Imbruvica (Ibrutinib)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Imbruvica Used For?
Imbruvica contains the active ingredient ibrutinib and is used to treat specific types of blood cancers in adults.
Primary Uses
Imbruvica is prescribed to treat three main blood cancers: Mantle Cell Lymphoma (MCL), Chronic Lymphocytic Leukaemia (CLL) including Small Lymphocytic Lymphoma (SLL), and Waldenström’s macroglobulinemia (WM).
How It Works
Imbruvica is a Bruton’s tyrosine kinase inhibitor. By blocking this protein, it may help kill and reduce the number of cancer cells and may also slow the spread of the cancer.
How to Take Imbruvica
Take Imbruvica exactly as prescribed by your doctor. The dose depends on the type of cancer being treated.
Dosage Instructions
For MCL: 560 mg once daily. For WM and CLL/SLL: 420 mg once daily. Swallow capsules or tablets whole with water – do not open, break, or chew them. Take at the same time each day. Avoid grapefruit and Seville oranges (including juice and supplements) as they can increase the amount of Imbruvica in your blood.
What If You Miss a Dose?
If you miss a dose and it’s more than 12 hours until your next scheduled dose, take the missed dose as soon as possible, then continue with your regular schedule. If it’s almost time for your next dose, skip the missed dose and take the next one at the usual time.
Important: Never take a double dose to make up for a missed dose. Do not change your dose or stop taking Imbruvica until your doctor tells you to.
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:
- Diarrhea
- Feeling very tired
- Nausea
- Headache
- Swollen hands, ankles or feet
- Shortness of breath
- Dizziness
- Fainting
- Constipation
- Cold symptoms (infected nose, sinuses or throat)
- Fever
- Vomiting
- Decreased appetite
- Bleeding
- Bruises
- Skin rash
- Muscle and joint pain
- Muscle spasms
- Indigestion
- Sore stomach
- Sore or inflamed mouth
- Urinary tract infection
- Chills
- Body aches
- Blurred vision
- Low blood sodium
- High levels of uric acid or creatine in blood
Seek immediate medical attention if you experience:
- Serious bleeding (in eye, stomach, intestine, or brain)
- Blood in stools or urine
- Bleeding that lasts long or cannot be controlled
- Difficulty breathing or persistent cough (lung inflammation)
- Multiple symptoms like fever, swollen glands, bruising, skin rash (blood cell disorder)
- Stroke symptoms
- Heart problems (chest discomfort, shortness of breath, palpitations)
- Heart failure symptoms (breathlessness, difficulty breathing when lying down, swelling of feet/ankles/legs, weakness/tiredness)
- Left upper belly pain or pain below rib cage (spleen rupture)
- Low blood cell counts (anemia, neutropenia, thrombocytopenia)
- Liver problems (yellowing of eyes or skin)
- New cancers including skin cancer
- Sudden kidney problems
Important Warnings
There are several important warnings and precautions to be aware of before taking Imbruvica.
Who Should Not Take Imbruvica
Do not use Imbruvica if you are allergic to ibrutinib or any ingredients, use preparations containing St John’s Wort, are pregnant or planning to become pregnant, or are breastfeeding.
Medical Conditions to Discuss
Tell your doctor if you have: unusual bruising or bleeding or take medicines that increase bleeding risk, history of high blood pressure, irregular heartbeat, or heart failure, liver or kidney problems, current or past Hepatitis B infection, recent surgery or planned surgery.
Pregnancy and Breastfeeding
Do not become pregnant while taking Imbruvica. Do not breastfeed while taking this medication. Men should not father a child while taking Imbruvica and for 3 months after stopping treatment.
Drug Interactions
Many medications can interact with Imbruvica and affect how it works. Always tell your doctor about all medicines you’re taking.
Grapefruit interaction: Do not eat grapefruit or Seville oranges, drink their juice, or take supplements containing them while taking Imbruvica, as they can increase the medication levels in your blood.
- Blood thinners (warfarin, heparin)
- Aspirin and NSAIDs (ibuprofen, naproxen)
- Fish oil and vitamin E supplements
- Antibiotics (clarithromycin, telithromycin, ciprofloxacin, erythromycin, rifampin, azithromycin)
- Antifungal medicines (ketoconazole, posaconazole, itraconazole, fluconazole, voriconazole)
- HIV medicines (ritonavir, cobicistat, indinavir, nelfinavir, saquinavir, amprenavir, atazanavir, darunavir/ritonavir, fosamprenavir)
- Aprepitant (anti-nausea medicine)
- Nefazodone (depression medicine)
- Cancer medicines (crizotinib, imatinib)
- Blood pressure medicines (diltiazem, verapamil)
- Heart rhythm medicines (amiodarone, dronedarone)
- Fluvoxamine (OCD medicine)
- Seizure medicines (carbamazepine, phenytoin)
- Cholesterol medicines (rosuvastatin)
- St. John’s Wort
- Digoxin (heart medicine) – take at least 6 hours before or after Imbruvica
- Methotrexate – take at least 6 hours before or after Imbruvica
Alcohol & Driving
Imbruvica may affect your ability to drive or operate machinery, and you should discuss alcohol use with your doctor.
Alcohol
Tell your doctor if you drink alcohol. There is no specific information available about how alcohol affects Imbruvica.
Driving and Operating Machinery
Be careful before driving or using machines until you know how Imbruvica affects you. This medication may cause dizziness in some people, which may affect your ability to drive or use tools or machinery safely.
Storage
Store Imbruvica below 30°C. Keep capsules or tablets in their original container. Store in a cool, dry place away from moisture, heat, or sunlight. Do not store in the bathroom, near a sink, in the car, or on window sills. Keep out of reach of children.
Overdose Information
If you think you have taken too much Imbruvica, seek urgent medical attention immediately. Call the Poisons Information Centre (13 11 26 in Australia or 0800 POISON/0800 764 766 in New Zealand), contact your doctor, or go to the nearest hospital Emergency Department, even if you feel fine.
Frequently Asked Questions
Your doctor will monitor your progress with regular blood tests and check-ups. In the first few weeks of treatment, you may see an increase in white blood cells called lymphocytes, which is expected and may last for a few months. This doesn’t mean your cancer is getting worse.
The medication guide doesn’t specify food requirements, but you should avoid grapefruit and Seville oranges (including juice and supplements) as they can increase Imbruvica levels in your blood.
If you miss a dose and it’s more than 12 hours until your next scheduled dose, take the missed dose as soon as possible. If it’s almost time for your next dose, skip the missed dose. Never take a double dose.
You should tell your doctor if you drink alcohol. There is no specific information available about how alcohol affects Imbruvica, so discuss this with your healthcare provider.
Do not change your dose or stop taking Imbruvica until your doctor tells you to. Follow your doctor’s instructions and continue taking it until they advise you to stop.
Tell your doctor if you’re planning any surgery, as they may ask you to stop taking Imbruvica for a short time. Also inform them if you’ve recently had surgery, especially if it might affect how you absorb food or medicines.
Your doctor will check your heart function before and during treatment. They will also monitor your blood counts regularly and may perform liver function tests. Keep all your doctor’s appointments so your progress can be checked.
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.