Brukinsa (Zanubrutinib)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Brukinsa Used For?
Brukinsa is a targeted anticancer medicine that’s different from chemotherapy. It’s specifically designed to treat certain types of blood cancers by blocking a protein that helps cancer cells grow and survive.
Primary Uses
Brukinsa treats Waldenström’s macroglobulinaemia (a cancer causing white blood cells to make too much IgM protein), chronic lymphocytic leukaemia and small lymphocytic lymphoma (slowly progressing cancers of white blood cells), mantle cell lymphoma (cancer affecting white cells in lymph nodes), and marginal zone lymphoma (cancer affecting B-lymphocytes that may cause organ enlargement).
How It Works
Brukinsa works by blocking Bruton’s tyrosine kinase, a protein in the body that helps cancer cells grow and survive. By blocking this protein, Brukinsa can reduce the number and activity of cancer cells in your body.
Good to know: This is a targeted therapy that works differently from traditional chemotherapy by specifically blocking proteins that cancer cells need to survive.
How to Take Brukinsa
Take Brukinsa exactly as prescribed by your doctor. The medication comes in both tablet and capsule forms and can be taken with or without food.
Dosage Instructions
The recommended dose is 320 mg per day. You can take this either all at once (2 tablets or 4 capsules) or split into two doses of 160 mg (1 tablet or 2 capsules in the morning and 1 tablet or 2 capsules in the evening). Take at about the same time each day. Swallow tablets or capsules whole with water – don’t open, chew, or break them unless your doctor tells you to split a tablet in half.
What If You Miss a Dose?
If you miss your dose at the usual time, take it as soon as possible on the same day and return to your normal schedule the following day. If it’s almost time for your next dose, skip the missed dose and take your next dose when scheduled. Never take a double dose to make up for a missed one.
Important: Never take a double dose to make up for a missed dose. Don’t stop taking this medicine unless your doctor tells you to, as your treatment may stop working.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Feeling tired
- Bruising or increased tendency to bruise
- Bleeding or blood clots under skin
- Diarrhea
- Skin rash
- Muscle pain in arms or legs
Seek immediate medical attention if you experience:
- Signs of allergic reaction (itchy rash, difficulty breathing, swelling of face, lips, tongue, or throat)
- Signs of infection (fever, chills, body aches, cold or flu symptoms, shortness of breath, frequent painful urination)
- Serious bleeding (blood in stools, black stools, pink or brown urine, vomiting blood, coughing up blood, severe headache)
- Heart rhythm problems (atrial fibrillation and flutter)
- New cancers including skin cancers
- Low blood cell counts (anemia, neutropenia, thrombocytopenia)
Important Warnings
Before starting Brukinsa, tell your doctor about all your medical conditions and medications. This medicine requires careful monitoring and has specific precautions.
Who Should Not Take Brukinsa
Brukinsa should not be used during pregnancy as it can harm your unborn baby. Do not breastfeed while taking this medicine and for at least 2 weeks after your last dose.
Medical Conditions to Discuss
Tell your doctor if you have unusual bruising or bleeding, take blood-thinning medications, have had recent surgery or plan surgery, have irregular heartbeat or heart problems, have a history of infections, have ever had Hepatitis B or Herpes Zoster, have liver or kidney problems, have had stomach or gut surgery, or have high blood pressure.
Pregnancy and Breastfeeding
Brukinsa should not be used during pregnancy and can harm your unborn baby. If you could become pregnant, use condoms or another highly effective barrier method during treatment and for at least 1 week after your last dose. Hormonal contraceptives alone are not sufficient. Do not breastfeed while taking this medicine and for at least 2 weeks after your last dose.
Bleeding Risk: Brukinsa may make you bleed more easily. Your doctor may ask you to stop taking it for 3-7 days before and after surgery or dental procedures.
Drug Interactions
Brukinsa can interact with many medications and may increase your risk of bleeding. Always tell your doctor about all medicines, vitamins, and supplements you’re taking.
Grapefruit interaction: Do not eat grapefruit, drink grapefruit juice, or eat Seville oranges while taking Brukinsa, as they may change the amount of medicine in your blood and cause side effects.
- Aspirin and NSAIDs (ibuprofen, naproxen)
- Blood thinners (warfarin, heparin)
- Bleeding risk supplements (fish oil, vitamin E, flaxseed)
- Antibiotics (clarithromycin, erythromycin, rifampicin)
- Antifungal medicines (fluconazole, ketoconazole, itraconazole, posaconazole, voriconazole)
- HIV medicines (indinavir, ritonavir)
- Seizure medicines (carbamazepine, phenytoin)
- Heart medicines (diltiazem, verapamil)
- Hepatitis C medicines (telaprevir)
- Low sodium medicines (conivaptan)
Alcohol & Driving
Be cautious with activities requiring alertness and discuss alcohol use with your doctor.
Alcohol
Tell your doctor if you drink alcohol. Discuss any alcohol consumption with your healthcare provider.
Driving and Operating Machinery
Be careful before driving or using machines until you know how Brukinsa affects you. This medicine may cause fatigue, dizziness, or weakness in some people.
Storage
Keep Brukinsa in its original container until it’s time to take it. Store in a cool, dry place away from moisture, heat, and sunlight. Don’t store in the bathroom or near a sink, and don’t leave in the car or on windowsills. Keep out of reach of children. Take any unwanted or expired medicine to a pharmacy for safe disposal.
Overdose Information
If you think you’ve taken too much Brukinsa, seek urgent medical attention immediately. Call the Poisons Information Centre at 13 11 26, contact your doctor, or go to the nearest hospital emergency department, even if you don’t feel unwell.
Frequently Asked Questions
Laboratory tests may show an increase in white blood cells in the first few weeks of treatment, which is expected and may last for a few months. Your doctor will monitor your progress with regular blood tests.
Yes, both capsules and tablets can be taken with or without food. Take them with a glass of water and swallow whole.
Do not stop taking Brukinsa unless your doctor tells you to. Your treatment may stop working, which can cause your condition to worsen.
You should tell your doctor if you drink alcohol. Discuss any alcohol consumption with your healthcare provider before drinking while on this medication.
If you miss your dose at the usual time, take it as soon as possible on the same day and return to your normal schedule the next day. If it’s almost time for your next dose, skip the missed dose. Never take a double dose.
Your doctor needs to monitor your blood counts during treatment as Brukinsa can decrease blood cell counts (white blood cells, platelets, and red blood cells). Regular monitoring helps ensure your safety.
Tell your doctor about any planned surgery or dental procedures. Your doctor may ask you to stop taking Brukinsa for a short time (3 to 7 days) before and after your surgery because the medicine increases bleeding risk.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.