Your doctor may have told you to start taking a medicine called `Ibrutinib`. It's normal to feel a little scared and confused when you hear the name of a medicine like this. But don't worry, it's something that many people experience. In this article, we'll talk about what this medicine is, what it does to your body, and what you need to be careful about when using it, in a way that you can understand in a simple way.
Simply put, what is Ibrutinib?
This is a special medicine that is given to treat certain types of cancer. Specifically, it is mainly used for cancer conditions like leukemia and lymphoma.
Think about it, cancer cells are a type of cell that divides rapidly and grows without control. They have a special protein that helps them grow like that. This drug `Ibrutinib` blocks the activity of that protein. Then the ability of cancer cells to grow and spread is reduced or stopped.
In addition, this medicine is sometimes used to treat a complication called ``chronic graft versus host disease'' that occurs after something like a bone marrow transplant.
Things you need to tell your doctor before starting medication
Before you start this medication, your doctor needs to have a complete picture of your health . Therefore, if you have any of the conditions listed below, be sure to tell your doctor about it.
| Do you have these conditions? | Description |
|---|---|
| Bleeding diseases | If even a small wound takes a long time to stop bleeding or if there are only bruises. |
| Diabetes | If you are being treated for diabetes. |
| Surgery | If you have recently had surgery or are scheduled to have surgery in the future. |
| Heart disease | Any type of heart disease, heart failure, heart rhythm disorders. |
| High blood pressure or cholesterol | If you have high blood pressure or high cholesterol levels. |
| Liver diseases | Any type of liver disease. |
| Taking blood-thinning medication | If you are taking medications such as `Warfarin` or `Aspirin` to prevent blood clots. |
| Pregnancy or breastfeeding | If you are pregnant, trying to get pregnant, or breastfeeding. |
| Other allergies | If you are allergic to `Ibrutinib` or any other medicine or food. |
How exactly should I use this medicine?
- Take this medicine (tablet or capsule) with a full glass of water.
- Try to take it at the same time every day. That way, you won't forget and the medicine will work better.
- This is very important: Do not cut, crush, or chew the medicine. Swallow the tablet/capsule whole. Doing so may affect how well the medicine works.
- If you experience side effects, your doctor may change the dose of your medication or tell you to stop taking it for a while. Never stop taking your medication or change the dose without your doctor's advice.
Very important: Do not drink grapefruit juice or eat Seville oranges while taking this medication. These may interfere with the effectiveness of the medication.
What to do if you take too much medicine?
If you suspect that you have taken more than the prescribed dose of this medicine, do not waste time and immediately go to the nearest hospital Emergency Department (ETU). Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
What if I miss a dose of medication?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time.
Never take two doses of medicine at once to make up for a missed dose.
Other things that may interact with this medicine
Some other medications you are taking may interact with Ibrutinib. Therefore, it is very important to inform your doctor about all medications you are taking.
| Medicine/Food Category | Some examples |
|---|---|
| Some antibiotics | `clarithromycin`, `erythromycin`, `rifampin` |
| Some antivirals given for HIV or Hepatitis | Ask the doctor. |
| Medicines for fungal infections | `ketoconazole`, `itraconazole`, `voriconazole` |
| Medicines for epilepsy/ seizures | `carbamazepine`, `phenobarbital`, `phenytoin` |
| Some other cancer drugs | `apalutamide`, `enzalutamide`, `methotrexate` |
| Herbal products | St. John's Wort |
This list is not exhaustive. It is important for your own safety to tell your doctor about every medication, vitamin, and herbal remedy you are taking.
Things to be especially careful about when taking medication
- Regular medical checkups: Your doctor will often ask you to have blood tests. They are to check whether the medicine is working and if there are any side effects. So don't skip these tests.
- Bleeding risk: This medicine may make you bruise more easily or cause more bleeding from even a minor cut. Tell your doctor right away if you notice any unusual bleeding (e.g., blood in your stool, blood in your vomit, or small red/purple spots on your skin).
- Risk of infection: This medicine may slightly reduce your immunity. Therefore, the risk of developing infections is higher. If you experience symptoms such as fever, body aches, and sore throat, do not self-medicate and call your doctor. Minimize your visits to places where people are sick.
- Pregnancy and breastfeeding: This is very important. Avoid becoming pregnant while taking this medicine and for one month after stopping the medicine. This medicine can seriously harm an unborn baby. Also, avoid breastfeeding while taking this medicine and for one week after stopping the medicine.
Take special care of your dental health.
If you are going to have surgery or dental work, tell the doctor that you are taking this medicine. It is not advisable to have major dental surgery while taking this medicine. Therefore, it is best to see a dentist to resolve any dental problems before starting the medicine.
What are the possible side effects?
Like any medicine, Ibrutinib can cause side effects. However, not everyone gets them. Some are serious and need to be reported immediately. Some are normal and go away after a few days.
| Side effects that should be reported to your doctor immediately | |
|---|---|
| Side effect | Symptoms that indicate |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue. |
| Abnormal bleeding | Black or bloody stools, vomit that looks like coffee grounds, dark brown/red urine. |
| Heart failure | Difficulty breathing, swelling of the ankles and feet, sudden weight gain, extreme fatigue. |
| Changes in heart rate | Heart palpitations, dizziness, chest pain. |
| Liver damage | Pain in the upper right side of the abdomen, loss of appetite, yellowing of the eyes/skin, dark urine. |
| Tumor Lysis Syndrome (TLS) | A condition caused by the rapid division of cancer cells. Vomiting, diarrhea, muscle twitching, changes in heart rate. |
| Things that are usually not dangerous, but should be reported to the doctor if they persist | |
|---|---|
| Side effect | Description |
| Bone, joint, or muscle pain | Body aches, joint pain. |
| Diarrhea | Flatulence. |
| Nausea | Feeling like vomiting. |
| Mouth sores | Pain, redness, or sores inside the mouth or throat. |
If you notice anything unusual that isn't on this list, don't be afraid to talk to your doctor about it too.
Take-Home Message
- Ibrutinib is a targeted therapy that stops the growth of cancer cells such as leukemia and lymphoma.
- Before starting the medication, tell your doctor about all other illnesses you have and all medications you are taking.
- Take the prescribed dose exactly as the doctor tells you, at the prescribed time. Do not break, crush, or chew the medicine.
- Avoid grapefruit juice and Seville oranges completely while taking this medication.
- If you experience any dangerous side effects such as unusual bleeding, fever, or difficulty breathing, seek medical advice immediately.
- You should definitely avoid pregnancy and breastfeeding while taking this medicine and for the prescribed period of time.
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