorders include changes in the levels of white blood cells, red blood cells, and platelets (cells that help your blood to clot).

Low level of white blood cells

Your white blood cells are part of your immune system, and they help keep bacteria, viruses, and other germs from causing infections. Calquence can make the level of some white blood cells become too low. Symptoms of a low level of white blood cells can include fever, belly pain, trouble breathing, and chills.

One possible side effect of Calquence is neutropenia (a low level of white blood cells called neutrophils). Another possible side effect is lymphopenia, which is also called lymphocytopenia. This is a low level of white blood cells called lymphocytes. Here’s some information on the two conditions.

Neutropenia. In clinical studies, neutropenia occurred in 23% of people who took Calquence for mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), or small lymphocytic leukemia (SLL).

Here’s how often neutropenia occurred in people with MCL:

  • In people who took Calquence alone, 36% had neutropenia, and 15% had severe neutropenia.
  • Calquence wasn’t compared with a different drug or a placebo (treatment with no active drug).

Here’s how often neutropenia occurred in people with CLL:

  • In people who took Calquence alone, 23% to 48% had neutropenia, and 13% to 23% had severe neutropenia.
  • In people who took obinutuzumab plus chlorambucil, idelalisib plus rituximab, or bendamustine plus rituximab, 78% to 80% had neutropenia. And 40% to 53% had severe neutropenia.

SLL is considered a type of CLL, and Calquence was approved to treat SLL based on the results of studies of people with CLL. The rates of neutropenia in people who took Calquence for SLL are expected to be similar to those in people who took the drug in the CLL studies.

High level of white blood cells

Lymphocytosis (a high level of white blood cells known as lymphocytes) can occur with Calquence.

In one clinical study, 31.5% of people with MCL who took Calquence had lymphocytosis. Calquence wasn’t compared with a different drug or a placebo.

Here’s how often lymphocytosis occurred in people with CLL:

  • In people who took Calquence alone, 16% to 26% had lymphocytosis, and 15% to 19% had severe lymphocytosis.
  • In people who took obinutuzumab plus chlorambucil, idelalisib plus rituximab, or bendamustine plus rituximab, 0.6% to 23% had lymphocytosis. And 0.6% to 19% had severe lymphocytosis.

SLL is considered a type of CLL, and Calquence was approved to treat SLL based on the results of studies of people with CLL. The rates of lymphocytosis in people who took Calquence for SLL are expected to be similar to those in people who took the drug in the CLL studies.

Low level of red blood cells

Another blood disorder that may develop with Calquence use is anemia (a low level of red blood cells). Red blood cells are important in helping carry oxygen throughout your body. So if you have low levels of them, you may feel tired or weak. Symptoms of anemia can include tiredness, pale skin, and headache.

In clinical trials, researchers found the following:

  • Between 47% and 53% of people with CLL who took Calquence developed anemia.
  • In comparison, between 45% and 57% of people with CLL who took other medications also had anemia. The other drug combinations were obinutuzumab and chlorambucil, idelalisib plus rituximab, or bendamustine plus rituximab.

SLL is considered a type of CLL, and Calquence was approved to treat SLL based on the results of studies of people with CLL. The rates of anemia in people who took Calquence for SLL are expected to be similar to those in people who took the drug in the CLL studies.

Hemoglobin is a type of protein in your blood. When the hemoglobin level drops too low, it can lead to anemia. In 46% of people with MCL who took Calquence alone, their hemoglobin level decreased. And 10% of people had a severely decreased hemoglobin level. Calquence wasn’t compared with a different drug or a placebo.

Severe anemia. About 8% of people who took Calquence for MCL, CLL, or SLL had anemia that was considered serious. Researchers also found that serious anemia occurred in:

  • 10% to 15% of people with CLL who took Calquence alone
  • 8% to 17% of people with CLL who took obinutuzumab and chlorambucil, idelalisib plus rituximab, or bendamustine plus rituximab

Low level of platelets

Calquence may also cause thrombocytopenia (a low level of platelets). Platelets are cells that help clot your blood when you get a cut so that you don’t keep bleeding.

Symptoms of a low platelet level can include bruising more easily than usual, nosebleeds, and bleeding from cuts that lasts longer than usual.

In clinical trials, researchers found the following:

  • Between 32% and 33% of people with CLL who took Calquence alone had low platelet levels.
  • In comparison, between 41% and 61% of people with CLL who took other medications for their blood cancer also had low platelet levels. The other drug combinations were obinutuzumab and chlorambucil, idelalisib plus rituximab, or bendamustine plus rituximab.

SLL is considered a type of CLL, and Calquence was approved to treat SLL based on the results of studies of people with CLL. The rates of thrombocytopenia in people who took Calquence for SLL are expected to be similar to those in people who took the drug in the CLL studies.

In 44% of people with MCL who took Calquence alone, their platelet level decreased. A severe decrease occurred in 12% of people. Calquence wasn’t compared with a different drug or a placebo.

Severe thrombocytopenia. About 7% of people with MCL, CLL, or SLL who took Calquence alone developed thrombocytopenia that was considered serious. Researchers also found that severe thrombocytopenia occurred in:

  • 3.4% to 6% of people who took Calquence alone
  • 6% to 16% of people who took obinutuzumab plus chlorambucil, idelalisib plus rituximab, or bendamustine plus rituximab

Steps your doctor may take

During your Calquence treatment, your doctor will test your blood to look for low levels of white blood cells, red blood cells, or platelets. If you do develop decreased levels, your doctor may decrease your dose of Calquence or stop your treatment.

Infections

Infections are a side effect that may occur with Calquence. In clinical trials, researchers found the following:

  • Between 56% and 65% of people with CLL who took Calquence alone developed an infection.
  • In comparison, between 46% and 65% of people with CLL who took other medications also had an infection. The other drug combinations were obinutuzumab and chlorambucil, idelalisib plus rituximab, or bendamustine plus rituximab.

SLL is considered a type of CLL, and Calquence was approved to treat SLL based on the results of studies of people with CLL. The rates of infection in people who took Calquence for SLL are expected to be similar to those in people who took the drug in the CLL studies.

No infections were reported in people who took Calquence for MCL.

Serious infections

The most common type of serious infection that occurred was a respiratory tract infection, such as pneumonia. Researchers found the following:

In people with CLL, severe infections occurred in:

  • 14% to 15% of people who took Calquence alone
  • 11% to 28% of people who took obinutuzumab plus chlorambucil, idelalisib plus rituximab, or bendamustine plus rituximab

Other infections

It’s also possible to develop other, less common, infections while you’re taking Calquence. This includes certain types of viral infections, such as hepatitis B reactivation, or bacterial or fungal infections, such as pneumonia.

It’s important to note that hepatitis B reactivation is a risk only if you have a history of hepatitis B infection. In this case, taking Calquence may reactivate your infection, meaning it may make the infection come back.

If you’re at a high risk for developing these less common infections, your doctor may have you take other medications during your Calquence treatment. This is meant to help decrease your risk for these infections.

Symptoms of infections

If you develop any symptoms of infections, such as trouble breathing, fever, cough, or decreased energy, talk with your doctor. They’ll be able to help determine if your infection is serious and whether you should keep taking Calquence. In some cases, they may decrease your dose or have you stop taking the medication until your infection gets better.

Major bleeding

Calquence use may increase the risk of bleeding. In clinical trials of people with MCL, CLL, or SLL, 22% of people who took Calquence had bleeding.

Major bleeding may also occur. This is serious bleeding that, in rare cases, can be fatal. In the clinical trials, 3% of people who took Calquence for MCL, CLL, or SLL had severe bleeding. In 0.1% of people, this severe bleeding led to death.

Here’s how often bleeding and severe bleeding occurred in people with MCL:

  • In people who took Calquence alone, 8% had bleeding, and 0.8% had severe bleeding.
  • Calquence wasn’t compared with a different drug or a placebo.

Here’s how often bleeding and severe bleeding occurred in people with CLL:

  • In people who took Calquence alone, 16% to 20% had bleeding. And 1.3% to 1.7% had severe bleeding.
  • In people who took obinutuzumab plus chlorambucil, idelalisib plus rituximab, or bendamustine plus rituximab, 5% to 6% had bleeding. And 0% to 2.9% had severe bleeding.

SLL is considered a type of CLL, and Calquence was approved to treat SLL based on the results of studies of people with CLL. The rates of bleeding in people who took Calquence for SLL are expected to be similar to those in people who took the drug in the CLL studies.

Calquence and blood thinners

Taking Calquence along with medications to help prevent blood clots may also increase your risk for major bleeding. In clinical trials of people with MCL, CLL, or SLL, researchers found the following:

  • People who took Calquence and blood thinning medication had a 3.6% risk of having a serious bleed.
  • In comparison, people who took Calquence without blood thinning medication had a 2.7% risk of a serious bleed.

If you have any symptoms of bleeding while using Calquence, see a doctor right away. These symptoms include blood in your stool or vomiting blood. They can indicate serious bleeding and may be an emergency.

Secondary cancers

It’s possible to develop a secondary cancer with Calquence. A secondary cancer is a new cancer that’s not related to your MCL, CLL, or SLL.

In clinical trials of people with MCL, CLL, or SLL, secondary cancer occurred in 12% of people who took Calquence. The most common type of secondary cancer that occurred was skin cancer, which developed in about 6% of people who took the drug. The manufacturer of Calquence didn’t report how often secondary cancers occurred in people who took a different drug or a placebo.

While taking Calquence, tell your doctor if you have any new lumps or moles on your skin. Also mention if you have a mole that’s changing shape or color. They’ll be able to determine if the lump or mole should be removed.

To reduce your risk for skin cancer while taking Calquence, you should also protect yourself from the sun. This includes wearing sunscreen and a hat while outside.

If you have any questions about secondary cancers and Calquence, talk with your doctor.

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

Note: Some of the drugs listed here 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.

Alternatives for chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL)

Examples of other drugs that may be used to treat CLL or SLL include:

Alternatives for mantle cell lymphoma (MCL)

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

  • bendamustine (Treanda)
  • bortezomib (Velcade)
  • ventoclax (Venclexta)
  • ofatumumab (Arzerra)
  • doxorubicin
  • vincristine
  • cyclophosphamide
  • ibrutinib (Imbruvica)

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

Ingredients

The active drug ingredient in Calquence is acalabrutinib. The active drug ingredient in Imbruvica is ibrutinib.

Uses

The Food and Drug Administration has approved both Calquence and Imbruvica to treat the following types of cancer:

* Calquence received accelerated approval from the FDA for this use based on the overall response rate. This is the percentage of people who had fewer or no signs of MCL after their treatment. After more clinical trials of Calquence for MCL have been done, the FDA may give the drug full approval. To learn more, see the “FDA approval” section above.

In addition, Imbruvica is approved to treat:

Drug forms and administration

Calquence comes as a capsule that you swallow. Imbruvica comes as a capsule or a tablet that is also swallowed.

Side effects and risks

Calquence and Imbruvica both treat some of the same types of cancer. 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 Calquence, with Imbruvica, or with both drugs (when taken individually).

Serious side effects

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

Effectiveness

Calquence and Imbruvica have different FDA-approved uses, but they’re both used to treat MCL, CLL, and SLL.

These drugs haven’t been directly compared in clinical studies, but studies have found both Calquence and Imbruvica to be effective for treating MCL, CLL, and SLL.

In addition, a clinical trial is currently comparing Calquence and Imbruvica in people with CLL that has already been treated with another medication. The trial is still ongoing, and there are no results yet.

Costs

Calquence 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 estimates on WellRx.com, Calquence and Imbruvica generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Like Imbruvica (above), the drug Venclexta has uses similar to those of Calquence. Here’s a comparison of how Calquence and Venclexta are alike and different.

Ingredients

The active drug ingredient in Calquence is acalabrutinib. The active drug ingredient in Venclexta is venetoclax.

Uses

The Food and Drug Administration has approved both Calquence and Venclexta to treat chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL).

Calquence is also approved to treat mantle cell lymphoma (MCL),* if you’ve already tried at least one other medication to treat your MCL.

In addition, Venclexta is approved to treat a certain form of acute myeloid leukemia (AML) in older adults.

* Calquence received accelerated approval from the FDA for this use based on the overall response rate. This is the percentage of people who had fewer or no signs of MCL after their treatment. After more clinical trials of Calquence for MCL have been done, the FDA may give the drug full approval. To learn more, see the “FDA approval” section above.

Drug forms and administration

Calquence comes as a capsule that you swallow. Venclexta comes as a tablet that you swallow.

Side effects and risks

Calquence and Venclexta both contain medications to treat CLL and SLL. 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 Calquence, with Venclexta, or with both drugs (when taken individually).

Serious side effects

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

Effectiveness

Calquence and Venclexta have different FDA-approved uses, but they’re both used to treat CLL and SLL.

These drugs haven’t been directly compared in clinical studies, but studies have found both Calquence and Venclexta to be effective for treating CLL and SLL.

Ongoing clinical trials

In addition, these drugs are being tested to be used together in some cases. A clinical trial is in progress to test the combination of Calquence and Venclexta to treat CLL that hasn’t been treated before.

There’s also a clinical trial that’s testing the use of both Calquence and Venclexta in the treatment of CLL or SLL that hasn’t responded to another medication or has come back after treatment. In this study, both medications are being used together, either with or without the addition of obinutuzumab (Gazyva).

Although Venclexta isn’t currently approved to treat MCL, there is a clinical trial going on. Researchers are testing Venclexta and Calquence together to treat MCL in people for whom another treatment didn’t work.

Costs

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

According to estimates on WellRx.com, Calquence generally costs more than Venclexta. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

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

  • other medications that you are taking
  • side effects such as bleeding or a decreased level of red or white blood cells
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

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

Calquence comes as a capsule that you swallow. It’s available in one strength: 100 mg.

Dosage for chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL)

The dosage for chronic lymphocytic leukemia or small lymphocytic lymphoma is usually one capsule every 12 hours.

Typically, you’ll keep taking Calquence until your doctor recommends that you stop treatment. This may be because you develop side effects from the drug or it’s no longer working to treat your cancer.

In some cases, if you have CLL or SLL that hasn’t been treated before, you may take Calquence along with obinutuzumab (Gazyva). If you’re using both medications, be sure to take Calquence before you receive obinutuzumab. Obinutuzumab is given as an intravenous (IV) infusion by a healthcare provider. An infusion is an injection into a vein that’s given over a set time.

In some cases, your doctor may have you take a smaller dose of Calquence. These instances include having liver problems, such as hepatitis B, or taking other medications that may interact with Calquence. Talk with your doctor about the best dose for you to treat your CLL or SLL.

Dosage for mantle cell lymphoma (MCL)

The dosage for mantle cell lymphoma (MCL) is one capsule every 12 hours.

Usually, you’ll keep taking Calquence until your doctor recommends that you stop treatment. This may be because you develop side effects from the drug or it’s no longer working to treat your cancer.

What if I miss a dose?

If you miss your dose of Calquence by more than 3 hours, skip taking that dose and have your next dose at the regular time. Never take two doses at once to try to make up for a missed dose. This can be very dangerous because you could get too much medication at once.

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?

Calquence is meant to be used as a long-term treatment. If you and your doctor determine that Calquence is safe and effective for you, you’ll likely take it long term. But if you develop side effects from the drug or it’s no longer working to treat your cancer, your doctor may have you stop using Calquence.

Calquence is approved to be used along with obinutuzumab (Gazyva) to treat chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) that hasn’t been treated already. For more information on taking these two medications together, see the “Calquence dosage” section above.

If you’re at high risk for infection, your doctor may have you take medications to help prevent bacterial, viral, or fungal infections while taking Calquence. Talk with your doctor about your risk for developing infections and whether you need medications to help avoid them.

There’s no known interaction between Calquence and alcohol. However, if you’re taking Calquence and obinutuzumab (Gazyva) to treat your chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), you should avoid alcohol. This is because both alcohol and obinutuzumab can decrease your blood pressure, and the combination can be dangerous.

If you drink alcohol, talk with your doctor before you start taking Calquence. They’ll be able to tell you whether alcohol is safe for you and how much you can drink.

Calquence 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 the number of side effects or make them more severe.

Calquence and other medications

Below are some medications that can interact with Calquence. This section doesn’t contain all drugs that may interact with Calquence.

Before taking Calquence, 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.

Calquence and CYP3A4 inhibitors

Your body breaks down Calquence using an enzyme in your liver called CYP3A4. (An enzyme is a protein that aids chemical changes in your body.) However, other medications may block this enzyme from working properly. This can cause you to have too much Calquence in your body, which may increase your risk for side effects or overdose. (To learn more, see the “Calquence side effects” section above and the “Calquence overdose” section below.)

Drugs known as CYP3A4 inhibitors can be strong or moderate. You shouldn’t take strong CYP3A4 inhibitors, such as itraconazole (Tolsura, Sporanox), while you’re taking Calquence. But in some cases, you may need to take a strong CYP3A4 medication for a short period of time. Your doctor may have you stop taking Calquence until you’re done taking the other medication.

If you need to take a moderate CYP3A4 inhibitor while you’re using Calquence, your doctor may decrease your dose of Calquence while you’re using the other medication. This should help prevent any side effects from having too much Calquence in your body.

Before using Calquence, be sure to talk with your doctor or pharmacist about any other medications that you take. They’ll be able to determine if these drugs are CYP3A4 inhibitors and whether they’ll affect your treatment with Calquence.

Calquence and CYP3A4 inducers

Your body breaks down Calquence using an enzyme in your liver called CYP3A4. Some other medications can make this enzyme work more quickly than usual. This means that your body will break down Calquence too quickly, and you may not get enough medication.

You should avoid taking Calquence along with drugs known as strong CYP3A4 inducers, such as rifampin (Rimactane). This is because these medications can cause your body to break down Calquence too quickly, and you may not get enough Calquence to treat your cancer. If you need to take a medication that’s a strong CYP3A4 inducer, your doctor may increase your dose of Calquence. This helps ensure that you get enough medication to treat your condition.

Before taking Calquence, talk with your doctor or pharmacist about any medications that you’re using. They’ll be able to determine if any of these drugs are strong CYP3A4 inducers and adjust your treatment plan as needed.

Calquence and heartburn medications

Taking Calquence along with medications that reduce stomach acid may decrease the level of Calquence in your body. This means that you may not get enough Calquence in your system to treat your cancer.

Types of drugs that reduce stomach acid include antacids, proton pump inhibitors (PPIs), and H2-blockers.

Antacids

If you’re using an antacid, be sure to separate your antacid dose from your Calquence dose by at least 2 hours. By doing this, the level of Calquence shouldn’t decrease.

Examples of antacids include:

Proton pump inhibitors

PPIs are another group of medications that are used to treat heartburn. This is because PPIs last for a long period of time. Even by separating your doses, the PPI may still affect your dose of Calquence and make Calquence less effective. You shouldn’t take PPIs while you’re using Calquence.

Examples of PPIs include:

H2-blockers

H2-blockers are a common class of medications that are used to treat heartburn. (A class of medications is a group of drugs that work in a similar way.) You should take your dose of Calquence 2 hours before taking your H2-blocker. This should help prevent the interaction between these medications so that you’ll still have the correct level of Calquence in your body.

Examples of H2-blockers include:

  • famotidine (Pepcid)
  • cimetidine (Tagamet)
  • ranitidine (Zantac)

If you have heartburn or stomach acid problems, talk with your doctor about the best way to treat your condition. They can recommend the right medications for you and how to take them so they don’t affect your Calquence treatment.

Calquence and herbs and supplements

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

Calquence and foods

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

As with all medications, the cost of Calquence can vary. To find current prices for Calquence in your area, check out WellRx.com. The cost you find on WellRx.com is what you may pay without insurance. 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 may have to get Calquence 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.

Before approving coverage for Calquence, your insurance company may require you to get prior authorization. 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 Calquence, contact your insurance company.

Financial and insurance assistance

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

AstraZeneca Pharmaceuticals LP, the manufacturer of Calquence, offers the Calquence Patient Savings Program and the AstraZeneca Access 360 program. For more information and to find out if you’re eligible for support, call 844-275-2360 or click the program names.

Generic version

Calquence 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.

You should take Calquence according to your doctor’s or healthcare provider’s instructions.

Calquence comes as a capsule that you swallow. Be sure to take it with water.

When to take

Take your dose of Calquence every 12 hours unless your doctor directs you otherwise. If you miss your dose by more than 3 hours, skip that dose and take your next dose at the scheduled time.

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 Calquence with food

You can take your dose of Calquence with or without food. However, be sure to take the medication with water.

Can Calquence be crushed, split, or chewed?

You shouldn’t open, crush, split, or chew Calquence capsules. Swallow the medication whole with water.

Chronic lymphocytic leukemia (CLL) is a type of cancer that affects white blood cells in your bone marrow (the tissue inside bones). These cells begin to grow abnormally and don’t work as they should in your body. Eventually, the cancer cells move from your bone marrow into your blood. CLL is a very slow growing cancer. It’s the most common type of leukemia that occurs in adults.

Small lymphocytic leukemia (SLL) is very similar to CLL. But with SLL, the majority of the abnormal white blood cells are in your lymph nodes. Lymph nodes are part of your immune system, which helps you fight infections.

Mantle cell lymphoma (MCL) is a fast-growing type of cancer that affects your white blood cells. Specifically, it’s a kind of non-Hodgkin lymphoma. MCL occurs when your white blood cells begin to grow abnormally and reproduce quickly. These abnormal cells are usually found in your lymph nodes, bone marrow, digestive tract, and blood.

What Calquence does

Calquence works by blocking the growth of the abnormal white blood cells.

Calquence belongs to a class of medications called kinase inhibitors. (A class of medications is a group of drugs that work in a similar way.) Kinase inhibitors are targeted therapies. This means that they work on a specific protein in your body. As a result, these medications have fewer side effects than chemotherapy drugs, which aren’t as specific and affect many different cells.

The protein that Calquence blocks is called Bruton tyrosine kinase (BTK). BTK helps your white blood cells grow. By blocking BTK, Calquence helps reduce the growth of white blood cells, so they’ll eventually die. This kills the abnormal white blood cells that are causing the cancer.

How long does it take to work?

Calquence will begin working after your first dose of medication. However, it may take time for you to see a response. A response to the medication means that tests showed a decreased level of cancer cells or no cancer at all.

In clinical trials of people who took Calquence for their MCL, about 80% of people responded to treatment. For half of them, the peak of their response occurred 1.9 months after they started treatment. This means that their cancer had reached its best response by this time.

However, the timing may be different for each person who uses the medication. It wasn’t reported when the peak response was for people who took Calquence for CLL or SLL.

You shouldn’t take Calquence if you’re pregnant or planning to become pregnant. The drug can be harmful to a developing fetus and make birth harder for both the baby and mother.

There are no studies of Calquence in pregnant women, so the recommendations above are based on animal studies. The drug caused decreased body weight in fetuses, and bones were slower to form.

If you’re able to become pregnant, your doctor will give you a pregnancy test before you start using Calquence to make sure you’re not pregnant.

And if you’re already pregnant or plan to become pregnant, talk with your doctor about treatment options other than Calquence for your cancer.

You shouldn’t take Calquence if you’re pregnant or planning to become pregnant.

For women using Calquence

If you can become pregnant, you should use birth control while taking Calquence and for at least 1 week after your last dose of medication.

For men using Calquence

The maker of Calquence hasn’t provided any birth control recommendations for men who take the medication. However, if you’re a man who’s using Calquence and your sexual partner can become pregnant, talk with your doctor. They can review your birth control needs during and after your treatment.

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

You shouldn’t breastfeed while you’re taking Calquence and for 2 weeks after your last dose of medication.

There are currently no human studies on breastfeeding and Calquence. However, in animal studies, Calquence was present in breast milk, which means that a breastfed animal could consume it.

If you’re breastfeeding or planning to breastfeed, talk with your doctor about healthy ways to feed your child and what cancer treatments are right for you.

Here are answers to some frequently asked questions about Calquence.

Is Calquence a type of chemotherapy?

No, Calquence isn’t chemotherapy. Calquence is a type of targeted therapy. Targeted therapies work in specific areas of your body to treat certain kinds of cancer. This limits the side effects that you may have.

Chemotherapy, on the other hand, is a treatment for cancer that can affect your whole body. There can be many side effects with chemotherapy because the drug works on cells throughout your body that are growing quickly.

Am I able to use Calquence if I have surgery planned?

It depends on the surgery. Calquence may increase your risk for bleeding. This can include serious bleeding, which led to death in some cases in clinical studies. Because of that risk, your doctor may have you stop taking Calquence for 3 to 7 days before the surgery. However, in some cases, such as small surgical procedures, you may not have to stop taking Calquence.

Be sure to talk with your doctor before having any surgery to see if you need to stop taking Calquence for a time.

Can I keep taking my blood thinner while using Calquence?

You’ll likely be able to keep taking your blood thinner while using Calquence.

Calquence may increase your risk for bleeding, including major bleeds that in some cases may lead to death. (Symptoms of major bleeds include blood in your stool and vomiting blood.) If you’re also taking a blood thinner, you’re at an increased risk for bleeding.

However, you usually won’t need to stop taking your blood thinner. During your Calquence treatment, your doctor will monitor you for signs of bleeding, such as with blood tests. And be sure to tell your doctor about any bleeding that you have.

If you’re taking a blood thinner, ask your doctor if you should keep using it while you’re taking Calquence.

Are antacids and acid reducers safe to take during my Calquence treatment?

It depends on the medication. Some antacids and acid reducers may decrease the level of Calquence in your body. This means that you may not get enough Calquence in your body to treat your cancer.

Certain antacids are safe as long as you take them at least 2 hours apart from Calquence. Examples of these antacids include calcium carbonate (Tums) and magnesium hydroxide (milk of magnesia).

Other medications called H2-blockers are also safe if you take them at least 2 hours after Calquence. Examples of H2-blockers include famotidine (Pepcid), cimetidine (Tagamet), and ranitidine (Zantac).

However, you shouldn’t take drugs known as proton pump inhibitors (PPIs) with Calquence. These drugs last in your body for a long period of time. Even by separating your doses, the drugs may still affect your dose of Calquence. Examples of PPIs include omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), and esomeprazole (Nexium).

For more information about antacids and acid reducers, see the “Calquence interactions” section above.

If you’re taking any medication for heartburn or stomach acid problems, talk with your doctor before starting your Calquence treatment.

Will Calquence cure my condition?

Cancer doesn’t yet have a cure. But taking Calquence may stop your cancer from getting worse.

Talk with your doctor if you have questions about how Calquence can help treat your cancer.

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

  • Upcoming surgery. Before taking Calquence, talk with your doctor about any surgery you plan to have. The drug may increase your risk for bleeding, so you may need to stop using it before surgery.
  • Bleeding problems. Before using Calquence, be sure to tell your doctor about any bleeding problems, such as hemophilia or von Willebrand’s disease, that you have. Calquence may increase your risk for bleeding. So if you already have a condition that may cause bleeding, you’re at an even higher risk for bleeds. Your doctor will be able to determine if Calquence is the best medication for you.
  • Heart problems. If you have a heart problem that makes it hard for your heart rhythm to be well-controlled, tell your doctor about it before you start taking Calquence. The drug may cause heart rhythm problems such as atrial fibrillation. So if you already have a heart problem, Calquence may make your condition worse. Your doctor may recommend other treatment options.
  • Infections. Calquence may increase your risk for developing an infection. If you already have an infection, your doctor will treat it before you start taking Calquence. So talk with your doctor about any infections you have before you use Calquence.
  • Liver problems, such as hepatitis B. If you have any liver problems, including a history of hepatitis B, talk with your doctor before starting Calquence treatment. The drug may increase the risk of infections, such as hepatitis B, coming back. Also, Calquence is broken down by your liver. So if you already have liver problems, too much of the drug may build up in your system. As a result, your doctor may need to reduce your Calquence dose.
  • Pregnancy. You shouldn’t take Calquence if you’re pregnant or planning to become pregnant. For more information, please see the “Calquence and pregnancy” section above.
  • Breastfeeding. You shouldn’t breastfeed while you’re taking Calquence and for 2 weeks after your last dose of medication. For more information, please see the “Calquence and breastfeeding” section above.
  • Allergic reaction. If you’re allergic to Calquence or any of its ingredients, you shouldn’t use Calquence. Ask your doctor what other treatment options are available.

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

Using more than the recommended dosage of Calquence can lead to serious side effects.

Do not use more Calquence than your doctor recommends.

Overdose symptoms

It isn’t known what symptoms may occur if you take too much Calquence. Be sure to only take the dose of Calquence that your doctor prescribes. Never take two doses at once to make up for a missed dose.

What to do in case of overdose

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 Calquence 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.

You should store Calquence capsules at room temperature, between 68°F and 77°F (20°C and 25°C) in a tightly sealed container away from light. If necessary, you can keep the medication between 59°F and 86°F (15°C and 30°C). Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Calquence 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

Calquence is approved for use in patients with:

Administration

Calquence is a capsule that is usually taken every 12 hours. It should be swallowed whole and can be taken with or without food. Capsules should not be broken, open, or chewed.

Mechanism of action

Calquence is a kinase inhibitor, specifically an inhibitor of Bruton tyrosine kinase (BTK). BTK is an important part of the life cycle of B cells as well as B-cell reproduction. By inhibiting BTK, Calquence decreases B-cell tumor growth as well as cancerous B-cell reproduction.

Pharmacokinetics and metabolism

Calquence has an absolute bioavailability of 25%. The average time to peak plasma concentration for Calquence is 0.9 hours. The average time to peak plasma concentration for the active metabolite of Calquence, ACP-5862, is 1.6 hours.

Calquence is highly protein-bound. It is 97.5% protein-bound, and ACP-5862 is 98.6% protein-bound. The half-life of Calquence is 1 hour, and the half-life for ACP-5862 is 3.5 hours.

This drug is mostly metabolized via cytochrome P450 enzymes in the liver. Specifically, Calquence is metabolized by CYP3A. It is also metabolized by conjugation and hydrolysis in the liver to a lesser extent. The majority (84%) of Calquence is excreted in the feces, and about 12% is excreted in the urine.

Contraindications

There are no contraindications to taking Calquence.

Storage

Calquence tablets should be stored at room temperature, between 68°F and 77°F (20°C and 25°C) in a tightly sealed container away from light. If necessary, the medication can be stored between 59°F and 86°F (15°C and 30°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.