Imbruvica (Ibrutinib)

What is Imbruvica?

Imbruvica, developed by Pharmacyclics LLC and marketed by Janssen Biotech, is a targeted therapy known scientifically as ibrutinib. It belongs to a class of medications called Bruton's tyrosine kinase (BTK) inhibitors. BTK is a protein crucial for the survival and multiplication of cancerous B-cells, which are a type of white blood cell involved in immune responses. By blocking BTK, Imbruvica helps in interrupting the signaling pathways that promote cancer cell growth and survival.

How to use Imbruvica?

Prescription and Consultation:

Imbruvica is a prescription medication used for specific types of cancers like chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), and others. It’s crucial to obtain Imbruvica from a healthcare provider who will assess your medical history, current health status, and any other medications you are taking to ensure compatibility and safety.

Dosage and Administration:

• Dosage: Imbruvica is typically taken once daily, with or without food. Dosage is mentioned in the later part of the content. (See Dosages Section).
• Swallow Whole: Imbruvica capsules should be swallowed whole with a glass of water. They should not be chewed, crushed, or opened.
• Consistency: Take Imbruvica at the same time each day to maintain consistent levels of the medication in your bloodstream. It helps in better optimization of the medicine.

Monitoring and Follow-up:

• Regular Check-ups: Your healthcare provider will monitor your response to Imbruvica and assess for any potential side effects or complications. Regular check-ups and blood tests may be scheduled to monitor your condition and adjust treatment as necessary.

Managing Side Effects:

• Common Side Effects: Imbruvica may cause side effects such as diarrhea, nausea, fatigue, muscle spasms, and others. Inform your healthcare provider about any side effects you experience, as they can often provide strategies to manage them.
• Bleeding Risk: Due to its mechanism of action, Imbruvica may increase the risk of bleeding. Avoid activities that could increase the risk of injury, and inform healthcare providers if you have a history of bleeding disorders or are taking anticoagulant medications.

Lifestyle Considerations:

• Diet and Hydration: Maintain a healthy diet and stay hydrated while taking Imbruvica. Adequate hydration can help manage potential side effects like diarrhea.
• Sun Protection: Imbruvica may increase sensitivity to sunlight, so use sunscreen and protective clothing when outdoors.

What is Imbruvica Used for?

• Chronic Lymphocytic Leukemia (CLL): Imbruvica is used as a first-line treatment in combination with other medications or as a single agent in patients who have received at least one prior therapy.
• Mantle Cell Lymphoma (MCL): Imbruvica is approved for the treatment of MCL in adult patients who have received at least one prior therapy. It has also been approved for newly diagnosed MCL.
• Waldenström’s Macroglobulinemia: Imbruvica is indicated for the treatment of Waldenström’s Macroglobulinemia in patients who have received at least one prior therapy.
• Marginal Zone Lymphoma: Imbruvica is approved for the treatment of marginal zone lymphoma in patients who require systemic therapy and have received at least one prior anti-CD20-based therapy.

Side Effects of Imbruvica:

• Diarrhea
• Nausea and Vomiting
• Fatigue
• Muscle and Joint Pain
• Bruising and Bleeding
• Infections
• Rash
• Bleeding
• Cardiovascular Effects

Safety/Warnings:

• Bleeding Risk: Imbruvica can increase the risk of bleeding, including serious bleeding events such as gastrointestinal bleeding and intracranial hemorrhage. Patients taking Imbruvica should avoid activities that may increase the risk of injury, and those on anticoagulant therapy should be monitored closely.
• Infections: Imbruvica may impair immune function, leading to an increased susceptibility to infections. Patients should promptly report any signs of infection, such as fever, chills, or persistent sore throat, to their healthcare provider.
• Cardiovascular Effects: Imbruvica has been associated with hypertension (high blood pressure) and atrial fibrillation (irregular heartbeat). Blood pressure should be monitored regularly during treatment, and patients should notify their healthcare provider of any new or worsening symptoms of heart palpitations or shortness of breath.
• Second Primary Malignancies: There have been reports of other cancers developing in patients treated with Imbruvica. Healthcare providers should carefully weigh the risks and benefits of Imbruvica therapy, particularly in patients with a history of other cancers.
• Liver Toxicity: Imbruvica can affect liver function, causing elevated liver enzymes. Regular monitoring of liver function tests is typically recommended, and patients should notify their healthcare provider of any signs of liver problems, such as yellowing of the skin or eyes (jaundice) or abdominal pain.
• Pregnancy and Breastfeeding: Imbruvica may cause harm to an unborn baby and should not be used during pregnancy unless the potential benefits outweigh the risks. Women of childbearing potential should use effective contraception during treatment and for a period after discontinuing Imbruvica. Breastfeeding while taking Imbruvica is not recommended.

Drug Interactions:

• Anticoagulants (e.g., Warfarin): Imbruvica may increase the risk of bleeding when used concomitantly with anticoagulant medications. Close monitoring of blood clotting parameters is essential, and dose adjustments of anticoagulants may be necessary.
• Antiplatelet Agents (e.g., Aspirin, Clopidogrel): Imbruvica can also increase the risk of bleeding when used with antiplatelet agents. Healthcare providers should carefully assess the need for concomitant use and monitor patients for signs of bleeding.
• Strong CYP3A4 Inhibitors (e.g. Ketoconazole, Clarithromycin): CYP3A4 inhibitors can increase the exposure to Imbruvica, potentially leading to an increased risk of adverse effects. Dose adjustments of Imbruvica may be necessary when used concomitantly with strong CYP3A4 inhibitors.
• Strong CYP3A4 Inducers (e.g., Rifampin, St. John's Wort): CYP3A4 inducers may decrease the exposure to Imbruvica, potentially reducing its efficacy. Concomitant use should be avoided if possible, or alternative therapies considered.
• Gastric Acid Reducing Agents (e.g. Proton Pump Inhibitors): Proton pump inhibitors (PPIs) may reduce the absorption of Imbruvica. Consider separating the administration of PPIs and Imbruvica by several hours to minimize this interaction.

Dosages:

For chronic lymphocytic leukemia (CLL), the standard dosage is typically 420 mg once daily, whether it's used as first-line therapy or for relapsed/refractory cases.

In mantle cell lymphoma (MCL), both previously treated and newly diagnosed patients are often prescribed 560 mg once daily.

For Waldenström’s macroglobulinemia, marginal zone lymphoma, and chronic graft versus host disease (cGVHD), the recommended dosage is generally 420 mg once daily.

Storage:

• Room Temperature: Imbruvica capsules should be stored at room temperature between 20°C to 25°C (68°F to 77°F).
• Protect from Light: Keep Imbruvica capsules in their original packaging to protect them from light. No Direct light contact should be promoted.
• Dry Place: Store Imbruvica in a dry place away from moisture and humidity.
• Keep Out of Reach of Children: Store Imbruvica in a location where it is inaccessible to children and pets.

What is the cost of Imbruvica?

The cost of Imbruvica (ibrutinib) can vary widely depending on several factors, including the dosage prescribed, the duration of treatment, the patient's location, and their insurance coverage. Imbruvica oral capsule 140 mg, depending on the drugstore you visit, will set you back about $18,503 for a supply of 90 capsules. Without insurance or adequate coverage, the out-of-pocket costs for patients can be prohibitive, which leads to missed doses or dose absenteeism.

Is it safe to buy Imbruvica from an Online Pharmacy?

Buying medications like Imbruvica (ibrutinib) from online pharmacies can be risky. Here are some factors to consider:

• Authenticity and Quality: Online pharmacies vary widely in terms of legitimacy. Some may sell counterfeit or substandard medications that could be harmful or ineffective. It's crucial to ensure that the online pharmacy is reputable and licensed.
• Prescription Requirement: Imbruvica is a prescription medication for treating certain cancers. Legitimate online pharmacies will require a valid prescription from a healthcare provider before dispensing the medication. If they don't ask for a prescription, it could indicate they are operating illegally.
• Personal and Financial Information: Providing personal and financial information to an illegitimate online pharmacy can lead to identity theft or fraudulent charges.
• Health Risks: Using counterfeit or substandard medications can pose serious health risks, especially for medications like Imbruvica that are critical for treating cancer.

FAQs:

Why is Imbruvica Medication Prescribed?

Imbruvica (ibrutinib) is prescribed primarily for its effectiveness in treating various types of blood cancers and conditions related to the immune system. It is particularly beneficial in the treatment of chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), and Waldenström's macroglobulinemia. Imbruvica works by blocking specific proteins in cancer cells that promote their growth and survival.

How Should Imbruvica Be Used?

Imbruvica (ibrutinib) should be used strictly according to the prescription and guidance of a healthcare provider experienced in the treatment of cancers. It is typically taken orally, usually once daily with water and at approximately the same time each day.

What Should I Do if I Forget a Dose of Imbruvica?

If you forget to take a dose of Imbruvica (ibrutinib), it's essential to handle the situation carefully. If you realize you missed a dose within 12 hours of the scheduled time, take the missed dose as soon as you remember.

How long does it take for Imbruvica to work?

The time it takes for Imbruvica (ibrutinib) to work can vary depending on the specific type of cancer being treated and individual patient factors. In some cases, patients may start to notice improvements in their symptoms within a few weeks of starting treatment. However, the full therapeutic benefits of Imbruvica may take several months to become apparent as the medication works to inhibit the growth and spread of cancer cells.

When should I stop Imbruvica?

Deciding when to stop Imbruvica (ibrutinib) should always be guided by your healthcare provider, who will consider several factors including your response to treatment, any side effects experienced, and the overall progression of your condition. Your doctor may recommend discontinuing Imbruvica if your cancer responds well to the treatment, with no signs of progression, and if you are experiencing manageable side effects. However, abruptly stopping Imbruvica without medical guidance can be dangerous.

References:

• https://www.imbruvica.com/
• https://www.ema.europa.eu/en/medicines/human/EPAR/imbruvica
• https://www.drugs.com/price-guide/imbruvica