zanubrutinib at a glance
Medicine class
Bruton’s tyrosine kinase inhibitor
Main role
Treatment of selected B-cell leukaemias and lymphomas in adults
Taking the capsules
Swallow whole with water; they may be taken with or without food
Important safety issues
Bleeding, infections, reduced blood-cell counts and heart-rhythm problems require monitoring
What is zanubrutinib used for?
Licensed uses in adults include:
Waldenström’s macroglobulinaemia after previous treatment, or initially when chemo-immunotherapy is unsuitable
Marginal zone lymphoma after previous anti-CD20-based treatment
Chronic lymphocytic leukaemia
Mantle cell lymphoma after previous treatment
Relapsed or refractory follicular lymphoma after previous systemic treatments, with obinutuzumab
How does zanubrutinib work?
Zanubrutinib blocks BTK, an enzyme involved in signals that help B cells grow, move and survive. Suppressing these signals can reduce the survival and spread of malignant B cells.
zanubrutinib preparations and strengths
Capsule
Route: Oral
Strengths: 80 mg
How to take zanubrutinib
Take zanubrutinib exactly as directed by the specialist team.
Swallow each capsule whole with water.
Do not open, break or chew the capsules.
The capsules can be taken with or without food.
Check with the treatment team before stopping treatment or changing how it is taken.
Tell the team before planned surgery or dental procedures, as treatment may need to be temporarily withheld.
zanubrutinib side effects
Common or expected effects
- Bruising or bleeding
- Respiratory infection, including pneumonia
- Reduced neutrophils, platelets or red blood cells
- Muscle, joint or bone pain
- Rash
- Diarrhoea or constipation
- Cough
- Fatigue or dizziness
- High blood pressure
Get urgent medical advice
- Severe or internal bleeding
- Serious infection, sepsis or hepatitis B reactivation
- Fever with a low neutrophil count
- Atrial fibrillation or atrial flutter
- Severe allergic reaction
- Tumour lysis syndrome
- Widespread redness and peeling of the skin
zanubrutinib in pregnancy
Zanubrutinib should not be used during pregnancy because animal findings indicate potential fetal harm and human pregnancy data are lacking. Pregnancy testing is recommended before treatment when relevant. Highly effective contraception is required during treatment and for one month afterwards. Because effects on hormonal contraception are uncertain, an additional barrier method should be used. Contact the specialist team immediately if pregnancy occurs.
zanubrutinib while breastfeeding
Breastfeeding should be stopped during treatment because transfer into human milk is unknown and harm to a breastfed child cannot be excluded. Discuss feeding options with the specialist team.
zanubrutinib interactions
The specialist team should check prescription, non-prescription and herbal products before treatment and whenever medicines change.
Warfarin and other vitamin K antagonists
These should not be used with zanubrutinib because of the bleeding risk.
Anticoagulants, antiplatelets and NSAIDs
Medicines such as heparin, aspirin, ibuprofen or naproxen may further increase bleeding risk.
Strong or moderate CYP3A inhibitors
Some azole antifungals, macrolide antibiotics, antivirals, diltiazem and verapamil can increase zanubrutinib exposure, requiring specialist review and closer monitoring.
Common questions about zanubrutinib
Answers are fully visible for fast scanning and source review.
What cancers is zanubrutinib used to treat?
It is licensed for selected adults with Waldenström’s macroglobulinaemia, marginal zone lymphoma, chronic lymphocytic leukaemia, mantle cell lymphoma and follicular lymphoma. Eligibility and combination treatment depend on the cancer and previous therapy.
Can zanubrutinib be taken with food?
Yes. The capsules may be taken with or without food.
Can zanubrutinib capsules be opened or chewed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.