Indications
Acalabrutinib is a targeted cancer medicine used to treat certain blood cancers in adults, including chronic lymphocytic leukaemia (CLL) and small lymphocytic lymphoma (SLL), and mantle cell lymphoma (MCL), either on its own or together with other cancer medicines. It is prescribed and monitored by a cancer specialist (oncologist or haematologist).
How It Works
Acalabrutinib blocks an enzyme called Bruton’s tyrosine kinase (BTK). Cancerous B-cells (a type of white blood cell) depend on BTK signals to survive and multiply. By switching off this signal, Acalabrutinib slows the growth of the cancer cells and helps them die off.
Dosage and Administration
Take exactly as prescribed by your specialist. It is usually taken by mouth twice a day, about 12 hours apart, with or without food. Swallow the capsule or tablet whole with water: do not open, crush or chew it. If you miss a dose by more than 3 hours, skip it and take the next dose at the usual time. Do not stop treatment without speaking to your doctor.
Interactions
- Strong CYP3A blockers such as Ketoconazole, Itraconazole, Clarithromycin and some HIV medicines can raise Acalabrutinib levels: these are usually avoided.
- Strong CYP3A inducers such as Rifampicin, Carbamazepine, Phenytoin and St John’s Wort can lower its effect.
- Acid-reducing medicines can reduce absorption of the capsule form: avoid proton pump inhibitors such as Omeprazole with capsules, and take H2 blockers such as Famotidine 2 hours after Acalabrutinib.
- Blood thinners such as Warfarin, Apixaban or Aspirin increase the risk of bleeding.
- Tell your doctor about all medicines, supplements and herbal products.
Contraindications
- Allergy to Acalabrutinib or any ingredient.
- Severe liver impairment (generally not recommended).
Side Effects
Common side effects include headache (often in the first weeks), diarrhoea, tiredness, muscle and joint pain, bruising, cough and upper respiratory infections. Blood tests may show low white cells, red cells or platelets. Less common but serious effects include severe infections, serious bleeding, irregular heartbeat (atrial fibrillation) and new skin cancers.
Get urgent medical help if you have fever or chills, signs of serious bleeding (black stools, blood in urine or vomit, a severe headache, confusion, or bleeding that will not stop), a fast or irregular heartbeat, chest pain, shortness of breath, or fainting.
Pregnancy and Lactation
Acalabrutinib may harm an unborn baby. Women who could become pregnant should use effective contraception during treatment and for at least 1 week after the last dose, and should tell the doctor right away if pregnancy occurs. Do not breastfeed during treatment and for 2 weeks after the last dose.
Precautions and Warnings
- Regular blood counts and check-ups are needed.
- Tell your doctor before any surgery or dental procedure: treatment may need to be paused because of bleeding risk.
- People with past hepatitis B need monitoring, as the virus can become active again.
- Use sun protection and report new or changing skin lesions.
- Avoid live vaccines during treatment unless your specialist advises.
Overdose
There is no specific antidote. If too much has been taken, contact your doctor or go to hospital straight away for monitoring and supportive care.
Therapeutic Class
Antineoplastic agent: Bruton’s tyrosine kinase (BTK) inhibitor.
Storage
Store below 30°C in a dry place, in the original pack, away from light and out of the reach of children. Return unused medicine to a pharmacy for safe disposal.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.