How it is administered

Idelalisib is taken by mouth as a tablet. The recommended dose is 150 mg twice daily, with or without food. Tablets should be swallowed whole and not chewed or crushed. If a dose is missed by less than 6 hours, take it as soon as possible; if more than 6 hours, skip the missed dose and take the next dose at the usual time.

How it works

Idelalisib is a targeted therapy known as a kinase inhibitor. It works by blocking a specific enzyme called PI3Kδ (phosphatidylinositol 3-kinase delta), which is found in normal and cancerous B-cells. This enzyme plays a key role in the growth, survival, and movement of these cells.

By inhibiting PI3Kδ, idelalisib interferes with several cell signaling pathways that are important for the survival and spread of cancerous B-cells, such as those seen in certain blood cancers. This leads to reduced proliferation (growth) of malignant cells, increased cell death (apoptosis), and decreased ability of cancer cells to travel to and survive in places like the lymph nodes and bone marrow.

Who Should take it

Idelalisib is indicated, in combination with rituximab, for the treatment of patients with relapsed chronic lymphocytic leukemia (CLL) who cannot tolerate standard chemoimmunotherapy due to other health issues. While it was previously used for follicular lymphoma and other indolent non-Hodgkin lymphomas, it is no longer recommended or approved for these uses due to safety concerns.

If you have relapsed CLL and are unable to receive standard treatments, your doctor may consider idelalisib as part of your therapy. It is important to discuss your full medical history and other medications with your healthcare provider before starting idelalisib.

Who should not take it

You should not take idelalisib if you have had a serious allergic reaction (including anaphylaxis) to idelalisib or if you have ever experienced toxic epidermal necrolysis with any drug. Idelalisib is also not recommended for first-line treatment of any patient, including those with follicular lymphoma, CLL, or other indolent non-Hodgkin lymphomas.

Patients with severe liver problems or those who are pregnant should avoid idelalisib, as it may cause harm to the fetus. Always inform your healthcare provider of your complete medical history before starting this medication.

Commonly used with

Idelalisib is most commonly used in combination with rituximab for the treatment of relapsed CLL. It is not recommended to be used with bendamustine and rituximab, or with rituximab alone for follicular lymphoma or other indolent non-Hodgkin lymphomas due to increased risk of serious adverse reactions.

Commonly tested with

In clinical studies, idelalisib has been tested in combination with rituximab, ofatumumab, and bendamustine. However, its use is only approved and recommended in combination with rituximab for relapsed CLL. Studies in combination with other agents for follicular lymphoma and similar conditions were discontinued due to safety concerns.