Venclexta is a brand-name prescription medication. It’s used to treat certain cancers that affect your blood cells. Venclexta is FDA-approved to treat:

Venclexta is a targeted therapy for these types of cancer. It targets and blocks a specific protein within the cancerous blood cells that helps them live longer than they should.

Venclexta comes as tablets that you take by mouth. It’s available in three strengths: 10 mg, 50 mg, and 100 mg.

FDA approval

The Food and Drug Administration (FDA) first approved Venclexta in 2016.

Effectiveness

Venclexta was found to be effective for treating CLL/SLL in several clinical studies.

One study looked at adults with CLL who hadn’t had any treatment for their cancer yet. Some of the people took Venclexta with another targeted cancer therapy called obinutuzumab (Gazyva). Others took a chemotherapy drug called chlorambucil (Leukeran) with Gazyva. People who took Venclexta with Gazyva had a 67% lower risk of their cancer getting worse or spreading compared with those who took chlorambucil with Gazyva.

Venclexta was also found effective for treating newly diagnosed AML in clinical studies.

In one study, Venclexta was used with either azacitidine or decitabine (chemotherapy drugs). Of the people who took Venclexta with azacitidine, 37% reached complete remission. (Complete remission is when there are no signs or symptoms of the cancer.) Of the people who took Venclexta with decitabine, 54% achieved complete remission. About half the people who achieved complete remission stayed in remission for about 5 months or more.

For more information on Venclexta’s effectiveness, see the “Venclexta for acute myeloid leukemia (AML)” and “Venclexta other uses” sections below.

Venclexta 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.

Venclexta contains the active drug venetoclax.

Venclexta can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Venclexta. These lists do not include all possible side effects.

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

Mild side effects

The mild side effects of Venclexta that are more common can include:

  • diarrhea
  • nausea and vomiting
  • constipation
  • abdominal (belly) pain
  • cough
  • fatigue (lack of energy)
  • upper respiratory infection, such as the common cold
  • muscle, joint, or bone pain
  • edema (fluid retention that causes swelling of your legs, feet, arms, or hands)
  • fever
  • rash
  • dizziness

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 Venclexta are also possible. 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 include:

  • fetal death or severe birth defects if a pregnant woman is exposed to the drug

Other serious side effects are explained below in “Side effect details.” These 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.

Tumor lysis syndrome

Tumor lysis syndrome (TLS) is a side effect that can happen when cancer cells break down very quickly. When the cells break down, they release various substances into your blood. These include uric acid, potassium, calcium, and phosphate. Your kidneys have to quickly remove these substances to prevent them from building up in your blood. TLS can sometimes lead to kidney failure and the need for dialysis. It can quickly become life threatening.

In clinical studies, TLS occurred in:

To lower your risk for developing TLS, you should drink plenty of water during your Venclexta treatment. Drink six to eight glasses (1.5 L to 2 L) of water per day, starting 2 days before your first dose of Venclexta. Some people may also need to be given fluids directly into a vein. Your doctor may also ask you to take a medication called allopurinol (Lopurin, Zyloprim) to help prevent uric acid buildup in your body.

You’ll have frequent blood tests to check for signs of TLS during treatment. Tell your doctor right away if you get any symptoms of TLS, which may include:

  • fever
  • chills
  • nausea
  • vomiting
  • confusion
  • shortness of breath
  • dark or cloudy urine
  • muscle or joint pain
  • feeling weak or tired
  • irregular heartbeat
  • seizures

If you get TLS, your doctor may lower your dose of Venclexta or ask you to stop taking it temporarily until the problem is resolved.

Blood disorders

With CLL, SLL, and AML, people often have low numbers of healthy blood cells. Taking Venclexta can also cause problems with your blood cell counts.

Neutropenia (low white blood cell count) is the most common blood disorder that can happen with Venclexta. It raises your risk for getting infections, which can sometimes be serious or even fatal.

In clinical studies, respiratory tract infections, such as colds and pneumonia, were the most common type of infection reported in people who took Venclexta. Other types of infections reported included urinary tract infections and sepsis (blood infection).

Anemia (low red blood cell count) and thrombocytopenia (low platelet count) are also common with Venclexta.

The results below show how often these blood disorders occurred in clinical studies when Venclexta was taken on its own for CLL/SLL. How often they occur may depend on what condition Venclexta is used to treat and what other drugs are taken with Venclexta.

In clinical studies:

  • neutropenia occurred in 87% of people who took Venclexta on its own
  • anemia occurred in 71% of people who took Venclexta on its own
  • thrombocytopenia occurred in 64% of people who took Venclexta on its own

While you’re taking Venclexta to treat CLL, SLL, or AML, you’ll have frequent blood tests to check your blood cells. If you have problems with your blood cells, your doctor may lower your dose of Venclexta or ask you to stop taking it temporarily until the problem is resolved.

See your doctor right away if you get any symptoms of problems with your blood cells during treatment. These can include:

  • fever
  • chills
  • shortness of breath
  • any signs of infections, such as cough, sore throat, or pain when urinating
  • bruising easily
  • unusual bleeding, or taking longer than usual to stop bleeding
  • fatigue (lack of energy)
  • pale-looking skin or gums

Nausea

Venclexta may cause nausea. It can also be a symptom of TLS (see the “Tumor lysis syndrome” section above).

The results below show how often nausea was reported in clinical studies. The exact percentage depended on which drug, if any, was taken with Venclexta.

Nausea occurred in:

  • 19% to 42% of people who took Venclexta for CLL or SLL
  • 46% to 64% of people who took Venclexta for AML

Talk with your doctor about ways to manage nausea while taking Venclexta. Your doctor may suggest medication, but other tips for managing nausea include:

  • eating small amounts throughout the day, instead of having three main meals
  • avoiding greasy or fatty foods
  • sipping fluids often, instead of drinking a lot at once

Diarrhea

Some people may get diarrhea while taking Venclexta.

The results below show how often diarrhea was reported in clinical studies. The exact percentage depended on which drug, if any, was taken with Venclexta.

Diarrhea was reported in:

  • 28% to 43% of people who took Venclexta for CLL or SLL
  • 38% to 54% of people who took Venclexta for AML

If you have diarrhea while taking Venclexta, talk with your doctor about ways to manage this. They may recommend taking antidiarrheal medication.

Respiratory tract infections

Some people may have a higher risk for getting infections while taking Venclexta. In clinical studies, respiratory tract infections were the most common type of infection reported in people who took Venclexta.

The results below show how often upper respiratory infections (such as the common cold) and pneumonia (lung infection) occurred in clinical studies. The exact percentage depended on which drug, if any, was taken with Venclexta.

Upper respiratory tract infections were reported in:

  • 17% to 39% of people who took Venclexta for CLL or SLL

Pneumonia was reported in:

  • 9% to 14% of people who took Venclexta for CLL or SLL
  • 18% to 46% of people who took Venclexta for AML

To help protect yourself from infections, particularly respiratory infections, try to minimize your exposure to germs. Wash your hands often. Try to avoid crowds and people who are sick. Also, ask your doctor about getting a flu vaccine.

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

Venclexta is FDA-approved to treat newly diagnosed AML. It’s approved for use in adults who are ages 75 years or older, and in adults who can’t have standard chemotherapy.

Venclexta is used with either azacitidine (Vidaza), decitabine (Dacogen), or low-dose cytarabine to treat AML. These are all chemotherapy drugs.

AML is a cancer that affects myeloid cells. Myeloid cells are found in your bone marrow. They normally develop into red blood cells, white blood cells, and platelets. With AML, the myeloid cells develop abnormally, and form abnormal blood cells, called blasts, or leukemia cells. Leukemia cells can’t perform the usual functions of blood cells, and they take up a lot of space in your bone marrow. This leaves your bone marrow unable to make enough healthy blood cells.

Venclexta is a targeted therapy for AML. It targets and blocks a specific protein within the cancer cells that helps them live for longer than they should.

Note: See the “Venclexta other uses” section below for information on other approved uses.

Effectiveness for AML

In two clinical studies, Venclexta was found to be effective for treating newly diagnosed AML.

In the first study, Venclexta was used with either azacitidine or decitabine. Of the people who took Venclexta with azacytidine, 37% reached complete remission. (Complete remission is when there are no signs or symptoms of the cancer.) Of the people who took Venclexta with decitabine, 54% achieved complete remission. About half the people who achieved complete remission stayed in remission for about 5 months or more.

In a second study, Venclexta was used with low-dose cytarabine. Complete remission was reached in 21% of people. About half of these people remained in remission for about 6 months or more.

Besides being approved to treat acute myeloid leukemia, or AML, (see the section above), Venclexta is also approved to treat two other conditions. It’s also prescribed for some off-label uses.

Venclexta for CLL or SLL

Venclexta is FDA-approved to treat chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) in adults. CLL and SLL are cancers that affect certain white blood cells called B cells. With SLL, the cancer cells are mainly in the lymph nodes. With CLL, the cancer cells are mainly in the blood and bone marrow.

Venclexta is a targeted therapy for CLL and SLL. It targets and blocks a specific protein within the cancer cells that helps them live for longer than they should.

Effectiveness for CLL or SLL

One study looked at people with CLL who hadn’t had any treatment for their cancer yet. Some people took Venclexta for 1 year, plus another targeted therapy called obinutuzumab (Gazyva) for the first 6 months. The rest took a chemotherapy drug called chlorambucil (Leukeran) for 1 year, plus obinutuzumab for the first 6 months.

Those who took Venclexta with obinutuzumab had a 67% lower risk of their cancer getting worse or spreading compared with those who took chlorambucil with obinutuzumab. Of the people who took Venclexta with obinutuzumab:

  • 46% went into complete remission (when there are no signs or symptoms of the cancer), compared with 22% of people who took chlorambucil with obinutuzumab
  • 76% had no detectable cancer in their blood 3 months after completing treatment, compared with 35% of people who took chlorambucil with obinutuzumab
  • 57% had no detectable cancer in their bone marrow 3 months after completing treatment, compared with 17% of people who took chlorambucil with obinutuzumab
  • 58% had no detectable cancer in their blood 12 months after completing treatment, compared with 9% of people who took chlorambucil with obinutuzumab

Another study looked at people with CLL who had already had at least one treatment for their disease. Some people took Venclexta for 2 years plus a targeted therapy called rituximab (Rituxan) for the first 6 months. The rest took a chemotherapy drug called bendamustine (Treanda) plus rituximab for the first 6 months.

Those who took Venclexta with rituximab had an 81% lower risk of their cancer getting worse or spreading compared with those who took bendamustine with rituximab. Of the people who took Venclexta with rituximab:

  • 82% went into partial remission (when cancer is much improved but still present), compared with 68% of people who took bendamustine with rituximab
  • 8% went into complete remission or complete remission with incomplete marrow recovery (when there are no signs or symptoms of the cancer, but healthy blood cell counts remain low), compared with 4% of people who took bendamustine with rituximab
  • 53% of people who achieved a partial remission or better had no detectable cancer in their blood 3 months after completing treatment with rituximab, compared with 12% of people who took bendamustine with rituximab

Three further studies looked at people with CLL or SLL who had already had at least one treatment for their disease. These people took Venclexta on its own for 1 to 2 years. In these studies, between 70% and 80% of people had at least some improvement in their cancer. This may have been a partial remission, complete remission, or complete remission with incomplete bone marrow recovery.

Off-label uses for Venclexta

In addition to the uses listed above, Venclexta 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.

Venclexta for multiple myeloma (MM)

Multiple myeloma is a type of cancer that affects certain white blood cells called plasma cells. Venclexta is not FDA-approved to treat multiple myeloma, but it may be used off-label for this type of cancer. This would usually be as part of a clinical study.

There have been some safety issues related to this use of Venclexta. However, studies are ongoing to determine if the treatment is safe and effective for multiple myeloma.

Venclexta for myelodysplastic syndrome (MDS)

Myelodysplastic syndrome (MDS) is a term that refers to a group of cancers involving your blood cells and bone marrow. In some cases, MDS can progress to acute myeloid leukemia (AML). (Venclexta is approved to treat AML in adults ages 75 years or older, and in adults who can’t have standard chemotherapy.)

Venclexta is not FDA-approved to treat MDS. However, researchers are investigating its use for treating this condition. The drug can be used off-label for MDS, but this would usually be as part of a clinical study.

Venclexta for mantle cell lymphoma (MCL)

Mantle cell lymphoma (MCL) is a type of cancer that affects white blood cells called B lymphocytes.

Venclexta is not FDA-approved to treat MCL, but it may be used off-label to treat this type of cancer. This would usually be as part of a clinical study.

For chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), you may take Venclexta on its own, or you may take it with rituximab (Rituxan) or obinutuzumab (Gazyva). These are both targeted drugs called monoclonal antibodies. They help your body recognize and attack cancer cells.

For acute myeloid leukemia (AML), you’ll take Venclexta with either azacitidine (Vidaza), decitabine (Dacogen), or low-dose cytarabine. These are all chemotherapy drugs.

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

  • the condition you’re using Venclexta to treat
  • your liver function
  • other medications you’re taking
  • any side effects you get

When you first start treatment, you’ll take a low dose that will be gradually increased. This helps lower your risk for developing a side effect called tumor lysis syndrome (TLS), which can happen when cancer cells break down very quickly.

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

Venclexta comes as tablets that you take by mouth once a day. It’s available in three strengths: 10 mg, 50 mg, and 100 mg.

Dosage for AML

If you’re taking Venclexta for acute myeloid leukemia (AML), your dosage will likely be increased gradually over the first 3 days of treatment as follows:

  • day 1: 100 mg
  • day 2: 200 mg
  • day 3: 400 mg

If you take Venclexta with azacitidine or decitabine, you’ll likely continue to take 400 mg of Venclexta once daily after day 3. Keep taking it for as long as your doctor recommends.

If you take Venclexta with low-dose cytarabine, you’ll take 600 mg of Venclexta once daily starting on day 4. Keep taking it for as long as your doctor recommends.

Take your daily dose at the same time each day.

Dosage for CLL or SLL

If you’re taking Venclexta for chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), your dosage will likely be increased gradually over the first 5 weeks of treatment as follows:

  • week 1: 20 mg once daily
  • week 2: 50 mg once daily
  • week 3: 100 mg once daily
  • week 4: 200 mg once daily
  • week 5: 400 mg once daily

After this, you’ll likely continue to take 400 mg of Venclexta once a day for as long as your doctor recommends.

Take your daily dose at the same time each day.

What if I miss a dose?

If you forget to take a dose at your usual time, follow these instructions:

  • If it’s less than 8 hours after your dose was due, take the missed dose, and then take your next dose at the usual time.
  • If it’s more than 8 hours after your dose was due, skip the missed dose, and take your next dose at the usual time.

Never take a double dose to make up for a missed dose.

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

How long will I need to take Venclexta?

How long you take Venclexta will depend on the condition you’re using it to treat and what other medications you’re taking.

For CLL or SLL:

  • if you’re also taking obinutuzumab (Gazyva), you’ll likely take Venclexta for 1 year
  • if you’re also taking rituximab (Rituxan), you’ll likely take Venclexta for 2 years
  • if you’re taking Venclexta on its own, you’ll take it for as long as it continues to be safe and effective for you

For AML, you’ll take Venclexta for as long as it continues to be safe and effective for you.

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

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

Alternatives for AML

Examples of other drugs that may be used to treat acute myeloid leukemia (AML) include:

  • chemotherapy, such as:
    • azacitidine (Vidaza)
    • cladribine (Leustatin)
    • cytarabine
    • daunorubicin
    • decitabine (Dacogen)
    • etoposide
    • fludarabine (Fludara)
    • hydroxyurea
    • idarubicin
    • methotrexate
    • mitoxantrone
  • targeted therapies, such as:
    • enasidenib (Idhifa)
    • gemtuzumab ozogamicin (Mylotarg)
    • glasdegib (Daurismo)
    • ivosidenib (Tibsovo)
    • midostaurin (Rydapt)

Alternatives for CLL or SLL

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

  • chemotherapy, such as:
    • bendamustine (Treanda)
    • chorambucil (Leukeran)
    • cladribine (Leustatin)
    • cyclophosphamide
    • fludarabine (Fludara)
  • targeted therapies, such as:
    • acalabrutinib (Calquence)
    • alemtuzumab (Campath)
    • duvelisib (Copiktra)
    • idelalisib (Zydelig)
    • ofatumumab (Arzerra)
    • obinutuzumab (Gazyva)
    • rituximab (Rituxan)

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

Ingredients

Venclexta contains the active drug venetoclax. Imbruvica contains the active drug ibrutinib. These are both targeted treatments for cancer. They work in different ways, each targeting a certain feature of the cancer cells.

Uses

Venclexta is FDA-approved to treat:

Imbruvica is FDA-approved to treat:

  • CLL or SLL in adults
  • CLL or SLL with a 17p deletion (a particular genetic mutation in the cancer cells) in adults
  • mantle cell lymphoma in adults who’ve already had at least one treatment
  • Waldenström’s macroglobulinemia, a type of non-Hodgkin lymphoma, in adults
  • marginal zone lymphoma in adults who’ve already had certain other treatments
  • chronic graft versus host disease (when cells in your body are attacked by donor immune cells after a bone marrow or stem cell transplant) in adults when other treatments haven’t been successful

Drug forms and administration

Venclexta comes as tablets that you take by mouth once a day. Imbruvica comes as capsules and tablets that you take by mouth once a day.

Side effects and risks

Venclexta and Imbruvica have some similar side effects and others that differ. Below are examples of these side effects.

Mild side effects

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

  • Can occur with Imbruvica:
    • bruising
    • muscle spasms
  • Can occur with both Venclexta and Imbruvica:
    • diarrhea
    • nausea and vomiting
    • constipation
    • abdominal (belly) pain
    • cough
    • fever
    • muscle, joint, or bone pain
    • edema (fluid retention that causes swelling of your legs, feet, arms, or hands)
    • dizziness
    • rash

Serious side effects

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

Effectiveness

Venclexta and Imbruvica have different FDA-approved uses, but they’re both used to treat chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) in adults.

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

Costs

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

Venclexta is significantly less expensive than Imbruvica. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Venclexta and Daurismo are prescribed for similar uses. Below are details of how these drugs are alike and different.

Ingredients

Venclexta contains the active drug venetoclax. Daurismo contains the active drug glasdegib. They are both targeted treatments for cancer. They work in different ways, each targeting a certain feature of the cancer cells.

Uses

Venclexta and Daurismo are both FDA-approved to treat:

To treat AML, Venclexta is used with either azacitidine (Vidaza), decitabine (Dacogen), or low-dose cytarabine. These are all chemotherapy drugs. Daurismo is used with low-dose cytarabine.

Venclexta is also FDA-approved to treat chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) in adults.

Drug forms and administration

Venclexta and Daurismo both come as tablets that you take by mouth once a day.

Side effects and risks

Venclexta and Daurismo can cause some similar side effects and others that vary. Below are examples of these side effects.

Mild side effects

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

  • Can occur with Venclexta:
    • diarrhea
    • cough
    • joint pain
    • vomiting
    • abdominal (belly) pain
    • fever
    • dizziness
  • Can occur with Daurismo:
    • bleeding
    • reduced appetite
    • change in the way things taste
    • sore mouth or throat
  • Can occur with both Venclexta and Daurismo:
    • fatigue (lack of energy)
    • muscle or bone pain
    • nausea
    • edema (fluid retention that causes swelling of your legs, feet, arms or hands)
    • constipation
    • rash

Serious side effects

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

  • Can occur with Venclexta:
  • Can occur with Daurismo:
    • abnormal heart rhythm
  • Can occur with both Venclexta and Daurismo:
    • blood disorders, such as neutropenia (low white blood cell count), anemia (low red blood cell count), or thrombocytopenia (low platelet count)
    • fetal death or severe birth defects if a pregnant woman is exposed to the drug*

* Daurismo has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA).

Effectiveness

Venclexta and Daurismo have different FDA-approved uses, but they’re both used to treat acute myeloid leukemia (AML) in adults ages 75 years or older, or in adults who can’t have standard chemotherapy.

These drugs haven’t been directly compared in clinical studies. However, studies have found both Venclexta and Daurismo to be effective for treating newly diagnosed AML in adults.

Costs

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

Venclexta is significantly less expensive than Daurismo. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

There are no known interactions between Venclexta and alcohol. However, if Venclexta causes nausea or diarrhea, drinking alcohol could make these side effects worse.

If you drink alcohol, talk with your doctor about how much is safe for you to drink while you take Venclexta.

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

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

Venclexta and other medications

Below is a list of medications that can interact with Venclexta. This list does not contain all drugs that may interact with Venclexta.

Before taking Venclexta, 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.

Venclexta and certain antibiotic drugs

Taking Venclexta with certain antibiotics can cause Venclexta to build up in your body. This can raise your risk for getting side effects from Venclexta.

Examples of antibiotics that can make Venclexta build up in your body include:

  • ciprofloxacin (Cipro)
  • clarithromycin
  • erythromycin (Eryc, Ery-Tab)
  • telithromycin (Ketek)

These antibiotics should usually be avoided while you take Venclexta, especially while your dosage is being increased. If you need to take one of these drugs, your doctor will temporarily lower your Venclexta dosage.

Taking Venclexta with certain other antibiotics can lower the amount of Venclexta in your body. This could make it less effective. Therefore, these drugs should not be taken with Venclexta.

Examples of antibiotics that can make Venclexta less effective include:

  • rifabutin (Mycobutin)
  • rifampin (Rifadin)
  • rifapentine (Priftin)

Venclexta and certain antifungal drugs

Taking Venclexta with certain antifungal drugs can cause Venclexta to build up in your body. This can raise your risk for getting side effects from Venclexta.

Examples of antifungals that can make Venclexta build up in your body include:

  • fluconazole (Diflucan)
  • itraconazole (Sporanox, Onmel, Tolsura)
  • ketoconazole
  • posaconazole (Noxafil)
  • voriconazole (Vfend)

These antifungals should usually be avoided while you take Venclexta, especially while your dosage is being increased. If you need to take one of these drugs, your doctor will temporarily lower your Venclexta dosage.

Venclexta and certain drugs for HIV

Taking Venclexta with certain HIV treatments can cause Venclexta to build up in your body. This can raise your risk for getting side effects from Venclexta.

Examples of HIV drugs that can cause Venclexta to build up in your body include:

  • atazanavir (Reyataz)
  • cobicistat (Tybost)
  • darunavir (Prezista)
  • fosamprenavir (Lexiva)
  • indinavir (Crixivan)
  • lopinavir/ritonavir (Kaletra)
  • nelfinavir (Viracept)
  • ritonavir (Norvir)
  • saquinavir (Invirase)

These HIV drugs should usually be avoided while you take Venclexta, especially while your dosage is being increased. If you need to take one of these drugs, your doctor will temporarily lower your Venclexta dosage.

Venclexta and certain seizure medications

Taking Venclexta with certain seizure medications can lower the amount of Venclexta in your body. This could make it less effective. Therefore, you shouldn’t take these drugs with Venclexta.

Examples of seizure medications that can make Venclexta less effective include:

  • carbamazepine (Carbatrol, Equetro, Tegretol)
  • fosphenytoin (Cerebyx)
  • oxcarbazepine (Trileptal)
  • phenobarbital
  • phenytoin (Dilantin, Phenytek)
  • primidone (Mysoline)

Venclexta and warfarin

Taking warfarin (Coumadin, Jantoven) with Venclexta can increase the blood thinning effect of warfarin. This could raise your risk for bleeding. If you take Venclexta with warfarin, your blood clotting time should be checked regularly, especially after any increases in your Venclexta dosage.

Venclexta and digoxin

Taking digoxin (Lanoxin) with Venclexta can increase the amount of digoxin in your body. This can raise your risk for side effects with digoxin. If you need to take Venclexta with digoxin, take your digoxin dose at least 6 hours before your Venclexta dose.

Venclexta and live vaccines

Getting a live vaccine while taking Venclexta can cause serious infections.

Live vaccines contain weakened forms of viruses or bacteria. They don’t cause infections in people with healthy immune systems. However, they could cause infections if your immune system is weakened by cancer or from taking Venclexta.

While you’re taking Venclexta, you shouldn’t get live vaccines such as:

It’s safe to get inactive (not live) vaccines, such as the flu shot, while you’re taking Venclexta. However, it’s possible that the vaccines might be less effective than usual.

Venclexta and herbs and supplements

Don’t take St. John’s wort (Hypericum perforatum) while you’re taking Venclexta. St. John’s wort can lower the amount of Venclexta in your body and could make it less effective.

It’s possible that certain other herbs and supplements could affect the amount of Venclexta in your body. Examples of these supplements include:

However, it’s not known for sure if any of these herbs and supplements (besides St. John’s wort) interact with Venclexta. Check with your doctor or pharmacist before using any herbs or supplements while taking Venclexta.

Venclexta and foods

While taking Venclexta, don’t drink grapefruit juice or eat grapefruit. Also, don’t eat Seville oranges or starfruit. These fruits can make Venclexta build up in your body, which can raise your risk for side effects.

As with all medications, the cost of Venclexta 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 Venclexta at a specialty pharmacy. These are pharmacies authorized to carry specialty medications (drugs that are complex, have high prices, are difficult to take, or have special dosage or storage requirements).

Your insurance plan may require you to get prior authorization before approving coverage for Venclexta. 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 Venclexta.

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

Financial and insurance assistance

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

Genentech, Inc., the manufacturer of Venclexta, offers programs that may help lower the cost of your treatment. You can learn more about these programs on the manufacturer’s website.

If you have commercial (private) insurance and you’d like to know about ways to save on Venclexta, visit the BioOncology Co-pay Assistance Program web page or call 855-MYCOPAY (855-692-6729). And whether or not you have insurance coverage, you can find information about financial support by visiting the Access Solutions program page or calling 888-249-4918.

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

When to take

You can take your Venclexta dose at any time of day, but always take it at the same time.

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

Taking Venclexta with food

Take Venclexta with a meal and drink of water.

Can Venclexta be crushed, split, or chewed?

No. You should swallow Venclexta tablets whole. Don’t split, crush, or chew them.

Venclexta is used to treat chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and acute myeloid leukemia (AML). These are cancers that affect your blood cells.

What happens in CLL, SLL, and AML

CLL and SLL affect white blood cells called B lymphocytes. These cells normally help your body fight infections. With CLL and SLL, abnormal B lymphocytes that don’t work properly develop in your bone marrow.

When a person develops CLL, the cancer cells stay mainly in the bone marrow and blood. When a person develops SLL, the cancer cells move mainly to the lymph nodes.

AML affects myeloid cells found in the bone marrow. Myeloid cells normally develop into red blood cells, white blood cells, and platelets. With AML, the myeloid cells develop into abnormal blood cells that don’t work properly.

With all three diseases, the cancer cells take up a lot of space in your bone marrow. This prevents your bone marrow from making enough healthy blood cells. The cancer cells multiply faster and survive longer than healthy blood cells.

What Venclexta does

Venclexta is a targeted therapy for CLL, SLL, and AML. It’s a type of drug called a BCL-2 inhibitor.

BCL-2 is a protein that’s involved in regulating when cells in the body die. High levels of this protein are found in CLL, SLL, and AML cells. It helps these cells live longer than they should. It may also help the cells be resistant to chemotherapy.

Venclexta attaches to the BCL-2 protein and stops it from working. This causes the cancer cells to die.

How long does it take to work?

Venclexta starts to work within a few hours after you take your first dose. You probably won’t notice Venclexta working, unless you get symptoms of tumor lysis syndrome (TLS). (See the “Venclexta side effects” section for more information.)

You’ll have blood tests during your treatment to check that Venclexta is working for you.

In most cases, Venclexta should not be taken during pregnancy. This is because it could be harmful to a fetus.

Venclexta has not been studied in pregnant women. However, the drug caused fetal harm in animal studies. Animal studies don’t always predict what will happen in humans, but Venclexta could be harmful to a fetus if taken during pregnancy.

Tell your doctor if you are pregnant or planning to become pregnant before you start treatment with Venclexta.

See your doctor right away if you get pregnant or think you could be pregnant, while taking Venclexta.

Venclexta could be harmful to a fetus if taken during pregnancy. 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 Venclexta.

Women who could get pregnant should use birth control while taking Venclexta and for at least 30 days after stopping treatment.

It’s not known if Venclexta passes into breast milk. You should not breastfeed while you’re taking it.

If you’re currently breastfeeding, talk with your doctor about the best way to feed your child while you take Venclexta.

Here are answers to some frequently asked questions about Venclexta.

Why do I need to drink so much water during Venclexta treatment?

You need to drink plenty of water while you take Venclexta to lower your risk for developing a side effect called tumor lysis syndrome (TLS).

Drinking water is especially important in the 2 days before you start Venclexta, on the first day you take it, and on each day your dose is increased. You should aim to drink six to eight glasses of water (1.5 L to 2 L) each day during your treatment.

TLS can happen when large numbers of cancer cells break down very quickly. When the cells break down, they release chemicals such as uric acid, potassium, calcium, and phosphate into your blood. Your kidneys have to quickly remove these chemicals to avoid a buildup in your blood. Drinking lots of water helps your kidneys work to remove these chemicals from your blood.

Can I get a flu shot while I’m taking Venclexta?

Yes, you can. Getting the vaccine is the best way to protect yourself from getting the flu. Cancers like leukemia and lymphoma can weaken your immune system, making it harder to fight infections like the flu. Flu can be much more serious if you have a weak immune system.

You should get the injected form of the flu vaccine (the flu shot) while you’re taking Venclexta. This contains flu virus that has been inactivated, which means it can’t cause the flu.

You shouldn’t get the nasal spray form of the flu vaccine while you’re taking Venclexta. The nasal vaccine contains live strains of the flu virus. The virus has been weakened, and it can’t cause flu in healthy people. However, it’s possible that it could cause flu if you have a weak immune system.

Is Venclexta safe to use over a long period of time?

Yes. If you have SLL or CLL, you may take Venclexta for up to 1 year. If you have AML, you can take Venclexta for as long as you and your doctor determine it’s safe for you to take. Talk with your doctor about how long you should take Venclexta.

Is Venclexta a chemotherapy drug?

No, Venclexta is not chemotherapy. Chemotherapy works by attacking all cells that are multiplying rapidly. It can affect healthy cells along with cancer cells. This is why chemotherapy drugs can have many side effects.

Venclexta is a targeted therapy for cancer. It works on specific proteins inside the cancer cells that make the cells survive longer than they should. It can still affect some healthy cells and can cause some serious side effects. However, targeted therapies like Venclexta tend to have fewer side effects than chemotherapy.

Why do I need to have blood tests so often during Venclexta treatment?

You’ll have frequent blood tests so your doctor can check for possible side effects of Venclexta. These include TLS and reduced blood cell counts. Getting blood tests done often allows your doctor to quickly treat any problems that develop. If needed, they can also lower your dose or temporarily stop treatment.

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

  • Liver problems. If you have severe liver problems, you may be more likely to get side effects with Venclexta. Your doctor may prescribe a lower dose.
  • High levels of potassium, calcium, phosphorous, or uric acid in your blood. Venclexta can cause a side effect called tumor lysis syndrome (TLS). (With TLS, cancer cells break down very quickly, releasing chemicals such as potassium, calcium, phosphorous, and uric acid into your blood.) If you already have high levels of these chemicals, you may need to take medication to correct this before you start Venclexta.
  • Kidney problems. If your kidneys don’t work well, you may have a higher risk for developing TLS with Venclexta. Your doctor will monitor you closely during your Venclexta treatment.
  • Pregnancy. Venclexta may harm a developing fetus. For more information, see the “Venclexta and pregnancy” section above.
  • Breastfeeding. It’s not known if Venclexta passes into breast milk. You should not breastfeed if you take Venclexta. For more information, see the “Venclexta and breastfeeding” section above.

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

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

Do not use more Venclexta than your doctor recommends.

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

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

Storage

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

Store Venclexta tablets at or below 86°F (30°C) in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Venclexta 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

Venclexta is approved to treat:

Mechanism of action

Venclexta contains the active drug venetoclax. It targets and inhibits B cell lymphoma-2 (BCL-2), a protein found on the outer membrane of mitochondria. BCL-2 is anti-apoptotic and promotes cell survival. This protein is present in high levels in CLL and AML cells. It may be associated with resistance of the cells to chemotherapy.

By blocking BCL-2, Venclexta helps re-establish the normal processes for apoptosis. It has been shown to induce the death of cancer cells that overexpress BCL-2.

Pharmacokinetics and metabolism

The absorption of venetoclax is improved by food. Exposure is approximately tripled when taken with a low-fat meal, containing about 25% of calories from fat. Exposure increases approximately fivefold when taken with a high-fat meal, containing about 55% of calories from fat. Cmax of venetoclax is reached 5 to 8 hours after oral dosing with a meal.

Venetoclax binds highly to plasma proteins. It is mainly metabolized by CYP3A, and its major metabolite also has some activity against BCL-2. Almost 100% of the dose is excreted in the feces, with about 20% as unchanged drug.

The elimination half-life of venetoclax is about 26 hours.

Contraindications

Venclexta is contraindicated with strong CYP3A inhibitors when starting treatment or increasing Venclexta dose in CLL or SLL.

Storage

Store Venclexta at or below 86°F (30°C).

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

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