How it is administered

Venetoclax is taken by mouth as a tablet, once daily, with a meal and water. Tablets come in strengths of 10 mg, 50 mg, and 100 mg. The dose is gradually increased over several weeks (a process called ramp-up) to reduce the risk of tumor lysis syndrome. Tablets should be swallowed whole and not chewed, crushed, or broken.

How it works

Venetoclax is a targeted therapy known as a BCL-2 inhibitor. BCL-2 is a protein found in some blood cancer cells, such as those in chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and acute myeloid leukemia (AML). This protein helps cancer cells survive longer than they should by blocking the process of natural cell death (apoptosis).

Venetoclax works by binding directly to the BCL-2 protein, which frees up other proteins that trigger cell death. This leads to the destruction of cancer cells that rely on BCL-2 for survival. By restoring the normal process of cell death, venetoclax can help shrink tumors and control the disease. It is especially effective in blood cancers where BCL-2 is overexpressed and has shown benefit in combination with other therapies.

Who Should take it

Venetoclax is used to treat adults with certain blood cancers:

• Chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), either alone or in combination with other medicines such as obinutuzumab or rituximab.
• Newly diagnosed acute myeloid leukemia (AML) in adults who are 75 years or older, or who have health problems that prevent them from receiving intensive chemotherapy. In AML, venetoclax is given in combination with azacitidine, decitabine, or low-dose cytarabine.

Your doctor will decide if venetoclax is right for you based on your type of blood cancer, age, overall health, and previous treatments.

Who should not take it

Venetoclax should not be used in combination with strong CYP3A inhibitors (certain medications that affect how venetoclax is broken down in the body) at the start and during the ramp-up phase in patients with CLL or SLL, as this can increase the risk of dangerous side effects like tumor lysis syndrome.

Venetoclax is not recommended for use in children, as its safety and effectiveness have not been established in pediatric patients. It should also be avoided in pregnant women due to the risk of harm to the unborn baby. People who are allergic to venetoclax or any of its ingredients should not take it. Always tell your doctor about all the medications you are taking to avoid harmful interactions.

Commonly used with

Venetoclax is often used in combination with other medications to treat blood cancers:

• With obinutuzumab for previously untreated CLL/SLL
• With rituximab for previously treated CLL
• With azacitidine, decitabine, or low-dose cytarabine for newly diagnosed AML in certain adults

These combinations can improve treatment effectiveness and are chosen based on your specific diagnosis and health status.

Commonly tested with

Venetoclax has been tested in clinical trials with several other medications, including:

• Obinutuzumab and rituximab (for CLL/SLL)
• Azacitidine, decitabine, and low-dose cytarabine (for AML)

It has also been studied with other agents in research settings, but the above combinations are the most established for blood cancers.