Ibrutinib is used on its own or together with other medicines to treat a variety of cancers of the lymphocytes (a type of white blood cells in the body that help fight infection) including mantle cell lymphoma, marginal zone lymphoma, chronic lymphocytic leukaemia, small lymphocytic lymphoma and Waldenstrom’s macroglobulinemia. Lymphocytes are commonly found in the lymph nodes, spleen, thymus, bone marrow and other parts of the body.
This medicine may also be used to treat other conditions such as graft versus host disease (a disease associated with transplant of tissues or cells in the body) as decided by your doctor.
Take Ibrutinib exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take Ibrutinib at the same time each day.
This medicine is available as a tablet or a capsule. Swallow it whole with a glass of water. Do not open, break or chew the capsules. Do not cut, crush, or chew the tablets.
The dose of Ibrutinib will be decided by your doctor. Your doctor will advise you on the course of your treatment depending on your response to this medicine.
Ibrutinib must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Do not take this medicine with St. John’s wort, a herbal medicine.
Inform your doctor if you have kidney or liver disease.
It is important that you do not get pregnant while being treated with Ibrutinib. You may wish to discuss birth control methods with your doctor or pharmacist. Avoid pregnancy or fathering a child (for males) during treatment and for up to 1 month after you stop taking this medicine.
Let your doctor know if you are breastfeeding.
If you are going for surgery and dental work, inform your doctor or dentist that you are taking Ibrutinib.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and to check your response to this medicine regularly.
- Before beginning treatment with Ibrutinib, you will need to undergo pregnancy tests. You may also need to undergo screening for hepatitis B infection.
- Before beginning treatment and while you are being treated with this medicine, you may need to undergo electrocardiogram monitoring.
- Your doctor will need to monitor your blood count monthly and check your kidney and liver function periodically.
Ibrutinib may cause dizziness and visual disturbances (e.g. dry eyes, teary eyes, blurred vision, decreased clarity of vision). If affected, do not drive or take part in any activity in which you need to be alert or to see clearly.
Other side effects may include any of the following: headache, tiredness, diarrhoea, nausea, vomiting, constipation, stomach pain or discomfort, heartburn, cold sores, muscle pain or spasms, joint pain; appetite loss, rash, breaking of the nails, and swelling of the ankles, feet, or hands.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- severe headache, confusion, slurred speech, unusual or worsening bruises or bleeding, coughing up blood, blood in your vomit, urine or stool, black-colored stool
- signs and symptoms of an infection e.g. fever, chills, weakness, confusion, cough, cold or flu
- trouble thinking, memory loss, loss of vision, difficulty walking
- irregular or fast heartbeat, lightheadedness, breathlessness, chest pain or discomfort
- sore that doesn’t heal
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take this medicine with St. John’s wort, a herbal medicine.
Inform your doctor or pharmacist if you are taking any of these medicines:
- medicines for other cancers e.g. crizotinib, imatinib
- blood-thinning medicines e.g. warfarin, heparin
- antibiotics e.g. clarithromycin, telithromycin, ciprofloxacin, erythromycin
- medicines for TB or tuberculosis e.g. rifampicin
- medicines for HIV infection e.g. indinavir, nelfinavir, ritonavir, saquinavir, cobicistat
- medicines for fungal infections e.g. fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole
- medicines for heart disease e.g. amiodarone, dronedarone, diltiazem, verapamil, digoxin
- cholesterol-lowering medicines e.g. rosuvastatin
- medicines for fits or seizures e.g. carbamazepine or phenytoin
- medicines for rheumatoid arthritis (inflammation in joints of fingers, wrist, feet, ankles) e.g. methotrexate
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements (e.g. fish oil and vitamin E) and medicines that you buy without a prescription.
Avoid alcohol.
Avoid excessive consumption of grapefruit and Seville oranges (bitter oranges).
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
Always return any unused or expired tablets or capsules to the clinic, hospital or pharmacy for disposal. Do not throw it away in the household waste.
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