Imbruvica

Adult Dosing .

Dosage forms:  CAP: 70 mg, 140 mg; TAB: 140 mg, 280 mg, 420 mg; SUSP: 70 mg per mL

Special Note

[uses, dosing may vary]

Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments; consider holding tx >3-7 days before and after surgery if bleeding risk

CLL/SLL

[420 mg PO qd]

Info: use as monotherapy, w/ obinutuzumab, w/ rituximab, or part of multi-drug chemo regimen; do not open cap; do not cut/crush/chew tab

Waldenstrom macroglobulinemia

[420 mg PO qd]

Info: use as monotherapy or w/ rituximab; do not open cap; do not cut/crush/chew tab

chronic GVHD, refractory

[420 mg PO qd]

Info: do not open cap; do not cut/crush/chew tab

mantle cell lymphoma, relapsed or refractory

[indication withdrawn in US]

Info: drug shown to incr. adverse rxns

marginal zone lymphoma, relapsed or refractory

[indication withdrawn in US]

Info: drug not shown to improve survival

renal dosing

[see below]

CrCl >25: no adjustment; CrCl <25: not defined

HD/PD: not defined

hepatic dosing

[chronic GVHD]

bilirubin 1.6-3x ULN of hepatic origin or not d/t Gilbert syndrome: 140 mg qd; bilirubin >3x ULN of hepatic origin or not d/t Gilbert syndrome: avoid use

[all other indications]

Child-Pugh Class A: 140 mg qd; Child-Pugh Class B: 70 mg qd; Child-Pugh Class C: avoid use

Peds Dosing .

Dosage forms:  CAP: 70 mg, 140 mg; TAB: 140 mg, 280 mg, 420 mg; SUSP: 70 mg per mL

Special Note

[uses, dosing may vary]

Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments; consider holding tx >3-7 days pre- and post-surgery w/ bleeding risk

chronic GVHD, refractory

[1-11 yo]

Dose: 240 mg/m^2/dose PO qd; Max: 420 mg/dose; Info: do not open cap; do not cut/crush/chew tab

[12 yo and older]

Dose: 420 mg PO qd; Info: do not open cap; do not cut/crush/chew tab

renal dosing

[see below]

CrCl >25: no adjustment; CrCl <25: not defined

HD/PD: not defined

hepatic dosing

[1-11 yo]

bilirubin 1.6-3x ULN of hepatic origin or not d/t Gilbert syndrome: 80 mg/m^2/dose qd; bilirubin >3x ULN of hepatic origin or not d/t Gilbert syndrome: avoid use

[12 yo and older]

bilirubin 1.6-3x ULN of hepatic origin or not d/t Gilbert syndrome: 140 mg qd; bilirubin >3x ULN of hepatic origin or not d/t Gilbert syndrome: avoid use