Key takeaways

  • Imbruvica is a brand-name drug prescribed for certain types of blood cancer. It’s also used to treat chronic graft-versus-host disease. The medication comes in three oral forms: a tablet, a capsule, and a liquid suspension.
  • Imbruvica has potential side effects, including bleeding, infections, and changes in heart rhythm. Tell your doctor right away about any unusual symptoms while taking this drug.
  • Imbruvica can interact with several other medications, supplements, and even certain foods like grapefruit. Interactions can potentially affect Imbruvica’s effectiveness or increase the risk of side effects.

The Food and Drug Administration (FDA) has approved Imbruvica to treat the following in adults:

The FDA has also approved Imbruvica for this type of cGVHD in children ages 1 year and older.

For details on these conditions, see the “Imbruvica uses” section.

Drug details

Here you’ll find key information about Imbruvica.

  • Drug class: kinase inhibitor
  • Drug forms: oral tablet, oral capsule, and oral suspension
  • Generic available? no
  • Prescription required? yes
  • Controlled substance? no
  • Year of FDA approval: 2013

Imbruvica 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 ingredient in a brand-name medication. The generic is considered to be just as safe and effective as the original drug. Generics also tend to cost less than brand-name drugs.

Imbruvica contains the active ingredient ibrutinib. This means ibrutinib is the ingredient that makes Imbruvica work.

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

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

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Imbruvica and want to tell the FDA about it, visit MedWatch or call 800-332-1088.

Mild side effects

Side effects may vary depending on whether you take Imbruvica for cancer or chronic (long-term) graft-versus-host disease (cGVHD).

Mild side effects with cancer

In clinical trials of Imbruvica for chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and Waldenström macroglobulinemia (WM), the mild side effects of Imbruvica that occurred more often include:

  • diarrhea
  • rash
  • bruising
  • nausea
  • fatigue
  • fever
  • pain in your muscles or joints

The mild side effects of Imbruvica that occurred less frequently in these clinical trials include:

Mild side effects with chronic graft-versus-host disease

In clinical trials of Imbruvica for cGVHD, the mild side effects of Imbruvica that occurred more often include:

  • fatigue
  • bruising
  • diarrhea
  • muscle spasms (muscle cramps)
  • mouth sores
  • nausea

The mild side effects of Imbruvica that occurred less frequently in these clinical trials include:

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

Serious side effects

Serious side effects from Imbruvica 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 for people taking Imbruvica for CLL, SLL, WM, or cGVHD are very similar but may differ slightly. Serious side effects and their symptoms in people taking Imbruvica can include:

  • Thrombocytopenia (decreased level of platelets, which are blood cells that help clot your blood). Symptoms can include:
    • bleeding or bruising more easily than usual
    • bleeding from your gums
    • nosebleeds
    • blood in urine
  • Anemia (decreased level of red blood cells). Symptoms can include:
    • fatigue
    • headache
    • dizziness
    • fast heartbeat
  • Neutropenia (decreased level of white blood cells called neutrophils that help fight infections). Symptoms can include:
    • infections that won’t go away or keep coming back
    • pneumonia (a type of lung infection)
    • fever
    • skin infections
  • Infections, such as severe pneumonia. Symptoms can include:
    • fever
    • weakness
    • feeling sick and not getting better
    • chills
  • Changes in heart rhythm, heart failure, or sudden death. Symptoms can include:
  • High blood pressure. Symptoms can include:
    • headache
    • fatigue
    • irregular heartbeat
    • pounding feeling in your ears or neck
  • Tumor lysis syndrome (a condition that occurs when many cancer cells are killed at the same time and get released into your blood). Symptoms can include:
    • fatigue
    • nausea and vomiting
    • muscle and joint pain
    • irregular heartbeat
    • seizures
  • Other types of cancer, such as skin, lung, or prostate cancer. Symptoms can include:
    • growths on your skin
    • sores that don’t heal
    • bleeding sores
    • fatigue

Other serious side effects, explained in more detail 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 several of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Imbruvica. However, it’s not known how many people had an allergic reaction to Imbruvica in clinical trials. Symptoms of a mild allergic reaction can include:

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
  • difficulty breathing

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

Bleeding

Bleeding is a serious side effect that may occur in people taking Imbruvica. In clinical trials of the drug, major bleeding occurred, including bleeding in the brain or intestines. In rare instances, this side effect was fatal.

If you’re taking a blood thinner medication with Imbruvica, your risk of bleeding is increased. (See the “Imbruvica interactions” section to learn more.) If you’re having surgery, your doctor may pause your Imbruvica treatment a few days before the surgery. This depends on how major the surgery is. The goal is to help prevent serious bleeding from occurring.

If you have any symptoms of bleeding while you’re taking Imbruvica, it’s important to tell your doctor right away. These symptoms can include:

  • blood in your stool or urine
  • bleeding that won’t stop
  • vomiting or coughing up blood
  • bruising easily
  • dizziness
  • confusion
  • headache
  • feeling weak

If you have any concerns about bleeding during your Imbruvica treatment, talk with your doctor.

Imbruvica is a brand-name prescription drug approved to treat certain types of blood cancer in adults. Specifically, the Food and Drug Administration (FDA) has approved Imbruvica to treat:

The medication is also approved to treat an immune system problem called chronic graft-versus-host disease (cGVHD) in adults and children ages 1 year and older.

Imbruvica for chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL)

Imbruvica can be used for the treatment of CLL and SLL. Both CLL and SLL are types of non-Hodgkin’s lymphoma.

CLL is a type of leukemia (blood cancer). If you have CLL, your body makes a large number of abnormal lymphocytes (a type of white blood cell that works to fight infections). This can cause many problems, such as anemia (decreased level of red blood cells) and thrombocytopenia (decreased level of platelets in your blood). CLL is usually a slow-growing cancer that may take years to worsen.

SLL is a type of cancer that occurs in the lymph nodes, which are part of your immune system. Your lymph nodes contain lymphocytes. With SLL, your body makes a large number of abnormal lymphocytes in your lymph nodes. This causes problems with fighting infections. SLL is typically a slow-growing cancer that takes time to worsen.

CLL and SLL are very similar. However, typically CLL affects cells in your blood. SLL, on the other hand, affects cells in your lymph nodes. Imbruvica may sometimes be used with other medications to treat CLL or SLL. For example, the drug may be used along with rituximab (Rituxan). This is a type of immunotherapy that works by activating your immune system to fight the cancer.

Imbruvica can also be used in the treatment of CLL or SLL in people with a 17p deletion. This is a change in a person’s chromosomes, which make up their genes.

For more information about these conditions, refer to our leukemia hub and list of lymphoma articles.

Effectiveness

In clinical trials, Imbruvica was found to be safe and effective for treating CLL and SLL. For detailed information about these clinical trials, see Imbruvica’s prescribing information.

Imbruvica for Waldenström macroglobulinemia (WM)

Imbruvica can be used to treat WM, which is a type of non-Hodgkin’s lymphoma. This is a slow-growing cancer that occurs in the plasma cells, which are a type of white blood cell. These cells produce an abnormal amount of an antibody (a protein in the blood) called IgM. This increase in IgM is the major marker (sign) of WM. Another name for WM is lymphoplasmacytic lymphoma.

Imbruvica may sometimes be used with other medications to treat WM. For example, it may be used along with rituximab. This is a type of immunotherapy that works by activating your immune system to fight the cancer.

Effectiveness

In clinical trials, Imbruvica was found to be safe and effective for treating WM. For detailed information about these clinical trials, see Imbruvica’s prescribing information.

Imbruvica for chronic graft-versus-host disease (cGVHD)

Imbruvica can be used to treat cGVHD. This condition can occur after you have a stem cell transplant, a procedure that may help treat certain cancers. With cGVHD, your transplant cells (the graft) attack your own body (the host).

Imbruvica should be used for cGVHD only if you have already tried at least one other systemic treatment for cGVHD and your condition got worse. (Systemic treatment refers to a treatment that affects the whole body.)

Effectiveness

In clinical trials, Imbruvica was found to be safe and effective for treating cGVHD. For detailed information about these clinical trials, see Imbruvica’s prescribing information.

Imbruvica and children

The FDA has approved Imbruvica to treat cGVHD in children ages 1 year and older. The drug is not approved for treating other conditions in children. For more information about Imbruvica’s use for cGVHD, see the section just before this one.

Off-label use for Imbruvica

The Food and Drug Administration (FDA) approves prescription drugs such as Imbruvica to treat certain conditions. In addition to the uses listed previously, Imbruvica may also be used off-label for other conditions. Off-label use is when a drug that’s FDA approved to treat one condition is used to treat a different condition.

Here are a few examples of off-label uses for Imbruvica.

Imbruvica for diffuse large B-cell lymphoma

Imbruvica isn’t currently approved for use in people with diffuse large B-cell lymphoma (DLBCL). However, your doctor may prescribe the drug off-label for this use.

In a clinical trial of DLBCL, people took either ibrutinib (the active ingredient in Imbruvica) or a placebo (treatment with no active drug ingredient), along with a combination of chemotherapy drugs referred to as R-CHOP.

The study showed that people with DLBCL who are older than age 60 years experienced increased toxicity (higher risk of harm) when taking ibrutinib with R-CHOP. However, people younger than age 60 years may be more likely to live and live longer after taking ibrutinib with R-CHOP.

More research is needed to determine whether Imbruvica may be safe and effective in the treatment of DLBCL. However, DLBCL treatment guidelines recommend Imbruvica in certain cases where other treatment options did not work.

Imbruvica for mantle cell lymphoma or marginal zone lymphoma

The Food and Drug Administration (FDA) originally granted accelerated approval to Imbruvica to treat mantle cell lymphoma (MCL) and marginal zone lymphoma (MZL) in certain situations.

Accelerated approval is reserved for certain drugs designed to treat conditions that don’t have a lot of successful treatment options. However, after additional studies, the FDA decided not to grant full approval to Imbruvica for these cancers.

Current treatment guidelines still recommend the use of Imbruvica for certain cases of MCL or MZL. If you have questions about using Imbruvica for MCL or MZL, talk with your doctor.

As with all medications, the cost of Imbruvica 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 Imbruvica 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 Imbruvica. 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 request and let you and your doctor know whether your plan will cover Imbruvica.

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

Drug coupons

You can visit Optum Perks for price estimates of Imbruvica. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with insurance copays or benefits.

Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission. Learn more.

Financial and insurance assistance

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

Pharmacyclics LLC, the manufacturer of Imbruvica, offers the Imbruvica By Your Side support program and the Imbruvica Copay Card, which may help lower the cost of the drug. For more information and to find out if you’re eligible for support, call 888-968-7743 or visit the program website.

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

  • the type and severity of the condition you’re using Imbruvica to treat
  • the form of Imbruvica you take
  • other medical conditions you may have
  • other medications you may be taking
  • height and weight (for children younger than age 12 years)

If you develop side effects from taking Imbruvica, such as a decreased level of white blood cells or infections, your doctor may pause your dose until you recover. When you resume taking this medication, your doctor may start you at a lower dose and slowly increase it over time. This may help decrease the risk of having the side effect again because it lets your body adjust to the medication over time.

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

Imbruvica is available in three oral forms: a tablet, a capsule, and a liquid suspension (a type of liquid mixture). The following table lists the available strengths in milligrams (mg) for the tablet and capsule and milligrams per milliliter (mg/mL) of solution for the liquid suspension.

Imbruvica formStrength(s)
tablet140 mg
280 mg
420 mg
capsule70 mg
140 mg
liquid suspension70 mg/mL

Imbruvica tablets used to be available in a strength of 560 mg. However, the manufacturer has discontinued the Imbruvica 560-mg tablets.

Dosage for chronic lymphocytic leukemia and small lymphocytic lymphoma

The dosage for chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) is 420 mg once per day. If you’re taking Imbruvica along with rituximab (Rituxan) or obinutuzumab (Gazyva), you’ll take Imbruvica first.

Sometimes you may take Imbruvica either with bendamustine (Treanda) and rituximab or with obinutuzumab for your CLL or SLL. You should keep taking these drugs as your doctor recommends. However, if your CLL or SLL progresses (worsens) or if you develop side effects that you can’t tolerate, your doctor may have you stop taking them.

Dosage for Waldenström macroglobulinemia

The dosage of Imbruvica for Waldenström macroglobulinemia (WM) is 420 mg once per day. To treat your WM, you may take Imbruvica along with rituximab. If you’re taking these medications on the same day, you should take Imbruvica first.

Keep taking Imbruvica as your doctor recommends. However, if your WM progresses or if you develop side effects that aren’t tolerable, your doctor may have you stop taking the drugs.

Dosage for chronic graft-versus-host disease

The dosage for chronic graft-versus-host disease (cGVHD) is 420 mg once per day. You should keep taking Imbruvica as your doctor recommends. However, your doctor may have you stop taking the drug if:

  • your cGVHD worsens
  • you have side effects that aren’t tolerable
  • your original cancer comes back

Note: cGVHD results from stem cell transplants, a procedure that may be used to treat some cancers.

Children’s dosage

Imbruvica is approved to treat cGVHD in children ages 1 year and older.

For children younger than age 12 years, the Imbruvica dosage for cGVHD is based on body surface area (BSA), which is based on height and weight. If your child is prescribed the drug, their doctor will calculate their BSA to determine the correct dosage.

The Imbruvica dosage for children ages 12 years and older is 420 mg once per day.

For a child who is not able to swallow tablets or capsules, their doctor may recommend the liquid suspension form of Imbruvica.

What if I miss a dose?

If you forget to take your dose of Imbruvica and it’s still the same day, take the dose as soon as you remember. If it’s the next day, take your dose at the usual time.

You should never take two doses of Imbruvica in the same day. Do not try to make up for a missed dose the next day by taking two doses.

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?

Imbruvica is meant to be used as a long-term treatment. However, if your cancer progresses or if you have side effects that are no longer tolerable, your doctor may have you stop taking the drug.

If you’re using Imbruvica for cGVHD, your doctor may have you stop taking the drug if your cancer returns, your cGVHD worsens, or you have side effects that are no longer tolerable. You may also stop taking Imbruvica as directed by your doctor when you no longer have a high risk of cGVHD.

If you and your doctor determine that Imbruvica is safe and effective for you, you’ll likely take it long term.

There are no known interactions between alcohol and Imbruvica. However, some conditions, such as those affecting the kidney or liver, may require you to limit how much alcohol you drink or not drink any at all. These include chronic kidney disease and hepatitis. (Depending on the severity of these conditions, your doctor may recommend a reduced dose of Imbruvica.)

If you drink alcohol, talk with your doctor about how much is safe to drink while being treated for your condition.

Here are answers to some frequently asked questions about Imbruvica.

Is Imbruvica chemotherapy?

No, Imbruvica isn’t a type of chemotherapy. Typically, chemotherapy drugs affect all cells in your body that are quickly multiplying, not just cancer cells. So chemotherapy may cause a lot of side effects.

Imbruvica’s mechanism of action (how it works) is different from that of chemotherapy drugs. Imbruvica is a type of drug called a kinase inhibitor, which is a targeted therapy. It works by targeting a specific enzyme in your body. (An enzyme is a protein that makes reactions occur more quickly.)

By blocking this enzyme, Imbruvica stops the growth of cancer cells. The drug also blocks the action of cells in your immune system that can cause chronic (long-term) graft-versus-host disease (cGVHD).

Because targeted therapy works on specific cells, it may cause fewer side effects than chemotherapy. (To learn more about the side effects of Imbruvica, see the “Imbruvica side effects” section.)

Can I take Tylenol or ibuprofen with Imbruvica?

While using Imbruvica, it’s safe to take acetaminophen (Tylenol). However, you should not take ibuprofen (Advil, others).

Ibuprofen may increase your risk of bleeding and raise your blood pressure. Imbruvica may also cause bleeding and increased blood pressure. (For more information, see the “Imbruvica side effects” section.) So taking Imbruvica with ibuprofen may lead to serious bleeding or high blood pressure that can be harmful.

If you need a pain reliever while using Imbruvica but can’t take acetaminophen, talk with your doctor. They can recommend other options.

Will Imbruvica cure my condition?

No, Imbruvica won’t cure your condition. When used in the treatment of lymphoma or leukemia, Imbruvica works to help prevent your condition from progressing and help you reach remission.

Remission is when tests no longer show any cancer cells in your body and the cancer symptoms go away. The goal of treating lymphoma and leukemia is for you to go into remission. Some people remain in remission for the rest of their lives. Other people relapse, meaning that their cancer returns.

If you’re taking Imbruvica to treat cGVHD, your condition may improve over time. And if your doctor thinks that your stem cell transplant will no longer attack your body after treatment, they may have you stop taking the drug.

Can I keep taking Imbruvica if I’m having surgery or a dental procedure?

You may be able to. If you plan to have any type of surgery or dental procedure during your Imbruvica treatment, first talk with your doctor.

Because Imbruvica may increase your risk of bleeding, your doctor may have you pause your Imbruvica use before your surgery. This may be done to help prevent serious bleeding from occurring. Depending on the procedure that you’re having, it may not be necessary to stop taking Imbruvica.

It’s recommended that you talk with your doctor before you stop taking this medication.

How long do people stay on Imbruvica?

It depends. Doctors will recommend how long to take the drug based on a person’s unique situation. In general, the drug is meant to be taken long term.

If you take Imbruvica for cancer, you’ll likely continue taking it until the cancer progresses or you have side effects that aren’t tolerable.

If you’re using Imbruvica for cGVHD, your doctor may have you stop taking the drug if your cGVHD worsens or you have side effects that are no longer tolerable. They may also have you stop Imbruvica if your cancer returns. (cGVHD results from stem cell transplants. This procedure is often used to treat certain cancers.)

In addition, you may stop taking Imbruvica as directed by your doctor when you no longer have a high risk of cGVHD.

To find out how long you might take Imbruvica, talk with your doctor.

Other drugs are available that can treat lymphoma, leukemia, or chronic (long-term) graft-versus-host disease (cGVHD). Some may be a better fit for you than others. If you’re interested in finding an alternative to Imbruvica, talk with your doctor. They can tell you about other medications that may work well for you.

Some of the medications listed here are chemotherapy drugs, such as bendamustine (Treanda) and cyclophosphamide. And some of the other medications are types of immunotherapy. Immunotherapy is a treatment that helps your body use its own immune system to fight cancer. Examples of immunotherapy include rituximab (Rituxan) and ofatumumab (Arzerra).

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 and small lymphocytic lymphoma

Examples of other drugs that may be used to treat chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) include:

  • bendamustine (Treanda)
  • acalabrutinib (Calquence)
  • alemtuzumab (Lemtrada)
  • rituximab (Rituxan)
  • venetoclax (Venclexta)
  • ofatumumab (Arzerra)
  • idelalisib (Zydelig)
  • fludarabine
  • pentostatin (Nipent)
  • cyclophosphamide

Alternatives for Waldenström macroglobulinemia

Examples of other drugs that may be used to treat Waldenström macroglobulinemia (WM) include:

  • bortezomib (Velcade)
  • carfilzomib (Kyprolis)
  • ixazomib (Ninlaro)
  • chlorambucil (Leukeran)
  • cyclophosphamide
  • fludarabine
  • bendamustine (Treanda)
  • rituximab (Rituxan)
  • obinutuzumab (Gazyva)
  • ofatumumab (Arzerra)

Alternatives for chronic graft-versus-host disease

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

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

Ingredients

The active ingredient in Imbruvica is ibrutinib. The active ingredient in Venclexta is venetoclax.

Uses

The Food and Drug Administration (FDA) has approved Imbruvica for use in adults to treat the following conditions:

The FDA has also approved Imbruvica for this type of cGVHD in children ages 1 year and older.

For details on these conditions, see the “Imbruvica uses” section.

Venclexta is FDA approved for use in adults to treat the following conditions:

For treating AML, Venclexta is used with the medications cytarabine (in a low dose), decitabine, or azacitidine.

Drug forms and administration

Imbruvica is available in three oral forms: a tablet, a capsule, and a liquid suspension. You’ll take the drug once per day.

Venclexta comes as an oral tablet. You’ll take it once per day.

Side effects and risks

Imbruvica and Venclexta both contain medications to treat CLL and SLL. Therefore, these medications can cause some similar side effects. However, they can cause some different side effects as well. Here you’ll find examples of these side effects.

Mild side effects

The following tables contain examples of mild side effects that can occur with Imbruvica, with Venclexta, or with both drugs (when taken individually).

Mild side effectImbruvicaVenclexta
bruising✓
diarrhea✓✓
nausea✓✓
fatigue✓✓
mild infections, such as urinary tract infections✓✓
pain in your muscles or joints✓✓
mouth sores✓✓
rash✓✓
dizziness✓✓
headache✓✓
fever✓✓

Serious side effects

The following table lists examples of serious side effects that can occur with Imbruvica, with Venclexta, or with both drugs (when taken individually).

Serious side effectImbruvicaVenclexta
major bleeding✓
changes in heart rhythm, heart failure, or sudden death✓
high blood pressure✓
other types of cancer, such as skin, lung, or prostate cancer✓
tumor lysis syndrome✓✓
neutropenia✓✓
infections, such as severe pneumonia✓✓
allergic reaction✓✓
thrombocytopenia✓✓
anemia✓✓

Effectiveness

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

Both drugs have been studied for use together. Treatment guidelines recommend that Imbruvica or Venclexta be prescribed for certain people with CLL and SLL. Also, clinical trials have found both Imbruvica and Venclexta to be effective for treating CLL and SLL on their own.

Costs

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

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

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

Ingredients

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

Uses

The Food and Drug Administration (FDA) has approved Imbruvica for use in adults to treat the following conditions:

The FDA has also approved Imbruvica for this type of cGVHD in children ages 1 year and older.

For details on these conditions, see the “Imbruvica uses” section.

Calquence is approved for use in adults to treat the following:

Drug forms and administration

Imbruvica is available in three oral forms: a tablet, a capsule, or a liquid suspension. You’ll take the drug once per day.

Calquence comes as a tablet that you swallow. You’ll take it every 12 hours.

Side effects and risks

Imbruvica and Calquence both contain drugs that are used in the treatment of CLL and SLL. Therefore, these medications can cause some similar side effects. However, they can cause some different side effects as well. The following tables give examples of these side effects.

Mild side effects

The following table lists examples of mild side effects that can occur with Imbruvica, with Calquence, or with both drugs (when taken individually).

Mild side effectsImbruvicaCalquence
mouth sores✓
headache✓✓
diarrhea✓✓
pain in your muscles or joints✓✓
rash✓✓
bruising✓✓
nausea✓✓
fatigue✓✓
fever✓✓
dizziness✓✓
mild infections, such as urinary tract infections✓✓

Serious side effects

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

Serious side effectImbruvicaCalquence
high blood pressure✓
tumor lysis syndrome✓
heart failure or sudden death✓
thrombocytopenia✓✓
anemia✓✓
neutropenia✓✓
major bleeding✓✓
changes in heart rhythm✓✓
infections such as severe pneumonia✓✓
other types of cancer such as skin, lung, or prostate cancer✓✓
allergic reaction✓✓

Effectiveness

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

These drugs haven’t yet been directly compared in clinical trials, but studies have found both Imbruvica and Calquence to be effective for treating CLL and SLL. A clinical trial is currently being held to compare Imbruvica with Calquence for the treatment of CLL.

Treatment guidelines recommend that Imbruvica or Calquence be prescribed for certain people with CLL and SLL.

Costs

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

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

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

Different drug 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.

This section provides an overview of interactions that may occur with Imbruvica.

Imbruvica and other medications

The following text gives examples of medications that can interact with Imbruvica. This section doesn’t list all drugs that may interact with Imbruvica.

Before taking Imbruvica, 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, reduce side effects, and allow your doctor to adjust your Imbruvica dose if needed.

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

Imbruvica and certain HIV drugs

Taking Imbruvica along with certain HIV drugs may increase the level of Imbruvica in your body. This may put you at a higher risk of side effects such as bleeding or diarrhea because you’re getting more medication than you should.

Examples of HIV medications that may interact with Imbruvica include:

  • ritonavir (Norvir)
  • nelfinavir (Viracept)

If you’re taking any HIV medications, talk with your doctor before you start to use Imbruvica. They may be able to recommend a different treatment for you.

Imbruvica and certain antibiotics

Imbruvica may interact with certain antibiotics. These antibiotics may increase the level of Imbruvica in your body and cause you to get too much medication.

Examples of antibiotics that may interact with Imbruvica include:

  • clarithromycin
  • erythromycin (Erythrocin)

If you must take an antibiotic for a short period of time, your doctor may pause your Imbruvica treatment until your infection is better. Talk with your doctor about what antibiotics are safe for you to take.

Imbruvica and certain antifungals

Certain antifungal medications may interact with Imbruvica. These antifungal drugs may raise the level of Imbruvica in your body, which can lead to an increase in side effects. (To learn more about side effects, see the “Imbruvica side effects” section.)

Examples of antifungal medications that should be avoided while taking Imbruvica include:

  • ketoconazole
  • itraconazole (Sporanox)
  • posaconazole (Noxafil)
  • voriconazole (Vfend)

If you need an antifungal medication for a short time while you’re taking Imbruvica, your doctor may have you pause your Imbruvica use until your infection goes away. Your doctor may also decrease your dose of Imbruvica while you’re taking an antifungal medication so that you’re not getting exposed to too much medication.

Imbruvica and certain seizure medications

You should avoid taking certain seizure medications while using Imbruvica. Some seizure medications may decrease the level of Imbruvica in your body. This can cause Imbruvica to not work as well to treat your cancer or immune system problem.

Examples of seizure medications to avoid while taking Imbruvica include:

  • carbamazepine (Tegretol)
  • phenytoin (Dilantin)
  • phenobarbital
  • oxcarbazepine (Trileptal)

If you’re taking medication to manage seizures, talk with your doctor before starting Imbruvica.

Imbruvica and blood-thinning medications

You should avoid taking blood thinners (medications that thin your blood) while using Imbruvica. This is because Imbruvica can cause you to bleed more easily and put you at a higher risk of serious bleeding. Medications that thin your blood or prevent it from clotting can also increase your risk of bleeding.

Examples of blood-thinning medications that should not be taken along with Imbruvica include:

If you need to take a blood-thinning medication while using Imbruvica, talk with your doctor about the best treatment options for you.

Imbruvica and rifampin

You should avoid taking rifampin (Rimactane) while you’re using Imbruvica. This is because rifampin decreases the level of Imbruvica in your body. As a result, Imbruvica won’t work as well to treat your cancer or immune system problem.

If you’re taking rifampin, talk with your doctor before starting to use Imbruvica. They can recommend the right treatment for you.

Imbruvica and herbs and supplements

St. John’s wort is an herbal product that some people use for depression. However, this herbal product may interact with Imbruvica, causing the level of Imbruvica in your body to decrease. This means that you won’t be getting your proper dose of Imbruvica, and it may not work properly.

If you’re taking St. John’s wort, tell your doctor before starting Imbruvica.

You should always check with your doctor or pharmacist before using any herbal products or supplements while taking Imbruvica.

Imbruvica and foods

While you’re taking Imbruvica, you should avoid consuming grapefruit, grapefruit juice, and Seville oranges. These citrus juices and fruits can cause the level of Imbruvica in your body to increase. This can result in serious side effects that may be dangerous to your health. (For more about side effects, see the “Imbruvica side effects” section.)

If you have any questions about foods or juices to avoid while taking Imbruvica, talk with your doctor.

Imbruvica may be used along with other drugs to treat your condition. In clinical trials, Imbruvica was shown to be effective when used along with the following drugs:

You should take Imbruvica according to your doctor’s or healthcare professional’s instructions. Imbruvica is available as a tablet or capsule that you swallow with a full glass of water. It’s also available as a liquid suspension that you take by swallowing. You’ll take the medication once per day.

When to take

You should take Imbruvica once per day at about the same time each day.

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 Imbruvica with food

You can take Imbruvica with or without food. However, you should take the tablets or capsules with a glass of water.

Can Imbruvica be crushed, split, or chewed?

No, you should swallow Imbruvica tablets or capsules whole. Never cut, crush, or chew Imbruvica tablets or capsules. Do not open the capsules.

If you have difficulty swallowing pills, mention this to your doctor. They may prescribe the oral suspension form of Imbruvica instead of the tablet or capsule.

Imbruvica is used for different types of lymphoma and leukemia (blood cancer). Specifically, Imbruvica can be used for the treatment of chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and Waldenström macroglobulinemia (WM). CLL, SLL, and WM are types of non-Hodgkin’s lymphoma.

The drug can also be used to treat an immune system problem called chronic (long-term) graft-versus-host disease (cGVHD).

Keep reading to find out Imbruvica’s mechanism of action for treating these conditions. (Mechanism of action refers to how a drug works.) For details about the conditions Imbruvica is used to treat, see the “Imbruvica uses” section.

What Imbruvica does to treat cancer

For CLL, SLL, and WM, Imbruvica works by blocking an enzyme in your body called Bruton’s tyrosine kinase (BTK). An enzyme is a protein that makes reactions occur more quickly.

BTK usually helps your cells grow and reproduce. BTK also causes cancer cells to reproduce quickly, which leads to the cancer getting worse. Imbruvica works by blocking the action of BTK, which stops the cancer from growing.

What Imbruvica does to treat cGVHD

Imbruvica works by blocking the action of BTK in your body. In the case of cGVHD, BTK can cause your immune system cells to grow in number. And too many immune system cells can cause your cGVHD to worsen. BTK blocks the immune cells from reproducing, which eases your symptoms of cGVHD.

How long does it take to work?

Imbruvica begins blocking the reproduction of cancer cells or overactive immune system cells after your first dose. You should keep taking Imbruvica each day unless your condition progresses or you have side effects from taking the medication that you can’t tolerate. (For more about side effects, see the “Imbruvica side effects” section.)

It’s recommended that you talk with your doctor before you stop taking this medication.

The safety of Imbruvica hasn’t been studied in pregnant people. In animal studies, Imbruvica has been shown to cause fetal anomalies (commonly called birth defects) such as bone problems. However, animal studies don’t always predict what will happen in humans.

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

It’s not known whether Imbruvica is safe to take during pregnancy. However, animal studies show that Imbruvica can cause harm to a developing fetus. Because of this, females of reproductive age (ages 15 to 49 years) should take a pregnancy test before starting treatment with Imbruvica. Females should also avoid pregnancy for up to 1 month after they’ve stopped treatment.

Males should avoid a pregnancy with their partner while taking Imbruvica and for 1 month after they stop taking the medication.

If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Imbruvica.

Note: Sex and gender exist on spectrums. Use of the terms “female” and “male” in this article refers to sex assigned at birth.

It’s not known whether Imbruvica passes into breast milk or whether it’s safe for a child who is breastfed.

Due to the potential for serious harm to the child, it’s recommended not to breastfeed during treatment and for 1 week after the last dose of Imbruvica.

If you’re breastfeeding or planning to do so, it’s important to talk with your doctor before you start to take Imbruvica. They can recommend the best way to feed your child.

Before taking Imbruvica, discuss your health history with your doctor. Imbruvica may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

  • bleeding problems
  • heart rhythm problems
  • increased cholesterol levels
  • high blood pressure
  • diabetes
  • a current infection
  • liver problems
  • allergic reaction to Imbruvica or any of its ingredients
  • pregnancy
  • breastfeeding

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

Using more than the recommended dosage of Imbruvica can lead to serious side effects. Do not use more Imbruvica than your doctor recommends.

In clinical trials, there was only one report of someone who took too much medication. This person had an increase in their liver enzyme levels. (An increase in these levels can be a sign of liver damage.) However, after they stopped using Imbruvica, the levels returned to normal. There were no other overdose cases in clinical trials.

Overdose symptoms

Symptoms of an overdose can include increased liver enzyme levels and a higher risk of side effects.

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 America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or go to the nearest emergency room right away.

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 another 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.

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