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How long can you stay on Imbruvica (ibrutinib)?

Medically reviewed by Carmen Pope, BPharm. Last updated on Sep 19, 2023.

Official answer

by Drugs.com
  • Imbruvica is usually given until disease progression or unacceptable toxicity occurs, or in the case of graft vs host disease, recurrence of an underlying malignancy.
  • The average duration of Imbruvica therapy in CLL clinical trials has been around 41 months (range, 2–51 months).

Imbruvica (ibrutinib) is usually continued indefinitely if it is being well tolerated, there is limited disease progression, and toxicity has not occurred.

In some people, very good partial clinical responses may occur within three to six months.

However, most people are kept on Imbruvica indefinitely regardless of clinical response. This is a common treatment strategy for people with certain types of leukemia and solid tumors because often when the treatment agent is stopped, symptoms can reappear and lymph nodes enlarge within a relatively short period, particularly if patients have not been taking Imbruvica for very long or if they have tried many other previous treatments.

The average duration of Imbruvica therapy in clinical trials has been around 41 months (range, 2–51 months). In people who have stopped Imbruvica, the average survival after treatment discontinuation was 8 months.

What is the dosage of Imbruvica?

The recommended starting dose for Imbruvica varies depending on the condition being treated, but examples include:

  • Waldenstrom's macroglobulinemia: 420mg once daily
  • Chronic lymphocytic leukemia (CLL): 420mg once daily
  • Small lymphocytic lymphoma: 420mg once daily
  • Chronic graft-versus-host disease: 420mg once daily.

Dosages may need reducing if toxicities occur. Imbruvica is usually given until disease progression or unacceptable toxicity occurs, or in the case of graft vs host disease, recurrence of an underlying malignancy.

What are the most common side effects with Imbruvica?

The most common side effects reported with Imbruvica include:

  • Back pain
  • Bruising
  • Chest pain, atrial fibrillation, atrial flutter
  • Diarrhea
  • Heartburn
  • High blood pressure
  • Infection
  • Lowered blood counts
  • Muscle aches
  • Tiredness
  • Blood in the urine.

These are typically noted more at the beginning of therapy, but for most people, they resolve quickly with time and are often non-existent within 2-3 months. Older people are more at risk of side effects including bruising. In general, Imbruvica is usually well tolerated.

What is Imbruvica?

Imbruvica is a targeted medicine that works by inhibiting the enzyme Bruton tyrosine kinase (BTK), which is part of a crucial signaling pathway in certain cancers, especially B-cell leukemias and lymphomas.

By blocking this pathway Imbruvica triggers the death of cancer cells. Imbruvica may be used in the treatment of

  • Waldenstrom's macroglobulinemia
  • Chronic lymphocytic leukemia
  • Small lymphocytic lymphoma.

Imbruvica may also be used to treat chronic graft-versus-host disease.

References
  • Imbruvica (ibrutinib) capsules [Package Insert] Pharmacyclics LLC, an AbbVie Company and Janssen Biotech, Inc https://www.drugs.com/pro/imbruvica.html
  • You and I support program. Pharmacyclics LLC, an AbbVie Company and Janssen Biotech, Inc https://youandisupport.com/
  • Preetesh J, Keating M, Wierda w, et al. Long-term Follow-up of Treatment with Ibrutinib and Rituximab in Patients with High-Risk Chronic Lymphocytic Leukemia. Clinical Cancer Research. October 19, 2016; DOI: 10.1158/1078-0432.CCR-16-1948

Read next

How much does Imbruvica cost?

According to the Drugs.com price guide which bases its price on the Drugs.com discount card which is accepted at most U.S. pharmacies, the cost for Imbruvica 420mg tablet is around $616 per tablet or $17 269 for a supply of 28 tablets depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans. Continue reading

Can ibrutinib be stopped safely?

Stopping ibrutinib can result in a disease flare-up in patients with chronic lymphocytic leukemia (CLL). A 2020 study in The Oncologist found that approximately 25% of ibrutinib patients with a median interruption period of 8 days experienced a flare or rapid CLL progression. Continue reading

Acalabrutinib vs. ibrutinib: How do they compare?

A 2021 phase III study in the Journal of Clinical Oncology found that while both medications have similar efficacy, acalabrutinib was better tolerated with fewer side effects. Continue reading

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