Leukemias, lymphomas, and other hematologic cancers:
Indications for BRUKINSA:
Mantle cell lymphoma (MCL) in adult patients who have received at least one prior therapy.
Swallow whole with water. 160mg twice daily or 320mg once daily until disease progression or unacceptable toxicity. Severe hepatic impairment: 80mg twice daily. Concomitant strong CYP3A inhibitors: 80mg once daily. Concomitant moderate CYP3A inhibitors: 80mg twice daily. Dose modifications for adverse reactions: see full labeling.
Risk of serious hemorrhagic events (monitor); consider the benefit/risk of withholding treatment for 3–7 days pre- and post-surgery. Monitor for fever and infections; evaluate promptly if occurs. Consider prophylaxis for opportunistic infections in high risk patients. Monitor for cytopenias; obtain CBCs during therapy. Monitor for cardiac arrhythmias (esp. in those with cardiac risk factors, hypertension, acute infections). Risk of second primary malignancies (eg, skin cancer or other carcinomas); advise patients to use sun protection. Hepatic or severe renal impairment, or on dialysis: monitor. Embryo-fetal toxicity. Advise females and males of reproductive potential to use effective contraception during and for ≥1 week after the last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for ≥2 weeks after the last dose).
Bruton tyrosine kinase (BTK) inhibitor.
Concomitant moderate or strong CYP3A inducers may reduce zanubrutinib efficacy (eg, rifampin, efavirenz); avoid use. Concomitant moderate or strong CYP3A inhibitors may increase risk of toxicities (eg, itraconazole, fluconazole, erythromycin); reduce zanubrutinib dose (see Adults). Increased risk of hemorrhage with concomitant antiplatelets or anticoagulants; monitor.
Neutrophil count decreased, platelet count decreased, upper respiratory tract infection, WBC count decreased, hemoglobin decreased, rash, bruising, diarrhea, cough, musculoskeletal pain, pneumonia, urinary tract infection, hematuria, fatigue, constipation, hemorrhage.