8 mins read

Overview: Imbruvica is a medicine used to treat chronic lymphocytic leukemia or small lymphocytic lymphoma, Waldenstrom’s macroglobulinemia, and chronic graft versus host disease. Common side effects of Imbruvica include diarrhea, feeling tired, joint or muscle pain or spasms, bruising, rash, fever, mouth sores, headache, or nausea. Serious side effects can include bleeding, infections, heart problems, increased blood pressure, and liver problems. Imbruvica comes in a tablet, capsule, or liquid that you take by mouth.

Uses

What is Imbruvica used for?

Imbruvica (ibrutinib) is commonly used to treat the following conditions. 

Learn more about How Imbruvica Works to Treat Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma.

Imbruvica may also be used for other conditions as determined by your healthcare provider.

How does Imbruvica work (mechanism of action)?

Imbruvica is a type of medicine called a tyrosine kinase inhibitor. It inhibits Bruton’s tyrosine kinase (BTK) on B cells, which are a type of white blood cell. When Imbruvica inhibits BTK, it stops cancer cells from growing and causes them to die. It also stops B cells from being activated and growing, which can help treat cGvHD.  

How is Imbruvica supplied (dosage forms)?

Brands and other names

  • Imbruvica 

Dosage forms and strengths

  • 70 mg and 140 mg oral capsules
  • 140 mg, 280 mg, and 420 mg oral tablets
  • 70 mg/mL oral suspension

How should I store Imbruvica?

Oral Capsule and Tablet. Imbruvica capsules or tablets should be stored in their original container at room temperature, between 68 F to 77 F (20 C to 25 C). They may be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time. Do not remove the tablets from their blister packs until you are ready to take them.

Oral Liquid. Imbruvica oral liquid should be kept in the refrigerator or at room temperature, between 36 F to 77 F (2 C to 25 C), in its original container. Avoid freezing. Do not use it if the seal is broken or missing. You should throw away any liquid that is not used after 60 days of opening the bottle.  

Side Effects

What are the most common side effects of Imbruvica?

The most common side effects of Imbruvica are listed below. These side effects may vary depending on the condition that is being treated. Tell your healthcare provider if you have any of these side effects that bother you.

  • Blood disorders (see below)
  • Diarrhea
  • Feeling tired
  • Muscle, bone, joint, or stomach pain
  • Bruising
  • Rash
  • Nausea
  • Fever
  • Muscle spasms
  • Mouth sores (stomatitis)
  • Bleeding
  • Headache
  • Infection in the lungs (pneumonia)

There may be other side effects of Imbruvica that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Imbruvica?

While less common, the most serious side effects of Imbruvica are described below, along with what to do if they happen.

Severe Allergic Reactions. Imbruvica may cause allergic reactions, which can be serious. Stop taking Imbruvica and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Severe Bleeding. Imbruvica can increase your risk of severe bleeding that can lead to death. Some people with serious bleeding may need a blood transfusion or surgery. Call your healthcare provider right away if you have any of the following signs of severe bleeding while taking Imbruvica.

  • Pink, red, or brown urine (pee)
  • Vomit with blood that looks like coffee grounds
  • Red or black stools (looks like tar)
  • Coughing up blood or blood clots 

Serious Infections. Serious infections that can lead to death can happen while you are taking Imbruvica. Keep all appointments to have your blood work checked. Call your healthcare provider right away if you have any of the following symptoms of an infection.

  • Fever or chills
  • Feeling weak
  • Cough
  • Shortness of breath
  • Sore throat

Heart Problems. Imbruvica may cause heart problems, such as heart failure and serious heart rhythm problems, that can lead to death. People who already have a heart problem may be at higher risk. Get emergency help if you have any of the following symptoms of heart problems.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Dizziness or feeling faint or lightheaded
  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs

Increased Blood Pressure (Hypertension). Imbruvica may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your healthcare provider if your blood pressure increases while taking this medicine. If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your healthcare provider right away if you have any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea or vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Blood Disorders. Imbruvica can cause blood disorders, such as low platelet levels (thrombocytopenia), low red blood cell levels (anemia), and low white blood cell levels (neutropenia). Keep all appointments with your healthcare provider, including for blood work, to check for these problems. Stop taking Imbruvica and get help right away if you have any of the following symptoms.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Cancer. New cancers can happen during your treatment with Imbruvica. These may happen on your skin or other organs. Tell your healthcare provider about any new symptoms that you may get. 

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking Imbruvica. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Tumor Lysis Syndrome. Imbruvica can cause a fast breakdown of cancer cells. This can lead to a condition called tumor lysis syndrome, which can be serious. It is important to drink plenty of water while taking Imbruvica and to keep all appointments for blood work so your healthcare provider can see how your body is responding. Tell your healthcare provider right away if you have any of the following signs of tumor lysis syndrome while taking Imbruvica.

  • Nausea and vomiting
  • Weakness
  • Swelling or fluid retention
  • Shortness of breath
  • Muscle cramps
  • Seizures

Warnings & Precautions

Who should not use Imbruvica?

Allergies to Ingredients. People who are allergic to any of the following should not take Imbruvica.

  • Imbruvica
  • Ibrutinib
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Imbruvica.

What should I know about Imbruvica before using it?

Do not take Imbruvica unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share Imbruvica with other people, even if they have the same condition as you. It may harm them.

Keep Imbruvica out of the reach of children. If you keep Imbruvica oral liquid in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.

If you are prescribed Imbruvica capsules or tablets, take the capsule or tablet whole with a glass of water. Do not open, break, or chew Imbruvica capsules. Do not chew, crush, or cut Imbruvica tablets.

If you are prescribed Imbruvica oral liquid, only use the syringes that come with the medicine to measure your dose. Shake the bottle well before each dose. 

Be sure to stay hydrated when you are taking Imbruvica by drinking plenty of fluids, especially if you have diarrhea. 

What should I tell my healthcare provider before using Imbruvica?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Imbruvica is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Bleeding problems
  • Heart rhythm problems, high blood pressure, high cholesterol, diabetes, or if you smoke
  • Liver problems

Surgery. Tell your healthcare provider if you have had or plan to have surgery or a procedure. Your risk of bleeding may be increased with Imbruvica. Your healthcare provider may want to temporarily stop Imbruvica before and after your surgery, depending on your risk of bleeding. See the Serious Side Effects section for more details.

Infection. Tell your healthcare provider if you currently have an infection. Your risk of infection may be increased with Imbruvica. See the Serious Side Effects section for more details.

Other Medicines and Supplements. Imbruvica may interact with other medicines and supplements. Before taking Imbruvica, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Imbruvica may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. You should not be pregnant before starting Talvey. If you become pregnant, stop taking Imbruvica right away and contact your healthcare provider. If you can become pregnant, you should use effective birth control while taking Imbruvica and for at least one month after your last dose. If you can get a partner pregnant, you should use effective birth control (such as condoms) while taking Imbruvica and for one month after your last dose.

Breastfeeding. It is not known if Imbruvica passes into breast milk. Do not breastfeed while taking Imbruvica and for one week after your last dose. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. 

How can I get more information about Imbruvica?

For more information about Imbruvica, you can visit the manufacturer’s website at www.imbruvica.com or call them at 888-968-7743.

Interactions

Does Imbruvica interact with foods or drinks?

You should not eat grapefruit or Seville oranges, or drink grapefruit juice, while you are taking Imbruvica. These foods or drinks can increase the levels of Imbruvica in your body, which may raise the risk of side effects.

It is unknown if drinking alcohol will affect Imbruvica.

Does Imbruvica interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC)

medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking Imbruvica.

  • A blood thinner, which is a medicine used to treat or prevent blood clots
  • An medicine used to treat or prevent fungal infections, such as ketoconazole, posaconazole (Noxafil), or voriconazole (Vfend)
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis

Some other medicines may alter the blood levels of Imbruvica. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Imbruvica. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Imbruvica?

If you or someone else has used too much Imbruvica, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Imbruvica?

If you miss a dose, take it as soon as you remember on the same day. Go back to your usual dosing schedule on the next day. Do not take double or extra doses.

Look up another drug