How it is administered

Ibrutinib is taken by mouth (orally) and is available as immediate-release capsules, tablets, and an oral suspension. The most common dose for adults with chronic lymphocytic leukemia (CLL) is 420 mg once daily, taken at about the same time each day. Capsules and tablets should be swallowed whole with a glass of water—do not open, break, or chew them. The oral suspension is measured and taken according to your doctor's instructions.

If you miss a dose, take it as soon as possible on the same day, then return to your normal schedule the next day. Do not take extra doses to make up for a missed dose.

How it works

Ibrutinib is a type of targeted therapy known as a Bruton’s tyrosine kinase (BTK) inhibitor. It works by blocking the activity of BTK, a protein that is important for the survival and growth of B-cells, which are a type of white blood cell. In chronic lymphocytic leukemia (CLL), the cancerous B-cells rely on BTK to receive signals that help them grow and avoid dying.

By blocking BTK, ibrutinib disrupts these signals, leading to slower growth and increased death of the cancerous B-cells. This helps control the disease and can reduce symptoms. Ibrutinib also affects the movement and adhesion of B-cells, making it harder for them to survive in the body. This targeted approach helps to limit the impact on normal, healthy cells compared to traditional chemotherapy.

Who Should take it

Ibrutinib is indicated for adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), including those with a specific genetic change called 17p deletion. It is also used in combination with other medications, such as rituximab, obinutuzumab, or bendamustine, for certain patients with CLL/SLL.

Your doctor may recommend ibrutinib if you have been newly diagnosed with CLL/SLL, if your disease has come back after previous treatments, or if you have high-risk features like the 17p deletion. The decision to use ibrutinib depends on your overall health, prior treatments, and specific characteristics of your leukemia.

Who should not take it

There are no absolute contraindications listed for ibrutinib, but certain people should use caution or avoid it. Patients with severe liver impairment should not take ibrutinib. It should also be avoided in those who are pregnant, as it can cause harm to an unborn baby. Women of childbearing potential should use effective contraception during treatment and for one month after the last dose.

People who have a history of severe bleeding, active infections, or serious heart rhythm problems should discuss the risks and benefits with their doctor before starting ibrutinib. Always inform your healthcare provider about all your medical conditions and medications before starting treatment.

Commonly used with

Ibrutinib can be used alone or in combination with other medications for CLL. Common combinations include:

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

Your doctor will choose the best combination based on your individual situation and prior treatments.

Commonly tested with

Ibrutinib has been tested in clinical trials both as a single agent and in combination with other drugs for CLL and other blood cancers. Commonly tested combinations include:

• Rituximab
• Obinutuzumab
• Bendamustine and rituximab (BR)
• Compared to other standard treatments like chlorambucil or chemoimmunotherapy regimens

These studies help determine the best ways to use ibrutinib for different types of patients and stages of disease.