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idelalisib (Oral route)

eye-del-a-LIS-ib

Oral route(Tablet)

Serious hepatotoxicity, including fatalities, has been reported in 14% of patients administered idelalisib. Serious and severe diarrhea and colitis, including fatalities, has also been reported in 14% of idelalisib patients. Monitor hepatic function before and during treatment and monitor for the development of diarrhea or colitis. Pneumonitis or intestinal perforation, which may be serious or fatal, can occur. Monitor for pulmonary symptoms and bilateral interstitial infiltrates. Interrupt, reduce dose, or discontinue treatment with idelalisib as recommended. Discontinue use if intestinal perforation occurs .

Commonly used brand name(s)

In the U.S.

  • Zydelig

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antineoplastic Agent

Uses For idelalisib

Idelalisib is used in combination with rituximab to treat chronic lymphocytic leukemia (CLL). idelalisib is also used to treat follicular B-cell non-Hodgkin lymphoma (FL) and small lymphocytic lymphoma (SLL) in patients who have received at least two previous treatments. Idelalisib interferes with the growth of cancer cells, which are eventually destroyed by the body. It is an antineoplastic agent (cancer medicine).

idelalisib is available only with your doctor's prescription.

Before Using idelalisib

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For idelalisib, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to idelalisib or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of idelalisib in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of idelalisib in the elderly. However, elderly patients are more likely to have unwanted effects, which may require caution in patients receiving idelalisib.

Pregnancy

Pregnancy Category Explanation
All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking idelalisib, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using idelalisib with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Alfuzosin
  • Colchicine
  • Dihydroergotamine
  • Dronedarone
  • Eliglustat
  • Eplerenone
  • Isavuconazonium Sulfate
  • Ivabradine
  • Lomitapide
  • Lovastatin
  • Lurasidone
  • Maraviroc
  • Naloxegol
  • Ranolazine
  • Silodosin
  • Simvastatin
  • Tolvaptan
  • Triazolam

Using idelalisib with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Ado-Trastuzumab Emtansine
  • Alfentanil
  • Alprazolam
  • Amiodarone
  • Amlodipine
  • Amprenavir
  • Apixaban
  • Aprepitant
  • Aripiprazole
  • Artemether
  • Astemizole
  • Atazanavir
  • Atorvastatin
  • Bedaquiline
  • Boceprevir
  • Bosutinib
  • Brentuximab Vedotin
  • Brinzolamide
  • Bromocriptine
  • Budesonide
  • Buprenorphine
  • Buspirone
  • Cabazitaxel
  • Cabozantinib
  • Carbamazepine
  • Ceritinib
  • Cilostazol
  • Cisapride
  • Citalopram
  • Clarithromycin
  • Clonazepam
  • Clozapine
  • Cobicistat
  • Conivaptan
  • Crizotinib
  • Cyclosporine
  • Dabrafenib
  • Daclatasvir
  • Darifenacin
  • Darunavir
  • Dasatinib
  • Delamanid
  • Delavirdine
  • Dexamethasone
  • Diltiazem
  • Docetaxel
  • Domperidone
  • Donepezil
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Dutasteride
  • Efavirenz
  • Eletriptan
  • Elvitegravir
  • Enzalutamide
  • Ergotamine
  • Erlotinib
  • Erythromycin
  • Eslicarbazepine Acetate
  • Estradiol
  • Eszopiclone
  • Ethinyl Estradiol
  • Everolimus
  • Exemestane
  • Felodipine
  • Fentanyl
  • Fluticasone
  • Fosamprenavir
  • Fosaprepitant
  • Fosphenytoin
  • Halofantrine
  • Haloperidol
  • Hydrocodone
  • Ifosfamide
  • Iloperidone
  • Imatinib
  • Indinavir
  • Irinotecan
  • Isradipine
  • Itraconazole
  • Ivacaftor
  • Ketoconazole
  • Lapatinib
  • Letrozole
  • Levomilnacipran
  • Levonorgestrel
  • Lopinavir
  • Losartan
  • Lumefantrine
  • Macitentan
  • Medroxyprogesterone
  • Mefloquine
  • Methadone
  • Midazolam
  • Mifepristone
  • Mitotane
  • Nateglinide
  • Nefazodone
  • Nelfinavir
  • Nifedipine
  • Nilotinib
  • Nimodipine
  • Nisoldipine
  • Olaparib
  • Ondansetron
  • Ospemifene
  • Oxycodone
  • Paclitaxel
  • Palbociclib
  • Panobinostat
  • Paritaprevir
  • Pazopanib
  • Perampanel
  • Phenobarbital
  • Phenytoin
  • Pimozide
  • Pomalidomide
  • Ponatinib
  • Posaconazole
  • Prednisolone
  • Prednisone
  • Primidone
  • Propafenone
  • Quetiapine
  • Quinidine
  • Quinine
  • Regorafenib
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rilpivirine
  • Riociguat
  • Ritonavir
  • Roflumilast
  • Romidepsin
  • Ruxolitinib
  • Salmeterol
  • Saquinavir
  • Saxagliptin
  • Sildenafil
  • Simeprevir
  • Sirolimus
  • Solifenacin
  • Sorafenib
  • St John's Wort
  • Sunitinib
  • Suvorexant
  • Tacrolimus
  • Tamoxifen
  • Tamsulosin
  • Telaprevir
  • Telithromycin
  • Temsirolimus
  • Terfenadine
  • Theophylline
  • Ticagrelor
  • Tipranavir
  • Tofacitinib
  • Toremifene
  • Trabectedin
  • Tramadol
  • Trazodone
  • Triamcinolone
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Verapamil
  • Vilanterol
  • Vilazodone
  • Vincristine
  • Vinflunine
  • Vorapaxar
  • Voriconazole
  • Zaleplon
  • Zileuton
  • Ziprasidone
  • Zolpidem

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of idelalisib. Make sure you tell your doctor if you have any other medical problems, especially:

  • Diarrhea or
  • Lung or breathing problems (eg, pneumonitis) or
  • Neutropenia (low number of white blood cells) or
  • Stomach or bowel problems (eg, perforation)—Use with caution. May make these conditions worse.
  • Infection—May decrease your body's ability to fight infection.
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of idelalisib

Medicines used to treat cancer are very strong and can have many side effects. Before receiving idelalisib, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.

Take idelalisib exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

idelalisib comes with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Swallow the tablet whole. Do not crush, break, or chew it. You may take idelalisib with or without food.

Dosing

The dose of idelalisib will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of idelalisib. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For chronic lymphocytic leukemia, follicular B-cell non-Hodgkin lymphoma, and small lymphocytic lymphoma:
      • Adults—At first, 150 milligrams (mg) two times a day. Your doctor may adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of idelalisib, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss a dose of idelalisib, you may still take it up to 6 hours after the time you normally take it. However, if it is more than 6 hours, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using idelalisib

It is very important that your doctor check your progress at regular visits while you are using idelalisib. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to use it. Blood tests may be needed to check for unwanted effects.

Using idelalisib while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant while you are using idelalisib and for at least 1 month after stopping it. If you think you have become pregnant, tell your doctor right away.

Idelalisib may cause diarrhea, and in some cases it can be severe. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

Check with your doctor right away if you have chest pain, cough, shortness of breath, or trouble breathing while using idelalisib. Also, tell your doctor immediately if you have an abdominal or stomach pain, chills, fever, nausea, or vomiting.

Serious skin reactions can occur with idelalisib. Check with your doctor right away if you have blistering, peeling, or loose skin, red skin lesions, severe acne or skin rash, or sores or ulcers on the skin while you are using idelalisib.

idelalisib may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using idelalisib.

Check with your doctor if you notice any signs of fever, chills, or sore throat. These could be symptoms of an infection resulting from low white blood cell counts.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

idelalisib Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Abdominal or stomach pain or tenderness
  • black, tarry stools
  • body aches or pain
  • chills
  • clay colored stools
  • confusion
  • cough
  • cough producing mucus
  • dark urine
  • decreased appetite
  • difficulty with breathing
  • dizziness
  • ear congestion
  • fainting
  • fast heartbeat
  • fever
  • headache
  • itching or skin rash
  • lightheadedness
  • loss of appetite
  • loss of voice
  • lower back or side pain
  • nausea and vomiting
  • pain
  • pain or tenderness around the eyes and cheekbones
  • painful or difficult urination
  • pale skin
  • rapid, shallow breathing
  • sneezing
  • sore throat
  • stomach cramps
  • stuffy or runny nose
  • swelling of the feet or lower legs
  • tightness in the chest
  • troubled breathing
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • watery or bloody diarrhea
  • yellow eyes or skin
Less common
  • Bladder pain
  • bloody or cloudy urine
  • difficult, burning, or painful urination
  • frequent urge to urinate
  • lower back or side pain
Incidence not known
  • Blistering, peeling, or loosening of the skin
  • chest pain
  • cracks in the skin
  • difficulty with swallowing
  • general feeling of discomfort or illness
  • heartburn
  • hives
  • indigestion
  • joint or muscle pain
  • loss of heat from the body
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • red, swollen skin
  • scaly skin
  • severe abdominal or stomach pain, cramping, or burning
  • thickening of bronchial secretions
  • vomiting of material that looks like coffee grounds, severe and continuing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • decreased appetite
  • difficulty with moving
  • muscle pain or stiffness
  • night sweats
  • pain in the joints
  • rapid weight gain
  • tingling of the hands or feet
  • trouble sleeping
  • unusual weight gain or loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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