• Acalabrutinib is an anti-cancer agent which was approved by the US FDA in October 2017 for treating patients with mantle cell lymphoma (MCL).
Acalabrutinib is a kinase inhibitor which is prescribed to treat adult patients suffering from mantle cell lymphoma, a type of blood cancer, who have been already treated with at least one chemotherapy medication.
It blocks the growth of the cancer cells.
Acalabrutinib should not be used in in the following conditions:
• Allergy to acalabrutinib
• Pregnancy and breastfeeding
• Hepatitis B infection
• Children below 18 years of age
• The recommended dose of acalabrutinib is 100mg which should be taken twice daily.
• Dose modifications are recommended if adverse reactions of grade 3 or more occur.
• The treatment with acalabrutinib can either be stopped until side effects resolve or it can be permanently discontinued depending on the seriousness of the reaction.
• Acalabrutinib comes as a capsule which should be taken by mouth either with or without food.
• Acalabrutinib capsules should be swallowed with sufficient quantity of water.
• Do not open or split or crush the contents of the capsule.
• Take acalabrutinib capsules around the same time every day and take the dose exactly as advised.
• Patients taking acalabrutinib must be monitored for the signs of bleeding as acalabrutinb increases the risk of bleeding particularly in patients on anticoagulant or antiplatelet treatment.
• Acalabrutinib treatment can be stopped temporarily for three to seven days before and after surgery to avoid the risk of bleeding.
• Monitor patients for the signs of bacterial, viral or fungal infections which should be treated appropriately with adequate medical care. Patients at risk of opportunistic infections may require preventive treatment before starting acalabrutinib therapy.
• Complete blood counts should be assessed every month during acalabrutinib therapy to detect low blood counts and to treat at the earliest.
• Patients are advised to protect from sun exposure by using sunscreen and protective clothing as acalabrutinib can cause sunburn and result in other cancers such as skin cancer.
• Atrial flutter and atrial fibrillation can occur in patients on acalabrutinib therapy. These should be treated with appropriate medical care and related supportive therapy.
• Common: Diarrhea, headache, muscle ache, tiredness, bruising, bleeding
• Gastrointestinal: Nausea, pain in the stomach, vomiting, constipation
• Cardiovascular: Bleeding events, irregular heartbeat, atrial flutter or fibrillation
• Blood: Reduced number of red blood cells, white blood cells or platelets
• Skin: Rashes, bruises, skin cancers
• Others: Nasal bleeding, increased level of creatinine in blood, serious infections including pneumonia and reactivation of hepatitis B infection, other cancers
• If a dose is missed for more than three hours after the scheduled time, continue with next scheduled dose and skip the missed dose.
• Do not take a double dose to make up the missed dose.
• Breastfeeding should de discontinued while on treatment with acalabrutinib and should not be resumed at least 2 weeks after the last dose of acalabrutinib.
• Patients are advised to report to the emergency center if serious reactions such as severe bleeding, serious infection or difficulty in breathing occur.
• Many drugs can result in life-threatening interactions when taken with acalabrutinib and their co-administration with acalabrutinib should be avoided.
• Anti-coagulants (e.g. warfarin)
• Antifungal medicines (e.g. Itraconazole, ketoconazole, voriconazole)
• Anti-viral medicines (e.g.Ribavirin, boceprevir, telaprevir)
Drugs like rifampicin reduce the blood levels of acalabrutinib, and can therefore reduce the effect of acalabrutinib.
• The co-administration of proton pump inhibitors such as omeprazole, lansoprazole, pantoprazole or antacids or antiulcer drugs like ranitidine or famotidine with acalabrutinib should be avoided as the combination reduces the concentration of acalabrutinib. A gap of a minimum of two hours should be maintained when administered with antacids. Acalabrutinib should be taken a minimum of 2 hours before drugs like ranitidine or famotidine.
• Store acalabrutinib capsules at room temperature between 20°C to 25°C
• Protect from excess heat and moisture
• Keep away from the reach of children.
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