Imbruvica (ibrutinib) Disease Interactions
There are 9 disease interactions with Imbruvica (ibrutinib):
- Atrial fibrillation
- Hepatic impairment
- Renal impairment
- Tumor lysis syndrome
- Lung toxicity
Ibrutinib (applies to Imbruvica) atrial fibrillation
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Arrhythmias
Atrial fibrillation and atrial flutter have occurred in patients treated with ibrutinib. The risk is increased in patients with cardiac risk factors, hypertension, acute infections, and a previous history of atrial fibrillation. It is recommended to monitor patients clinically for atrial fibrillation periodically and those patients who develop arrhythmic symptoms (e.g., palpitations, lightheadedness) or new onset dyspnea should have an ECG performed. Atrial fibrillation should be managed appropriately, and if it persists to consider the risks and benefits of ibrutinib treatment and follow dose modification according to clinical guidelines.
Ibrutinib (applies to Imbruvica) bleeding
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Bleeding Associated with Coagulation Defect
Cases of bleeding, including bruising, petechia, intracranial hemorrhage, including subdural hematoma; gastrointestinal bleeding, hematuria, post procedural hemorrhage, some leading to fatal bleeding events have been reported in patients treated with ibrutinib. Patients receiving antiplatelet or anticoagulant therapy may be at an increased risk of hemorrhage and these patients should be closely monitored for signs of bleeding. It is recommended to consider withholding ibrutinib for at least 3 to 7 days pre- and post-surgery depending upon the type of surgery and the risk of bleeding.
Ibrutinib (applies to Imbruvica) cytopenia
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts
Cytopenias including neutropenia, thrombocytopenia, and anemia have been reported with use of ibrutinib. Care should be taken with patients at risk, and it is recommended to monitor for complete blood counts monthly or as clinically appropriate.
Ibrutinib (applies to Imbruvica) hepatic impairment
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease
Ibrutinib is metabolized in the liver. In clinical trials, patients with hepatic impairment showed an increase in ibrutinib exposure following a single dose administration. It is recommended to monitor patients for signs of toxicity and follow dose modification as appropriate. The use of ibrutinib is not recommended in patients with moderate or severe hepatic impairment.
Ibrutinib (applies to Imbruvica) hypertension
Moderate Potential Hazard, Moderate plausibility.
The use of ibrutinib may cause hypertension. It is recommended to monitor for new onset hypertension or hypertension that is not adequately controlled after starting therapy and to adjust hypertensive medications and/or initiate antihypertensive treatment per clinical practices. Close monitoring of blood pressure is recommended.
Ibrutinib (applies to Imbruvica) infections
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral
Fatal and non-fatal infections, including cases of progressive multifocal leukoencephalopathy (PML) and Pneumocystis jirovecii pneumonia (PJP), have been reported with the use of ibrutinib. It is recommended to assess patients for fever and infections and treat appropriately.
Ibrutinib (applies to Imbruvica) renal impairment
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction
The use of ibrutinib in patients with mild to moderate renal impairment is not expected to influence on the exposure to ibrutinib. Caution and close monitoring is recommended in patients with severe renal impairment or patients on dialysis as there are no data available for these patients.
Ibrutinib (applies to Imbruvica) tumor lysis syndrome
Moderate Potential Hazard, Moderate plausibility.
Tumor lysis syndrome has been reported with ibrutinib therapy. It is recommended to assess the baseline risk (e.g., high tumor burden) and take appropriate precautions. Monitor patients closely and treat as appropriate.
Multikinase inhibitors (applies to Imbruvica) lung toxicity
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Interstitial Pneumonitis, Pulmonary Impairment
The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, permanently discontinue these agents and institute appropriate measures. Immediately withhold treatment in patients diagnosed with ILD/pneumonitis and permanently discontinue therapy if no other potential causes of ILD/pneumonitis have been identified.
Imbruvica (ibrutinib) drug interactions
There are 381 drug interactions with Imbruvica (ibrutinib)
Imbruvica (ibrutinib) alcohol/food interactions
There are 2 alcohol/food interactions with Imbruvica (ibrutinib)
More about Imbruvica (ibrutinib)
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- Drug class: BTK inhibitors
- FDA Approval History
Related treatment guides
Drug Interaction Classification
|Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.|
|No interaction information available.|
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