Common brand names

• Imbruvica

How it is administered

Ibrutinib is taken by mouth as a tablet, capsule, or oral suspension. The usual dose for blood cancers is 420 mg once daily, taken at about the same time each day. Tablets and capsules should be swallowed whole with water, without opening, breaking, or chewing them. The oral suspension should be measured and taken as directed by your healthcare provider.

If you miss a dose, take it as soon as possible on the same day, but do not take extra doses to make up for a missed one.

How it works

Ibrutinib is a type of medicine known as a Bruton’s tyrosine kinase (BTK) inhibitor. It works by blocking the activity of BTK, a protein that helps certain cancer cells (especially B-cells) grow and survive. By blocking BTK, ibrutinib interferes with signals that tell cancerous B-cells to multiply and move around the body.

This action helps slow down or stop the growth of cancer cells in diseases like chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and Waldenström’s macroglobulinemia. Ibrutinib can also affect how blood cells stick together and move, which is why it is important to monitor for side effects like bleeding.

Who should take it

Ibrutinib is prescribed for adults with certain types of blood cancers, including chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and Waldenström’s macroglobulinemia (WM). It is also used in adults and children (age 1 year and older) with chronic graft versus host disease (cGVHD) after other treatments have not worked.

While ibrutinib is not specifically approved for B-Cell Prolymphocytic Leukemia (B-PLL), it is sometimes considered in rare cases when other therapies are not suitable, as B-PLL is related to other B-cell cancers. Your doctor will determine if ibrutinib is appropriate for your specific condition.

Who should not take it

There are no absolute contraindications listed for ibrutinib, but certain people should use it with caution or avoid it:

• Pregnant women should not take ibrutinib, as it can harm an unborn baby.
• Women should not breastfeed during treatment and for at least 1 week after the last dose.
• People with severe liver problems should avoid ibrutinib.
• If you have active, serious infections or are at high risk for bleeding, your doctor may decide ibrutinib is not safe for you.

Always tell your healthcare provider about all your medical conditions before starting ibrutinib.

Commonly used with

Ibrutinib is sometimes used alone (monotherapy) or in combination with other medications, depending on the type of blood cancer being treated. Common combinations include:

• Rituximab (a monoclonal antibody)
• Obinutuzumab (another monoclonal antibody)
• Bendamustine (a chemotherapy drug, often with rituximab)

Your doctor will decide which combination is best for your situation.

Commonly tested with

Ibrutinib has been tested in clinical trials with several other medications for blood cancers, including:

• Rituximab
• Obinutuzumab
• Bendamustine
• Chlorambucil
• Fludarabine and cyclophosphamide (as part of FCR regimen)

These combinations are studied to find the best treatment options for different types of B-cell cancers.