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Imbruvica

Generic Name: ibrutinib (eye BROO ti nib)
Brand Names: Imbruvica

Medically reviewed on May 7, 2018

What is Imbruvica?

Imbruvica (ibrutinib) is a cancer medicine that interferes with the growth and spread of cancer cells in the body.

Imbruvica is used to treat certain types of non-Hodgkin lymphoma, including mantle cell lymphoma (MCL), Waldenstrom's macroglobulinemia, and chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) in people with or without 17p deletion.

Imbruvica is also used to treat marginal cell lymphoma and chronic graft-versus-host disease. It is sometimes given when other medicines have not been effective.

Imbruvica was approved to treat mantle cell and marginal lymphomas by the US Food and Drug Administration (FDA) on an "accelerated" basis. In clinical studies, some people responded to this medicine, but further studies are needed.

Important information

Imbruvica can make it easier for you to bleed. Contact your doctor or seek emergency medical attention if you have easy bruising, unusual bleeding, or any bleeding that will not stop. You may also have bleeding on the inside of your body, such as in your stomach or intestines, or in your brain.

Call your doctor at once if you have signs of bleeding inside your body, such as: dizziness, weakness, confusion, headache, speech problems, black or bloody stools, pink or brown urine, or coughing up blood or vomit that looks like coffee grounds.

Before taking this medicine

You should not use Imbruvica if you are allergic to ibrutinib.

To make sure Imbruvica is safe for you, tell your doctor if you have ever had:

  • liver or kidney disease;

  • an active infection;

  • a bleeding or blood clotting disorder;

  • a heart rhythm disorder;

  • risk factors for heart disease (such as diabetes, smoking, being overweight, having high blood pressure or high cholesterol)

  • surgery; or

  • a condition for which you take a blood thinner (warfarin, Coumadin, Jantoven).

Using Imbruvica may increase your risk of developing other types of cancer, such as skin cancer. Ask your doctor about your specific risk.

Ibrutinib can harm an unborn baby. Both men and women using this medicine should use birth control to prevent pregnancy. The use of this medicine by either parent may cause harm to the baby.

Keep using birth control for at least 1 month after your last dose of Imbruvica. Tell your doctor right away if a pregnancy occurs while either the mother or the father is using this medicine.

It is not known whether ibrutinib passes into breast milk. It may not be safe to breast-feed a baby while you are using this medicine. Ask your doctor about any risks.

How should I take Imbruvica?

Take Imbruvica exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take this medicine with a full glass of water. Drink plenty of liquids while you are taking Imbruvica.

Imbruvica is usually taken once per day until your body no longer responds to the medication. Take the medicine at the same time each day.

Do not open, break, or chew the Imbruvica capsules. Do not cut, crush, or chew the Imbruvica tablets. Swallow both tablets and capsules whole.

If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using Imbruvica. You may need to stop using the medicine for a short time.

Call your doctor if you have severe or ongoing diarrhea. You can easily become dehydrated while taking Imbruvica.

You may need frequent medical tests to be sure this medicine is not causing harmful effects. Your cancer treatments may be delayed based on the results of these tests.

Store in the original package at room temperature, away from moisture and heat.

Imbruvica dosing information

Usual Adult Dose for Lymphoma:

Initial dose: 560 mg orally once a day

Comment: Dose modifications may be necessary for adverse reactions.

Use: For the treatment of patients with mantle cell lymphoma (MCL) who have received at least one prior therapy.

Usual Adult Dose for Chronic Lymphocytic Leukemia:

Initial dose: 420 mg orally once a day

Comment: Dose modifications may be necessary for adverse reactions.

Use: The treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy or CLL with 17p deletion.

Usual Adult Dose for non-Hodgkin's Lymphoma:

Initial dose: 420 mg orally once a day

Comment: Dose adjustments of this drug are not required for patients undergoing plasmapheresis; dose modifications may be necessary for adverse reactions.

Use: The treatment of patients with Waldenstrom's macroglobulinemia.

What happens if I miss a dose?

Take the missed dose on the same day you remember it. Take your next dose at the regular time and stay on your once-daily schedule. Do not take extra medicine to make up the missed dose.

Do not take 2 doses on the same day.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Imbruvica?

Grapefruit and Seville oranges may interact with ibrutinib and lead to unwanted side effects. Avoid the use of grapefruit products and orange marmalades while taking Imbruvica.

Imbruvica side effects

Get emergency medical help if you have signs of an allergic reaction to Imbruvica: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using Imbruvica and call your doctor at once if you have:

  • severe or ongoing diarrhea;

  • chest pain, pounding heartbeats or fluttering in your chest, feeling like you might pass out;

  • pale skin, easy bruising, purple or red pinpoint spots under your skin;

  • little or no urinating, swelling in your feet or ankles;

  • signs of infection - fever, chills, weakness, mouth sores, skin sores, cough with mucus, wheezing, trouble breathing;

  • signs of tumor cell breakdown - confusion, weakness, muscle cramps, nausea, vomiting, fast or slow heart rate, decreased urination, tingling in your hands and feet or around your mouth; or

  • signs of bleeding inside your body - dizziness, weakness, confusion, problems with speech, prolonged headache, black or bloody stools, pink or brown urine, or coughing up blood or vomit that looks like coffee grounds.

Common Imbruvica side effects may include:

  • diarrhea, nausea;

  • fever, cough, trouble breathing;

  • blisters or ulcers in your mouth;

  • feeling tired;

  • bruising, rash; or

  • muscle pain, bone pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Imbruvica?

Other drugs may interact with ibrutinib, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Imbruvica only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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