Pirtobrutinib at a glance
Medicine class
Reversible, non-covalent Bruton’s tyrosine kinase inhibitor
Licensed uses
Chronic lymphocytic leukaemia and relapsed or refractory mantle cell lymphoma
Administration
Swallow tablets whole with water, with or without food; do not crush, chew or split them
Safety status
Subject to additional monitoring; suspected side effects can be reported through the Yellow Card Scheme
What is Pirtobrutinib used for?
UK-licensed uses as monotherapy in adults are:
Chronic lymphocytic leukaemia in people who have not previously received treatment.
Relapsed or refractory chronic lymphocytic leukaemia, whether or not a BTK inhibitor has previously been used.
Relapsed or refractory mantle cell lymphoma after previous treatment with a BTK inhibitor.
How does Pirtobrutinib work?
BTK carries growth and survival signals inside B cells. Pirtobrutinib binds reversibly and non-covalently to BTK, including wild-type BTK and BTK with C481 mutations, reducing signals that help malignant B cells multiply, move and survive.
Pirtobrutinib preparations and strengths
Tablet
Route: Oral
Strengths: 50 mg, 100 mg
How to take Pirtobrutinib
Follow the specialist cancer team’s instructions. Food does not affect administration.
Swallow each tablet whole with a glass of water.
Do not chew, crush or split the tablets.
If you vomit after taking a tablet, do not take an additional tablet; continue at the next scheduled time.
Pirtobrutinib side effects
Common or expected effects
- Low neutrophils, red blood cells or platelets
- Bruising or other bleeding
- Diarrhoea or nausea
- Rash
- Fatigue
- Pneumonia or upper respiratory infection
- Headache
- Joint pain
Get urgent medical advice
- Serious infection or sepsis
- Major bleeding, including gastrointestinal or intracranial bleeding
- Severe reduction in blood cells
- Atrial fibrillation or atrial flutter
- Drug-induced liver injury
- Severe allergic reaction
- Tumour lysis syndrome
Pirtobrutinib in pregnancy
Pirtobrutinib should not be used during pregnancy because animal and genotoxicity findings indicate potential fetal harm. Effective contraception is required for women who could become pregnant during treatment and for 5 weeks afterwards; men should use effective contraception and avoid fathering a child during treatment and for 3 months afterwards. Contact the specialist team immediately if pregnancy occurs.
Pirtobrutinib while breastfeeding
It is unknown whether pirtobrutinib passes into human milk, and risk to a breastfed child cannot be excluded. Breastfeeding should stop during treatment and for one week afterwards; discuss feeding plans with the specialist team.
Pirtobrutinib interactions
Give the cancer team a complete list of prescribed, non-prescribed and complementary products. Important examples include:
Anticoagulants, antiplatelets and NSAIDs
Warfarin, heparins, aspirin, ibuprofen and similar products may add to bleeding risk; the combination requires individual assessment and monitoring.
Strong CYP3A inducers
Rifampicin, carbamazepine and phenytoin can substantially reduce pirtobrutinib exposure and should be avoided where possible.
CYP2C8 substrates
Concentrations of medicines such as repaglinide, pioglitazone, rosiglitazone, selexipag and montelukast may increase.
Common questions about Pirtobrutinib
Answers are fully visible for fast scanning and source review.
What cancers is pirtobrutinib licensed to treat in the UK?
It is licensed as monotherapy for chronic lymphocytic leukaemia and for relapsed or refractory mantle cell lymphoma previously treated with a BTK inhibitor.
Is pirtobrutinib chemotherapy?
It is a targeted protein-kinase inhibitor rather than conventional cytotoxic chemotherapy, although it remains systemic anticancer treatment requiring specialist supervision.
Can pirtobrutinib tablets be crushed or split?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.