Ibrutinib (also known as IMBRUVICA) is a targeted therapy used to treat mantle cell lymphoma, another type of lymphoma called Waldenstrom’s macroglobulinaemia and chronic lymphocytic leukaemia.
During treatment, you will see a cancer doctor or nurse. This is who we mean when we mention a doctor or nurse in this information.
Ibrutinib is a type of targeted therapy drug called a tyrosine kinase inhibitor. It works by blocking (inhibiting) signals within cancer cells that make them grow and divide. This may help to stop or slow down the cancer growing.
When ibrutinib is givenBack to top
Ibrutinib may only be available in some situations. Your cancer doctor can tell you if it's appropriate for you. Some people may be given it as part of a clinical trial. If a drug isn’t available on the NHS, there may be different ways you are still able to have it. Your cancer doctor can give you advice.
Taking ibrutinib capsulesBack to top
You take ibrutinib once a day. Try and take the capsules at the same time each day. Swallow the capsules whole with a glass of water. Don’t chew or open them up.
Always take ibrutinib exactly as your nurse or pharmacist explained. This is important to make sure it works as well as possible for you.
You usually keep taking ibrutinib every day for as long as it keeps the cancer under control. Your doctor may ask you to stop taking ibrutinib or take a lower dose because of side effects. Always follow your doctor’s advice.
There are some other important things to remember when taking your capsules:
- If you forget a dose, take the capsules as soon as possible on the same day. Take the next dose at the usual time the next day. Never take a double dose to make up for the one you missed.
- Don’t eat grapefruit or Seville oranges (bitter oranges) while you’re taking ibrutinib. This can increase the amount of ibrutinib in your blood. This includes eating these fruits, drinking the juice or taking supplements that might contain them.
- Keep the capsules in the original package.
- Keep them safe and out of the sight and reach of children.
- Return any remaining capsules to the pharmacist if your treatment is stopped.
Possible side effects of ibrutinibBack to top
We explain the most common side effects of ibrutinib here. We haven’t included all the less common and rarer side effects. You may get some of the side effects we mention, but you will not get them all.
Your doctor can prescribe drugs to help control some side effects. It is very important to take them exactly as your nurse or pharmacist has explained. This will help the drugs work as well as possible for you.
Your nurse will give you advice about managing side effects. After your treatment is over, side effects will usually start to improve. Always tell your doctor or nurse about the side effects you have.
Serious and life threatening side effects
Sometimes cancer drugs can result in very serious side effects, which rarely may be life threatening. Your cancer doctor and nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. You can call them if you feel unwell or need advice any time of day or night. Save these numbers in your phone or keep them somewhere safe.
More information about this drug
We’re not able to list every side effect for this treatment here, particularly the rarer ones. For more detailed information you can visit the electronic Medicines Compendium (eMC).
Risk of infection
Ibrutinib can reduce the number of white cells in your blood. This will make you more likely to get an infection. When they are low it’s called neutropenia.
Contact the hospital straight away on the contact number you’ve been given if:
- your temperature goes over 37.5°C (99.5F) or over 38°C (100.4F), depending on the advice given by your chemotherapy team
- you suddenly feel unwell, even with a normal temperature
- you have symptoms of an infection – this can include feeling shaky, a sore throat, a cough or needing to pass urine a lot.
You will have regular blood tests during treatment. If your blood cells are low, your doctor may delay your treatment for a short time.
Anaemia (low red cells)
Ibrutinib can reduce the number of red cells in your blood. These cells carry oxygen around the body. If they are low you may be tired and breathless. Tell your doctor or nurse if you feel like this. If you are very anaemic, you may need a drip to give you extra red cells (blood transfusion).
Bruising and bleeding
Ibrutinib can increase the risk of bleeding and reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any bruising or bleeding you can’t explain. This includes nosebleeds, bleeding gums, blood spots or rashes on the skin. Tell your doctor if you are taking any medicines that may affect bleeding. This includes aspirin, blood thinning tablets such as warfarin, or injections such as heparin or vitamin E.
Contact your doctor straight away if you have any heavy or unusual bleeding. This includes vomiting or coughing up blood, unexpected vaginal bleeding, or blood in your urine or stools (bowel movements).
If you need to have any surgery, your doctor may ask you to stop taking ibrutinib for a few days before and after your operation.
Changes to your heartbeat
Ibrutinib may cause changes to your heartbeat. Let your doctor or nurse know if you notice your heartbeat is irregular or you feel more breathless than normal. They will check your heartbeat regularly.
This is usually mild. Your doctor can prescribe drugs to control diarrhoea. Let them know if it is severe or if it doesn’t get better. Make sure you drink at least two litres (three and a half pints) of fluids every day if you have diarrhoea.
Some people have constipation while taking ibrutinib. Drinking at least two litres (three and a half pints) of fluids every day will help. Try to eat more foods that contain fibre (such as fruit, vegetables and wholemeal bread) and do some regular gentle exercise.
Your doctor may prescribe anti-sickness (anti-emetic) drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist explains to you. If you still feel sick or are vomiting, contact the hospital as soon as possible. They can give you advice and change the anti-sickness drug to one that works better for you.
Your mouth may become sore and you may get ulcers. This can make you more likely to get an infection in your mouth. Gently clean your teeth and/or dentures morning and night and after meals. Use a soft-bristled or children’s toothbrush. Your nurse might ask you to rinse your mouth regularly or use mouthwashes. It’s important to follow any advice you are given and to drink plenty of fluids.
Tell your nurse or doctor if you have any problems with your mouth. They can prescribe medicines to prevent or treat mouth infections and reduce any soreness.
Muscle and joint pain
You may get pain in your joints or muscles during treatment. Tell your doctor if this happens so they can prescribe painkillers. Let them know if the pain does not get better. Try to get plenty of rest. Taking regular warm baths may help.
Effects on the nervous system
Ibrutinib can affect the nervous system. You may feel dizzy or unsteady. Tell your doctor or nurse straight away if you notice this. They may make some changes to your treatment if it becomes a problem for you. It’s important not to drive or operate machinery if you notice these effects.
Ibrutinib may cause headaches. If this happens, let your doctor or nurse know. They can give you painkillers.
Ibrutinib may cause blurry vision. Always tell your doctor or nurse if you notice any change in your vision.
Ibrutinib may affect your skin and can cause a rash. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day.
Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help.
Build up of fluid
You may put on weight or your ankles and legs may swell because of fluid building up. Tell your doctor or nurse if fluid builds up. If your ankles and legs swell it can help to put your legs up on a foot stool or cushion.
Less common side effects of ibrutinibBack to top
Raised levels of uric acid in the blood
Ibrutinib may cause the cancer cells to break down quickly. This releases uric acid (a waste product) into the blood. Rarely this can cause chemical imbalances in the blood that affect the kidneys and the heart. Your doctor will explain if you need treatment for this. You may have regular blood tests to check the uric acid levels.
Raised levels of white bloods cells
Leukaemia or lymphoma can cause very high levels of white blood cells in the blood. Ibrutinib can also cause this for the first few weeks of treatment. This is normal and not a sign that the cancer is getting worse. You will have regular blood tests while you are taking ibrutinib to check your levels.
Other information about ibrutinibBack to top
Ibrutinib may interact with several other types of medicines. This includes the herbal remedy St John’s Wort. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Your doctor will advise you not to become pregnant or to father a child during treatment. This is because ibrutinib may harm a developing baby. It’s important to use contraception during and for a few months after treatment to prevent pregnancy. You can talk to your doctor or nurse about this.
Women are advised not to breastfeed during treatment with ibrutinib. This is in case there is ibrutinib in the breast milk.
Ibrutinib may affect your fertility (being able to get pregnant or father a child). If you are worried about this, you can talk to your doctor or nurse before treatment starts.
Medical and dental treatment
If you need to go into hospital for any reason, always tell the doctors and nurses that you are having ibrutinib. Explain you are taking capsules that no one should stop or restart without advice from your cancer doctor. Give them contact details for your cancer doctor. Talk to your cancer doctor or nurse if you think you need dental treatment. Always tell your dentist you are taking ibrutinib before having any dental treatment.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (medicines.org.uk). If you’d like further information on the sources we use, please feel free to contact us.This information was reviewed by a medical professional.
Thanks to people like you
Thank you to all of the people affected by cancer who reviewed what you're reading and have helped our information to grow.
You could help us too when you join our Cancer Voices Network - find out more.