Imbruvica is a brand-name prescription drug approved to treat certain types of blood cancer in adults, including lymphoma and leukemia. The medication is also approved to treat an immune system problem called chronic graft versus host disease (cGVHD).

Lymphoma is a kind of cancer that affects cells in the immune system, which is the body’s defense against infection. And leukemia is a type of cancer that affects white blood cells. There are many different kinds of lymphoma and leukemia.

cGVHD can occur in people who have had a stem cell transplant. The transplanted cells (the graft) start to attack the person’s own cells in their body (the host).

Imbruvica contains the active drug ingredient ibrutinib, which belongs to a class of drugs called kinase inhibitors. (A class of drugs is a group of medications that work in a similar way.)

Imbruvica comes in two forms that you swallow: a tablet and capsule. The tablet is available in four strengths: 140 mg, 280 mg, 420 mg, and 560 mg. The capsule is available in two strengths: 70 mg and 140 mg. You’ll take Imbruvica once a day.

What it does

The FDA has approved Imbruvica to treat the following:

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

Effectiveness

Clinical trials were measured by a partial or complete response rate. A partial response means that the amount of cancer in the body has decreased. A complete response is when all the cancer has disappeared.

In these trials, 65.8% of people with MCL had a partial or complete response after taking Imbruvica. The drug wasn’t compared with a different medication or a placebo (treatment with no active drug).

For information on the effectiveness of Imbruvica in treating other conditions, see the “Imbruvica uses” section below.

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

Mild side effects

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

Mild side effects with cancer

The mild side effects of Imbruvica that are more common* when taken for cancer can include:

The mild side effects of Imbruvica that are less common** when taken for cancer can include:

* occurred in 20% or more of people in clinical studies

** occurred in less than 20% of people in clinical studies

Mild side effects with chronic graft versus host disease

The mild side effects of Imbruvica that are more common* when taken for cGVHD can include:

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

The mild side effects of Imbruvica that are less common** when taken for cGVHD can include:

* occurred in 20% or more of people in clinical studies

** occurred in less than 20% of people in clinical studies

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.

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 cancer 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 you don’t get better
    • chills
  • Changes in heart rhythm. 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 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 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:

  • 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 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. Major bleeding, including bleeding in the brain or intestines, has occurred and can lead to death. In more than 27 different clinical trials, major bleeds occurred in about 4% of people who took Imbruvica for cancer or cGVHD. About 0.4% of these people died from the bleeds. Imbruvica wasn’t compared with a different medication or a placebo (treatment with no active drug).

If you’re taking a blood thinner medication with Imbruvica, your risk for bleeding is increased. (See the “Imbruvica interactions” section to learn more.) And if you’re having surgery, your doctor may pause your Imbruvica treatment a few days before the surgery. This depends on how severe the surgery is. And 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.

Mouth sores

Mouth sores may occur with Imbruvica use. They can occur anywhere inside your mouth and may feel like a little cut. Six clinical trials looked at people with B-cell cancers, which are a type of lymphoma (a kind of cancer that occurs in your blood). B-cell cancers include:

Between 14% and 20% of people who took Imbruvica developed mouth sores. And of these people, up to 2% had serious mouth sores. Two of the six clinical trials compared Imbruvica with another drug (ofatumumab or chlorambucil). In the comparison studies, between 4% and 6% of people who took ofatumumab or chlorambucil developed mouth sores. And of these people, only 1% had serious mouth sores.

In clinical trials of people who took Imbruvica for cGVHD, 29% of people developed mouth sores. And about 2% of these people developed serious mouth sores. The drug wasn’t compared with a different medication or a placebo.

If you develop mouth sores that are painful or bothersome to you during your Imbruvica treatment, talk with your doctor about ways you can feel more comfortable.

Rash

Rashes may occur with Imbruvica. This is one of the most common side effects of taking the medication. Nine clinical trials looked at people with B-cell cancers, including MCL, CLL, SLL, WM, and MZL. Between 21% and 36% of people who took Imbruvica developed a rash. Of these people, up to 5% developed a severe rash.

Five of these trials compared Imbruvica with a different drug or a placebo. People took:

  • Imbruvica or ofatumumab
  • Imbruvica or chlorambucil
  • Imbruvica, bendamustine, and rituximab or bendamustine, rituximab, and a placebo
  • Imbruvica and obinutuzumab or chlorambucil and obinutuzumab
  • Imbruvica and rituximab or rituximab and a placebo

Between 11% and 25% of people who didn’t take Imbruvica developed a rash. And up to 2% of these people had serious rashes.

In clinical trials of cGVHD, a rash occurred in about 12% of people who took Imbruvica. None of these people had a severe rash. Imbruvica wasn’t compared with a different medication or a placebo.

If you develop a rash that causes you pain, itching, or swelling, talk with your doctor. They will be able to prescribe medication or creams or give you advice that can help ease your symptoms.

Joint pain

Joint pain may develop during Imbruvica treatment. Seven clinical trials looked at people with B-cell cancers, including MCL, CLL, SLL, WM, and MZL. Between 11% and 24% of people who took Imbruvica developed joint pain. Up to 3% had joint pain that was considered severe.

Four of these trials compared Imbruvica with a different drug or a placebo. People took:

  • Imbruvica or ofatumumab
  • Imbruvica or chlorambucil
  • Imbruvica and obinutuzumab or chlorambucil and obinutuzumab
  • Imbruvica and rituximab or rituximab and a placebo

Between 7% and 11% of people who didn’t take Imbruvica developed joint pain. And up to 1% of these people had serious joint pain.

In clinical trials of cGVHD, joint pain wasn’t a common side effect reported in people who took Imbruvica. So the exact number of how many people had joint pain isn’t known.

Although joint pain may be uncomfortable, it isn’t usually severe. But if you develop joint pain that’s bothersome to you while taking Imbruvica, talk with your doctor. They may be able to recommend ways to ease the pain.

Diarrhea

Diarrhea is a very common side effect of Imbruvica. Sometimes diarrhea may be serious and can make you dehydrated. Nine clinical trials looked at people with B-cell cancers, including MCL, CLL, SLL, WM, and MZL. Between 28% and 59% of people had diarrhea after taking Imbruvica. Up to 5% of these people had diarrhea that was serious.

Five of these trials compared Imbruvica with a different drug or a placebo. People took:

  • Imbruvica or chlorambucil
  • Imbruvica or ofatumumab
  • Imbruvica and obinutuzumab or chlorambucil and obinutuzumab
  • Imbruvica, bendamustine, and rituximab or bendamustine, rituximab, and a placebo
  • Imbruvica and rituximab or rituximab and a placebo

Between 10% and 23% of people who took didn’t take Imbruvica had diarrhea. And of these people, up to 2% had serious diarrhea.

In clinical trials of cGVHD, 36% of people who took Imbruvica developed diarrhea. Of those people, 10% had diarrhea that was considered severe. Imbruvica wasn’t compared with a different drug or a placebo.

If you develop diarrhea while taking Imbruvica, talk with your doctor about ways to ease your symptoms.

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

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.

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 restart 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 you having the side effect again because it lets your body adjust to the medication over time.

Your doctor may also change your dose if you’re taking certain medications that can interact with Imbruvica or if you have a liver condition, such as hepatitis. (To learn more, see the “Imbruvica interactions” and “Imbruvica precautions” sections below.) Before you start taking Imbruvica, talk with your doctor about your medical history and what the right starting dose is for you.

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 two forms that you swallow: a tablet and capsule. The tablet is available in four strengths: 140 mg, 280 mg, 420 mg, and 560 mg. The capsule is available in two strengths: 70 mg and 140 mg.

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 a day. If you’re taking Imbruvica along with rituximab (Rituxan) or obinutuzumab (Gazyva), you’ll take Imbruvica first.

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

Dosage for mantle cell lymphoma

For mantle cell lymphoma (MCL), the dosage is 560 mg once a day. You should keep taking Imbruvica as your doctor recommends. But if your MCL gets worse or if you develop side effects that aren’t tolerable, your doctor may have you stop taking the drug.

Dosage for Waldenström’s macroglobulinemia

The dosage of Imbruvica for Waldenström’s macroglobulinemia (WM) is 420 mg once a day. To treat your WM, you may take Imbruvica along with rituximab (Rituxan). If you’re taking these medications on the same, day, you should take Imbruvica first. Keep taking Imbruvica as your doctor recommends. But if your WM gets worse or if you develop side effects that aren’t tolerable, your doctor may have you stop taking the drugs.

Dosage for marginal zone lymphoma

For marginal zone lymphoma (MZL), the dosage is 560 mg once a day. You should keep taking Imbruvica as your doctor recommends. But if your MZL gets worse or if you develop side effects that aren’t tolerable, your doctor may have you stop taking the drug.

Dosage for chronic graft versus host disease

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

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

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. The next day, take your dose at the normal time.

You should never take two doses of Imbruvica in the same day. Don’t 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. But if your cancer gets worse 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, you may stop taking Imbruvica as directed by your doctor when you’re no longer at a high risk for the condition.

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

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

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

Imbruvica can be used for the treatment of chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). Both CLL and SLL are types of non-Hodgkin lymphoma.

CLL is a kind of leukemia (blood cancer). If you have CLL, your body makes a large number of abnormal lymphocytes, which are a type of white blood cell. 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 get worse.

SLL is a kind of cancer that occurs in the lymph nodes. Lymph nodes are part of your immune system. Inside your lymph nodes, there are lymphocytes, which work by fighting infections. 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 get worse.

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 your chromosomes, which make up your genes.

Effectiveness

Clinical trials measured partial or complete response rate. A partial response means that the amount of cancer in the body has decreased. A complete response is when all of the cancer has disappeared. People with CLL or SLL took either Imbruvica or a similar medication called ofatumumab (Arzerra). About 42.6% of people who took Imbruvica had a complete or partial response. In comparison, only 4.1% of people who took ofatumumab had a complete or partial response.

In another clinical trial, people with CLL or SLL took Imbruvica with a drug called bendamustine, or a placebo (treatment with no active drug) with bendamustine. In the Imbruvica/bendamustine group, 82.7% of people had a complete or partial response. This was compared to 67.8% of the placebo/bendamustine group.

There was also a third study in which people with CLL or SLL took Imbruvica along with obinutuzumab (Gazyva), or chlorambucil (Leukeran) with obinutuzumab. In the Imbruvica/obinutuzumab group, 88.5% of people had a complete or partial response. In comparison, 73.3% of the chlorambucil/obinutuzumab group had a complete or partial response.

People with CLL or SLL with a 17p deletion also had a good response to Imbruvica. In a clinical study, people took either Imbruvica or ofatumumab (Arzerra). About 47.6% of people who took Imbruvica had a complete or partial response. In comparison, only 4.7% of people who took ofatumumab had a complete or partial response.

Imbruvica for mantle cell lymphoma

Imbruvica can be used in the treatment of mantle cell lymphoma (MCL), which is a type of non-Hodgkin lymphoma. MCL occurs in white blood cells called lymphocytes. In people with MCL, a large number of lymphocytes grow abnormally. They then cause tumors to form in different areas of your body, including your lymph nodes, spleen, and bone marrow. MCL is an aggressive kind of cancer.

Effectiveness

Clinical trials were measured by a partial or complete response rate. A partial response means that the amount of cancer in the body has decreased. A complete response is when all of the cancer has disappeared.

In one clinical trial, researchers found that 65.8% of people with MCL had a partial or complete response after taking Imbruvica. In this trial, the drug wasn’t compared with another drug or a placebo.

Imbruvica for Waldenström’s macroglobulinemia

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

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

Effectiveness

Clinical trials were measured by a partial or complete response rate. A partial response means that the amount of cancer in the body has decreased. A complete response is when all of the cancer has disappeared.

In one clinical trial, 61.9% of people with WM had at least a partial response to Imbruvica. The drug wasn’t compared with a different drug or placebo in this trial.

In another trial, people with WM took Imbruvica with rituximab (Rituxan), or a placebo with rituximab. Researchers found that about 72% of the Imbruvica/rituximab group had a complete or partial response to treatment. In comparison, only 32% of the placebo/rituximab group had a complete or partial response.

Imbruvica for marginal zone lymphoma

Imbruvica is FDA-approved for the treatment of marginal zone lymphoma (MZL). This is a kind of non-Hodgkin’s lymphoma that is very slow growing. MZL is a specific type of lymphoma that starts in areas called the marginal zones of the lymph nodes. People with MZL have a lot of abnormal white blood cells. Because of this, people with MZL may get sick more easily or often have infections.

There are three different kinds of marginal cell lymphoma:

  • Mucosal-associated lymphoid tissue is a type of cancer that usually occurs in the stomach.
  • Nodal marginal zone lymphoma is a kind of lymphoma that occurs in the lymph nodes.
  • Splenic marginal zone lymphoma is a type of cancer that occurs in the spleen.

Imbruvica is approved to treat MZL only in people who have already tried a different type of medication called anti-CD20 treatments. These are immunotherapies, which means that they work by activating your immune system to fight the cancer. An example of an anti-CD20 immunotherapy treatment is rituximab (Rituxan).

Effectiveness

Clinical trials were measured by a partial or complete response rate. A partial response means that the amount of cancer in the body has decreased. A complete response is when all of the cancer has disappeared.

In a study of MZL, 46% of people who took Imbruvica had a complete or partial response. Imbruvica wasn’t compared with a different drug or a placebo in this trial.

Imbruvica for chronic graft versus host disease

Imbruvica can be used to treat chronic graft versus host disease (cGVHD). This condition can occur after you have a stem cell transplant. 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 another treatment and your condition got worse.

Effectiveness

Clinical trials were measured by a partial or complete response rate. A partial response means that the amount of cancer in the body has decreased. A complete response is when all of the cancer has disappeared.

In clinical trials of cGVHD, the response rate was measured by an assessment created by the National Institutes of Health. The results showed that 67% of people with cGVHD who took Imbruvica had a complete or partial response. Imbruvica wasn’t compared with a different drug or a placebo in this trial.

Off-label use for Imbruvica

In addition to the uses listed above, Imbruvica may be used off-label. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. Below is an example of an off-label use 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 drug in Imbruvica) or a placebo, along with a combination of rituximab (Rituxan), cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP).

The study showed that ibrutinib with R-CHOP wasn’t a good option compared with R-CHOP alone to treat people with DLBCL who are older than age 60 years. This is due to the large number of serious side effects that can occur in this age group. However, people younger than age 60 years may be more likely to live and live longer after taking Imbruvica with R-CHOP. This study notes that more research is needed to determine if Imbruvica may be safe and effective in the treatment of DLBCL.

There are no known interactions between alcohol and Imbruvica. However, some diseases such as kidney or liver conditions may require you to limit how much alcohol you drink or not drink any at all. These include chronic kidney disease and hepatitis.

Talk with your doctor about how much alcohol 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, on the other hand, 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 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 above.)

Can I take Tylenol or ibuprofen with Imbruvica?

While using Imbruvica, it’s safe to take acetaminophen (Tylenol). However, you shouldn’t take ibuprofen (Advil, others). Ibuprofen may increase your risk for bleeding and raise your blood pressure. Imbruvica may also cause bleeding and increased blood pressure. (For more information, see the “Imbruvica side effects” section above.) 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 you 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 getting worse 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.

Do I need to avoid citrus foods and drinks while taking Imbruvica?

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

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

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 for 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.

Never stop taking this medication without talking to your doctor first.

Other drugs are available that can treat lymphoma, leukemia, or chronic 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 below 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 (Campath)
  • rituximab (Rituxan)
  • venetoclax (Venclexta)
  • ofatumumab (Arzerra)
  • idelalisib (Zydelig)
  • fludarabine (Fludara)
  • pentostatin (Nipent)
  • cyclophosphamide

Alternatives for mantle cell lymphoma

Examples of other drugs that may be used to treat mantle cell lymphoma (MCL) include:

  • bortezomib (Velcade)
  • rituximab (Rituxan)
  • cyclophosphamide
  • bendamustine (Treanda)
  • doxorubicin
  • vincristine
  • cytarabine
  • acalabrutinib (Calquence)
  • venetoclax (Venclexta)
  • lenalidomide (Revlimid)

Alternatives for Waldenström’s macroglobulinemia

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

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

Alternatives for marginal zone lymphoma

Examples of other drugs that may be used to treat marginal zone lymphoma (MZL) include:

  • rituximab (Rituxan)
  • bendamustine (Treanda)
  • cyclophosphamide
  • vincristine
  • antibiotic treatment, such as clarithromycin (for people with MZL that’s caused by an infection)
  • chlorambucil (Leukeran)
  • lenalidomide (Revlimid)
  • ibritumomab tiuxetan (Zevalin)

Alternatives for chronic graft versus host disease

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

  • prednisone
  • daclizumab (Zenapax)
  • cyclosporine (Sandimmune)
  • infliximab (Remicade)
  • tacrolimus (Prograf)
  • mycophenolate (CellCept)

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

Uses

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

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

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

  • CLL
  • SLL
  • acute myeloid leukemia (AML) that’s newly diagnosed in people ages 75 years and older or in people who can’t have intense chemotherapy. Venclexta is used with the medications decitabine, azacitidine, or cytarabine in a low dose.

Drug forms and administration

Imbruvica is available as a tablet or capsule that you swallow. You’ll take the drug once a day.

Venclexta comes as a tablet that you swallow. You’ll take it once a 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. But they can cause some different side effects as well. Below are examples of these side effects.

Mild side effects

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

Serious side effects

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

  • Can occur with Imbruvica:
  • Can occur with Venclexta:
    • few unique serious side effects
  • Can occur with both Imbruvica and Venclexta:
    • tumor lysis syndrome (a condition that occurs when many cancer cells are killed at the same time and get released into your blood)
    • neutropenia (decreased level of white blood cells called neutrophils that help fight infections)
    • infections, such as severe pneumonia (a type of lung infection)
    • allergic reaction
    • thrombocytopenia (decreased level of platelets, which are blood cells that help clot your blood)
    • anemia (decreased level of red blood cells)

Effectiveness

Imbruvica 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 Imbruvica and Venclexta to be effective for treating CLL and SLL.

Both drugs are being currently tested in a clinical trial to be used together.

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 (above), 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 drug ingredient in Imbruvica is ibrutinib. The active drug ingredient in Calquence is acalabrutinib.

Uses

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

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

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

  • MCL if you’ve tried at least one other treatment
  • CLL
  • SLL

Drug forms and administration

Imbruvica is available as a tablet or capsule that you swallow. You’ll take the drug once a day.

Calquence comes as a capsule 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, SLL, and MCL. Therefore, these medications can cause some similar side effects. But they can cause some different side effects as well. Below are examples of these side effects.

Mild side effects

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

Serious side effects

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

  • Can occur with Imbruvica:
  • Can occur with Calquence:
    • few unique serious side effects
  • Can occur with both Imbruvica and Calquence:
    • thrombocytopenia (decreased level of platelets, which are blood cells that help clot your blood)
    • anemia (decreased level of red blood cells)
    • neutropenia (decreased level of white blood cells called neutrophils that help fight infections)
    • major bleeding
    • changes in heart rhythm
    • infections such as severe pneumonia (a type of lung infection)
    • 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, SLL, and MCL.

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

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

Imbruvica and other medications

Below is a list of medications that can interact with Imbruvica. This list doesn’t contain 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.

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 for side effects such as bleeding or diarrhea because you’re getting more medication than you should be.

Examples of HIV medications that may interact with Imbruvica include:

  • ritonavir (Norvir)
  • indinavir (Crixivan)
  • nelfinavir (Viracept)
  • saquinavir (Invirase)

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 (Biaxin)
  • telithromycin (Ketek)
  • 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 above.)

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

  • ketoconazole (Nizoral)
  • 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 disorder.

Examples of seizure medications to avoid while taking Imbruvica include:

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

If you’re taking medication to control seizures, talk with your doctor before starting to use 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 for serious bleeding. Medications that thin your blood or prevent it from clotting can also increase your risk for bleeding.

Examples of blood-thinning medications that shouldn’t be taken along with Imbruvica include:

  • apixaban (Eliquis)
  • rivaroxaban (Xarelto)
  • heparin
  • warfarin (Coumadin)

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 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 can be used for the treatment of 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, talk with your doctor before starting to use Imbruvica.

You should always check with your doctor or pharmacist before using any herb or supplement products 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 above.)

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:

  • bendamustine (Treanda)
  • obinutuzumab (Gazyva)
  • rituximab (Rituxan)

Imbruvica can also be used with venetoclax (Venclexta) for CLL and SLL. These two drugs are currently being tested in a clinical trial for use together. Imbruvica and venetoclax work in different ways to treat CLL and SLL. Studies have shown that they may be an effective combination treatment.

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 if your plan will cover Imbruvica.

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

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 YOU&i Support Program and the Imbruvica Copay Program. For more information and to find out if you’re eligible for support, call 877-877-3536 and select menu option 1, or visit the program website.

You should take Imbruvica according to your doctor’s or healthcare provider’s instructions. Imbruvica is available as a tablet or capsule that you swallow with a full glass of water. You’ll take the medication one time a day.

When to take

You should take Imbruvica once a 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 medication with a glass of water.

Can Imbruvica be crushed, split, or chewed?

No, you should swallow Imbruvica whole. Never cut, crush, or chew Imbruvica tablets or capsules. And don’t open the capsules either.

Imbruvica is used for many different types of lymphoma and leukemia (blood cancer). Lymphoma is a kind of cancer that occurs in the cells in your immune system, which is your body’s defense against infection. Lymphoma causes these cells to grow abnormally and out of control. Leukemia is a cancer of the white blood cells. Leukemia causes white blood cells to grow out of control as well.

Mantle cell lymphoma

Imbruvica can be used in the treatment of mantle cell lymphoma (MCL), which is a type of non-Hodgkin lymphoma. MCL occurs in white blood cells called lymphocytes. In people with MCL, a large number of lymphocytes grow abnormally. They then cause tumors to form in different areas of your body, including your lymph nodes, spleen, and bone marrow. MCL is an aggressive type of cancer.

Chronic lymphocytic leukemia and small lymphocytic lymphoma

Imbruvica can be used for the treatment of chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). Both CLL and SLL are types of non-Hodgkin lymphoma.

CLL is a type of leukemia. If you have CLL, your body makes a large number of abnormal lymphocytes, which are a kind of white blood cell. 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 get worse.

SLL is a kind of cancer that occurs in the lymph nodes. Lymph nodes are part of your immune system. Inside your lymph nodes, there are lymphocytes, which work by fighting infections. 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 get worse.

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

Waldenström’s macroglobulinemia

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

Marginal zone lymphoma

Imbruvica can be used for the treatment of marginal zone lymphoma (MZL). This is a type of non-Hodgkin’s lymphoma that is very slow growing. MZL is a specific kind of lymphoma that starts in areas called the marginal zones of the lymph nodes. People with MZL have a lot of abnormal white blood cells. Because of this, people with MZL may get sick more easily or often have infections.

There are three different types of marginal cell lymphoma:

  • Mucosal-associated lymphoid tissue is a type of cancer that usually occurs in the stomach.
  • Nodal marginal zone lymphoma is a kind of lymphoma that occurs in the lymph nodes.
  • Splenic marginal zone lymphoma is a type of cancer that occurs in the spleen.

What Imbruvica does to treat cancer

For the cancers mentioned above (MCL, CLL, SLL, WM, and MZL), 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 normally 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.

Chronic graft versus host disease

Imbruvica can also be used to treat an immune system problem called chronic graft versus host disease (cGVHD). This disease can occur in people who have had a stem cell transplant. The disease occurs when the transplanted stem cells (the graft) produce cells that attack your body (the host).

cGVHD can be acute or chronic. Acute GVHD occurs within a few weeks of the transplant. cGVHD may not occur for years after a transplant. You may develop symptoms such as skin rashes or trouble breathing, or symptoms of liver problems such as yellowing of your eyes or skin.

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 get worse. 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 cells after your first dose. You should keep taking Imbruvica each day unless your condition gets worse or if you have side effects from taking the medication. (For more about side effects, see the “Imbruvica side effects” section above.) Never stop taking Imbruvica without first talking to your doctor.

Some clinical trials of Imbruvica measured the average time to response. This is the average length of time that it took for a change in the person’s cancer to occur after they started taking Imbruvica. A “response” includes partial and complete responses. A partial response means that the amount of cancer in the body has decreased. A complete response means that there was no sign of cancer cells.

Here are the typical times to response for people with MZL, MCL, WM, or cGVHD:

  • MZL: about 4.5 months
  • MCL: about 1.9 months
  • WM: about 1.2 months
  • cGVHD: 12.3 weeks

The safety of Imbruvica hasn’t been studied in pregnant women. However, in animal studies, Imbruvica has been shown to cause birth defects such as bone problems.

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

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

As for men, they 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.

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

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

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

  • Bleeding problems. If you have any conditions that cause you to bleed more easily than usual (such as anemia), talk with your doctor before you start to take Imbruvica. The drug can cause bleeding, including serious bleeding that can lead to death. If you’re already at an increased risk for bleeding, taking Imbruvica may increase this risk even further.
  • Pregnancy and breastfeeding. It’s not known if Imbruvica is safe to take during pregnancy or while breastfeeding. For more information, please see the “Imbruvica and pregnancy” and “Imbruvica and breastfeeding” sections above.
  • Heart rhythm problems. While you’re taking Imbruvica, it’s possible that you may develop a heart rhythm problem such as atrial fibrillation. If you have a history of heart rhythm problems, you may be at an increased risk for developing one again. Talk with your doctor about your heart health before starting to take Imbruvica. They may monitor your heart while you use this medication, especially if you have a history of heart rhythm problems.
  • Increased cholesterol levels. If you have high cholesterol, you may have an increased risk for developing heart disease. Because Imbruvica may cause heart disease, you may be at an even higher risk if you also have high cholesterol. Talk with your doctor about ways to control your cholesterol levels.
  • High blood pressure. If you have high blood pressure, you may have a higher risk for an increase in your blood pressure while you’re taking Imbruvica. So talk with your doctor before starting to use the drug. Your doctor will monitor your heart during your treatment. They may also need to increase or change your blood pressure medication to make sure it’s still working to treat your high blood pressure.
  • Diabetes. If you have diabetes, you may have a higher risk for developing heart disease. Imbruvica may cause heart problems. So you may be at an increased risk for these problems if you also have diabetes. Talk with your doctor about the best way to control your diabetes to help prevent heart disease.
  • Current infection. If you have a current infection, you shouldn’t start taking Imbruvica. This is because Imbruvica can increase your risk for developing some infections, such as pneumonia. If you have a current infection, your doctor will treat it before you start using Imbruvica.
  • Liver problems. If you have liver problems such as hepatitis, your body may not get rid of Imbruvica quickly enough. This may cause the medication to build up in your body and cause side effects. (See the “Imbruvica side effects” section to learn more.) If you have liver problems, your doctor may decrease your dose of Imbruvica so that you don’t get exposed to too much medication.
  • Allergic reaction. If you’re allergic to Imbruvica or any of its ingredients, you shouldn’t take the drug. Ask your doctor what other treatments are better choices for you.

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

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

Don’t 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 function 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 function levels and a higher risk for 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 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 Imbruvica 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 with 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 Imbruvica tablets and capsules at room temperature between 68°F to 77°F (20°C to 25°C). If needed, you may store Imbruvica between 59°F to 86°F (15°C and 30°C) for a short time. Keep Imbruvica capsules in their original container until you use the medication. And avoid storing Imbruvica in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Imbruvica 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.

The FDA website 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

Imbruvica is indicated for use in certain types of leukemia and lymphoma along with chronic graft versus host disease (cGVHD). The Food and Drug Administration (FDA) has approved Imbruvica to treat the following:

Treatment duration should continue until progression occurs or the patient experiences intolerable side effects.

Mechanism of action

Imbruvica works by covalently binding to and blocking Bruton’s tyrosine kinase (BTK). BTK is a kinase enzyme that works by promoting B cells to mature and reproduce. However, BTK can also promote cancer cells or immune system cells to reproduce, which causes proliferation. By blocking BTK, Imbruvica slows cancer cell production. In the case of cGVHD, Imbruvica blocks the overactive immune system that is causing symptoms.

Pharmacokinetics and metabolism

Imbruvica has an absolute bioavailability of about 2.9%. After an oral dose, Imbruvica reaches its maximum plasma concentration between 1 to 2 hours.

The half-life of Imbruvica is about 4 to 6 hours.

This drug is metabolized via the cytochrome P450 system. It is mainly metabolized by CYP3A but is also metabolized to a lesser extent by CYP2D6. There is an active metabolite of Imbruvica (PCI-45227) that also inhibits BTK, but at a rate of about 15 times less.

About 80% of Imbruvica is excreted in the feces and 10% in the urine.

Contraindications

There are no contraindications to taking Imbruvica.

Storage

Imbruvica tablets or capsules should be stored at room temperature between 68°F to 77°F (20°C to 25°C). If necessary, excursions between 59°F to 86°F (15°C and 30°C) are allowed. Imbruvica capsules should be kept in their original container until they are used. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

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.

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