ibrutinib at a glance
Medicine class
Bruton’s tyrosine kinase inhibitor
Usual uses
Certain forms of mantle cell lymphoma, chronic lymphocytic leukaemia and Waldenström’s macroglobulinaemia
Administration
Swallow the film-coated tablet whole with water; do not break or chew it
Food warning
Avoid grapefruit and Seville oranges, including their juices and supplements
What is ibrutinib used for?
UK-licensed adult uses include:
Previously untreated mantle cell lymphoma in transplant-eligible patients within its specified combination pathway
Relapsed or refractory mantle cell lymphoma
Previously untreated or previously treated chronic lymphocytic leukaemia
Waldenström’s macroglobulinaemia after previous treatment, or initially when chemo-immunotherapy is unsuitable
How does ibrutinib work?
Ibrutinib blocks Bruton’s tyrosine kinase, a signalling protein used by B cells. This disrupts signals that help malignant B cells survive, multiply, move and adhere within tissues.
ibrutinib preparations and strengths
Tablet
Route: Oral
Strengths: 140 mg, 280 mg, 420 mg, 560 mg
How to take ibrutinib
Follow the specialist cancer team’s instructions.
Swallow tablets whole with a glass of water.
Do not break or chew them.
Avoid grapefruit and Seville oranges, including juices and supplements containing them.
Do not stop treatment without speaking to the specialist team.
ibrutinib side effects
Common or expected effects
- Diarrhoea, nausea, vomiting or indigestion
- Bruising or bleeding more easily
- Rash
- Muscle, limb, back or joint pain
- Headache or dizziness
- Mouth soreness or constipation
- Respiratory, lung or skin infections
- Reduced neutrophils or platelets
- High blood pressure
Get urgent medical advice
- Major or internal bleeding
- Severe infection or sepsis
- Atrial fibrillation, other serious arrhythmias or heart failure
- Stroke symptoms
- Severe allergic reaction
- Severe fungal or opportunistic infection
- Liver failure or hepatitis B reactivation
- Tumour lysis syndrome
- Lung inflammation or scarring
- Progressive multifocal leukoencephalopathy or haemophagocytic lymphohistiocytosis
- Severe blistering or peeling skin reaction
ibrutinib in pregnancy
Ibrutinib should not be used during pregnancy because animal findings indicate potential fetal harm and human pregnancy data are unavailable. People who could become pregnant should use highly effective contraception during treatment and for three months after stopping, and contact their specialist immediately if pregnancy occurs.
ibrutinib while breastfeeding
Breastfeeding should stop during treatment. It is unknown whether ibrutinib or its metabolites enter human milk, and risk to a breastfed child cannot be excluded. Discuss feeding options with the specialist team.
ibrutinib interactions
The oncology team should check all prescription, non-prescription, herbal and complementary products.
Warfarin and other vitamin K antagonists
Concurrent use is not recommended because of the risk of serious bleeding.
Anticoagulants, antiplatelets and NSAIDs
These may increase bleeding risk and require specialist assessment and monitoring.
Strong or moderate CYP3A4 inhibitors
Examples including clarithromycin, azole antifungals, ritonavir, verapamil and diltiazem can increase ibrutinib exposure and toxicity.
Common questions about ibrutinib
Answers are fully visible for fast scanning and source review.
What cancers is ibrutinib used to treat?
Its UK licences cover specified adult cases of mantle cell lymphoma, chronic lymphocytic leukaemia and Waldenström’s macroglobulinaemia.
Is ibrutinib chemotherapy?
It is a targeted protein kinase inhibitor rather than conventional cytotoxic chemotherapy, although it may be used alongside other cancer treatments.
Can the tablets be crushed or chewed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.