idelalisib at a glance
Medicine class
PI3K-delta inhibitor
Main licensed uses
Selected chronic lymphocytic leukaemia and refractory follicular lymphoma in adults
Administration
Film-coated tablet swallowed whole, with or without food
Important safety issue
Serious infections, colitis, liver injury, lung inflammation and severe skin reactions require active monitoring
What is idelalisib used for?
Licensed uses in adults include:
Chronic lymphocytic leukaemia, combined with rituximab or ofatumumab after previous therapy.
First-line chronic lymphocytic leukaemia with a 17p deletion or TP53 mutation when no other therapy is suitable.
Follicular lymphoma used alone when refractory to two previous treatment lines.
How does idelalisib work?
Idelalisib selectively inhibits PI3K-delta, which is overactive in several B-cell cancers. This disrupts signals supporting malignant-cell growth, survival and retention within lymph nodes and bone marrow.
idelalisib preparations and strengths
Tablet
Route: Oral
Strengths: 100 mg, 150 mg
How to take idelalisib
Follow the specialist cancer team’s instructions.
Swallow the film-coated tablet whole; do not chew or crush it.
It may be taken with or without food.
Tell the team if swallowing tablets is difficult.
idelalisib side effects
Common or expected effects
- Infections
- Reduced neutrophil count
- Diarrhoea or bowel inflammation
- Raised liver enzymes
- Rash
- Fever
- Raised blood triglycerides
- Temporary rise in circulating lymphocytes
Get urgent medical advice
- Serious or opportunistic infection
- Severe or persistent diarrhoea or colitis
- Liver injury
- Pneumonitis or organising pneumonia
- Severe blistering skin reactions, including SJS, TEN or DRESS
- Progressive multifocal leukoencephalopathy
idelalisib in pregnancy
Idelalisib is not recommended during pregnancy because animal findings indicate potential fetal harm and human data are limited. Highly effective contraception is required during treatment and afterwards as directed by the specialist; supplement hormonal contraception with a barrier method. Contact the oncology team promptly if pregnancy occurs.
idelalisib while breastfeeding
Breastfeeding should be discontinued during treatment because transfer into human milk is unknown and risk to the infant cannot be excluded. Discuss feeding options with the cancer and maternity teams.
idelalisib interactions
A full review of prescribed, non-prescribed and herbal products is essential.
Rifampicin, phenytoin, carbamazepine and St John’s wort
These CYP3A inducers can substantially reduce idelalisib exposure and should generally be avoided.
Sensitive CYP3A substrates
Exposure to medicines including alfuzosin, amiodarone, quetiapine, simvastatin, midazolam and triazolam may increase markedly, potentially causing serious toxicity.
Fentanyl, alfentanil, methadone or buprenorphine/naloxone
Concentrations may increase, requiring monitoring for sedation and respiratory depression.
Common questions about idelalisib
Answers are fully visible for fast scanning and source review.
Is idelalisib chemotherapy?
It is a targeted anticancer treatment rather than conventional cytotoxic chemotherapy. It inhibits PI3K-delta in malignant B cells.
Can it be taken with food?
Yes. Food is not required for administration.
Can the tablets be crushed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.