Duvelisib is prescribed for treatment-resistant chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) and follicular lymphoma (FL) in adult patients.
Duvelisib is used in patients whose cancer condition returns after chemotherapy or in patients who showed treatment failure with at least two cancer-treating drugs.
Duvelisib blocks certain enzymes and interferes with their cell multiplication and survival resulting in cancer suppression.
Duvelisib should not be used in patients-
• If there is an allergy to duvelisib
• Pregnant and breastfeeding women
• The recommended dose of duvelisib is 25 mg twice daily taken continuously in 28-days treatment cycles.
• Patients should be treated with certain antiviral medications with the intention to prevent cytomegalovirus (CMV) infections and reactivation of CMV.
• Preventive measures must be followed during treatment with duvelisib to avoid Pneumocystis jiroveci pneumonia (PJP). If PJP is suspected, duvelisib therapy has to be stopped immediately.
• The dose of duvelisib can be reduced or adjusted to 15 mg twice daily if any severe side effects occur.
• Discontinue the treatment with duvelisib permanently if the patient is unable to tolerate the reduced dose (15 mg twice daily).
• If the dose of duvelisib missed is within 6 hours take it as soon as possible.
• Never take the missed dose, if the time has exceeded 6 hours. Take the following dose as per the next scheduled time.
• Do not take an extra dose of duvelisib to make up for the missed dose as it can result in harm to the patients.
• Duvelisib comes as a capsule and should be taken by mouth either with or without food.
• Swallow the duvelisib capsule as a whole with a sufficient quantity of water.
• Do not chew, break, or open the capsule.
• Take the capsules exactly at the same time every day.
• Patients given duvelisib should be monitored for the symptoms and signs of respiratory infections and treated accordingly.
• Diarrhea or colitis can occur during the treatment with duvelisib and patients must be advised to consult the doctor in case of severe diarrhea.
• If the patient does not respond to duvelisib during antidiarrheal therapy, withhold duvelisib and provide supportive therapy under the supervision of a medical specialist.
• Pneumonitis and severe skin reactions have been reported during the treatment. In such circumstances, the patients must be given a reduced dose, and the usual dose should be resumed when the side effects are under control.
• Liver function should be monitored regularly during the treatment. If the liver enzymes are abnormal the treatment should either be stopped temporarily or permanently based on the damage caused to the liver.
• Monitor neutrophil counts for at least every two weeks during the first two months of duvelisib therapy. Patients with very low neutrophil counts should be monitored every week, and the dose of duvelisib should be adjusted accordingly.
• Gastrointestinal: Diarrhea, stomach pain, nausea, vomiting, constipation, mucositis
• Nervous system: Headache, fever, abnormal weakness
• Respiratory: Cough, difficulty in breathing, sinusitis, pneumonia or lung infection
• Lab abnormalities: Abnormal levels of neutrophils, platelets, red blood cells, lymphocytes, liver enzymes, potassium, calcium, and sodium
• Others: Muscle pain, weight loss, decreased appetite, rashes, fluid accumulation
• Women of reproductive potential and men with active female partners should use effective contraception during duvelisib treatment and must continue for at least one month after the last dose of duvelisib.
• Breastfeeding is not advised during the treatment and for at least one month after the last dose of duvelisib.
• Never suggest duvelisib capsules to another person even if they have the same medical condition and do not use duvelisib for the condition it is not prescribed.
• Do not stop taking duvelisib capsules without the consent of the doctor.
The doctor should be informed before prescribing duvelisib if the patient is taking or has a plan to take any prescription, Over-The-Counter (OTC) drugs, or herbal supplements to avoid dangerous drug side effects.
• Store duvelisib capsules at room temperature between 20°C and 25°C.
• Keep the duvelisib capsules in their original container.
• Place the medicine container away from the reach of children.
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