How it is administered

Ibrutinib is taken by mouth as an immediate-release capsule, tablet, or oral suspension. The most common adult dose for blood cancers is 420 mg once daily, swallowed whole with water at about the same time each day. For children with chronic graft-versus-host disease (cGVHD), the dose is based on body surface area. Capsules and tablets should not be opened, broken, or chewed, and oral suspension should be measured carefully using the provided device.

How it works

Ibrutinib is a type of targeted therapy known as a Bruton’s tyrosine kinase (BTK) inhibitor. BTK is a protein that plays a crucial role in the signaling pathways inside B-cells, a type of white blood cell involved in many blood cancers. By forming a covalent bond with BTK, ibrutinib blocks its activity, which disrupts signals that tell cancerous B-cells to grow and survive.

This inhibition leads to reduced proliferation and survival of malignant B-cells, and also affects their ability to move and adhere to other tissues. As a result, ibrutinib helps control the spread and growth of blood cancers such as chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and Waldenström’s macroglobulinemia (WM). In patients with cGVHD, it helps by modulating immune cell activity.

Who Should take it

Ibrutinib is prescribed for adults with chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), including those with a specific genetic change called 17p deletion, and for adults with Waldenström’s macroglobulinemia (WM). It is also approved for adults and children aged 1 year and older with chronic graft-versus-host disease (cGVHD) after failure of one or more lines of systemic therapy.

Your healthcare provider will determine if ibrutinib is right for you based on your diagnosis, previous treatments, and overall health. It is often used alone or in combination with other medications, especially in blood cancers.

Who should not take it

There are no absolute contraindications listed for ibrutinib, but it should be used with caution in certain situations. People with severe liver impairment should not take ibrutinib. It is not recommended for use during pregnancy, as it can cause harm to an unborn baby, and women should avoid breastfeeding during treatment and for one week after the last dose.

People with a history of significant bleeding, active infections, or serious heart problems should discuss the risks and benefits with their doctor. Your healthcare provider will monitor you closely if you have other health conditions that could increase your risk of side effects.

Commonly used with

Ibrutinib is often used in combination with other medications for blood cancers. For CLL/SLL, it may be combined with rituximab, obinutuzumab, or bendamustine and rituximab (BR). For WM, it can be used with rituximab. In cGVHD, it is typically used after other therapies have failed and may be given alongside supportive care medications.

Your doctor will decide the best combination based on your specific condition and prior treatments.

Commonly tested with

Clinical studies have tested ibrutinib both as a single agent and in combination with other drugs. In CLL/SLL, it has been studied with rituximab, obinutuzumab, and bendamustine. In WM, it has been tested with rituximab. For cGVHD, studies have focused on its use after other systemic therapies have failed, sometimes alongside standard supportive treatments.

These combinations are designed to improve treatment outcomes and may be adjusted based on your response and tolerance.