venetoclax at a glance
Medicine class
BCL-2 inhibitor and targeted antineoplastic treatment
Usual uses
Selected adult treatment plans for chronic lymphocytic leukaemia or newly diagnosed acute myeloid leukaemia
Taking the tablets
Swallow whole with water and take with a meal; do not chew, crush or break them
Key safety risks
Tumour lysis syndrome, reduced blood-cell counts and serious infection require prevention and monitoring
What is venetoclax used for?
UK-licensed uses in adults include:
Previously untreated chronic lymphocytic leukaemia, in specified combinations with acalabrutinib, obinutuzumab or ibrutinib.
Previously treated chronic lymphocytic leukaemia, in combination with rituximab.
Selected chronic lymphocytic leukaemia as monotherapy, according to previous treatment and 17p-deletion or TP53-mutation status.
Newly diagnosed acute myeloid leukaemia in people ineligible for intensive chemotherapy, combined with a hypomethylating agent or low-dose cytarabine.
How does venetoclax work?
BCL-2 is a protein that helps some CLL and AML cells avoid programmed cell death. Venetoclax binds selectively to BCL-2, releasing signals that disrupt the cancer cell’s mitochondria and trigger cell death.
venetoclax preparations and strengths
Tablet
Route: Oral
Strengths: 10 mg, 50 mg, 100 mg
How to take venetoclax
Follow the specialist treatment plan exactly. Swallow the tablets whole with water and a meal; do not chew, crush or break them. Avoid grapefruit products, Seville oranges and starfruit.
Do not change or stop treatment without speaking to the specialist team.
Maintain the hydration plan provided by the treatment team, particularly when treatment starts or changes.
If vomiting occurs after taking venetoclax, do not take a replacement tablet; take the next prescribed tablet at its usual time.
venetoclax side effects
Common or expected effects
- Reduced white cells, red cells or platelets
- Infections, including respiratory or urinary infections
- Diarrhoea, nausea or vomiting
- Constipation or mouth sores
- Tiredness or weakness
- Reduced appetite
- Headache, dizziness or joint pain
Get urgent medical advice
- Tumour lysis syndrome, which can disturb electrolytes, kidney function and heart rhythm or cause seizures
- Neutropenia with fever or other signs of serious infection, including pneumonia or sepsis
- Significant or unexplained bleeding
- Severe reduction in blood-cell counts
venetoclax in pregnancy
Venetoclax is not recommended during pregnancy because animal evidence indicates possible fetal harm and adequate human data are unavailable. People who could become pregnant should use highly effective contraception during treatment and for at least 30 days afterwards; because hormonal contraception may be less reliable, an additional barrier method is advised. Tell the specialist team immediately about a pregnancy or planned pregnancy.
venetoclax while breastfeeding
Breastfeeding should be stopped during venetoclax treatment. It is unknown whether venetoclax enters human milk, and harm to a breastfed child cannot be excluded; discuss feeding plans with the specialist team.
venetoclax interactions
Venetoclax has clinically important interactions. The specialist team should review prescribed, non-prescription and herbal products before treatment and whenever medicines change.
Strong or moderate CYP3A inhibitors, including clarithromycin, azole antifungals, ritonavir, ciprofloxacin, diltiazem and verapamil
These can substantially increase venetoclax exposure and the risk of tumour lysis syndrome or other toxicity; some combinations are contraindicated during CLL treatment initiation and titration.
CYP3A inducers, including rifampicin, carbamazepine, phenytoin and modafinil
These may lower venetoclax exposure and reduce effectiveness, so concomitant use should generally be avoided.
St John’s wort
This herbal preparation is contraindicated because it may reduce venetoclax exposure and effectiveness.
Common questions about venetoclax
Answers are fully visible for fast scanning and source review.
Is venetoclax chemotherapy?
Venetoclax is a targeted anticancer treatment rather than conventional cytotoxic chemotherapy. It selectively blocks the BCL-2 survival protein and is often combined with other anticancer treatments.
Why are blood tests needed with venetoclax?
Blood tests detect tumour lysis syndrome, electrolyte or kidney changes and reductions in blood cells. Monitoring is particularly important when treatment starts, changes or resumes after interruption.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.