Names and pronunciation
(a-Kal′a-broo-tin-ib) Calquence
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Drug reference
(a-Kal′a-broo-tin-ib) Calquence
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Func. class.: Antineoplastic
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Chem. class.: Kinase inhibitor
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ACTION: Second-generation kinase inhibitor, decreases proliferation of can- cer cells
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USES: For the treatment of mantle cell lymphoma (MCL) in patients who have received at least 1 prior therapy
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CONTRAINDICATIONS: Hypersensitivity Precautions: Serious infections, sec- ondary malignancies, children, preg- nancy, breastfeeding Toxicity-related dosage changes Refer to manufacturer’s information Available forms. Capsules 100 mg
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SIDE EFFECTS CNS: Headache, fatigue EENT: Epistaxis CV: Atrial fibrillation/flutter GI: Anorexia, constipation, diarrhea, nausea, vomiting HEMA: Thrombocytopenia, neutropenia, anemia MS: Myalgia RESP: Dyspnea, cough INTEG: Rash MISC: Infections, secondary malignancies
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INTERACTIONS Increase: Risk of bleeding: anticoagu- lants, antiplatelet, monitor for bleeding Increase: Acalabrutinib level: CYP3A4 inhibitors (dilTIAZem, erythromycin, verapamil), avoid using together Decrease: Acalabrutinib level: H2-receptor antagonists (raNITIdine), separate by 2 hr Decrease: Acalabrutinib level: PPIs, avoid concurrent use Decrease: Acalabrutinib level: Calcium antacids, separate by 2 hr Decrease: Acalabrutinib level: CYP3A4 inducers, reduce dose, or avoid use
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Administer: PO route • Give whole; do not crush, chew, or break tablets • Give without regard to food • If dose is missed by >3 hr, skip and continue with regular schedule, do not take a double dose • Store at room temperature
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DOSAGE AND ROUTES • Adult: PO 100 mg bid (approximately 12 hr apart) until disease progression • Hepatic dose: Avoid use
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Assess: • For secondary malignancies (skin cancers) • For atrial fibrillation/flutter • For myelosuppression, obtain CBC monthly or more often • For severe bleeding/hemorrhage, in- terruption for major surgeries may be needed • For serious infection, fever, chills, flu- like symptoms, antibiotics may be needed
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • If dose is missed, give when remem- bered if less than 3 hr, if more than 3 hr, skip and take the next dose at the regu- larly scheduled time, do not double, to swallow whole with a whole glass of water • To notify prescriber of severe bleeding (blood in stool or urine; prolonged or uncontrolled), that product may be inter- rupted for surgery (fever, chills, flulike symptoms), antibiotics may be needed • That lab tests and follow-up exams will be needed • Teach patient to notify prescriber of secondary malignancy (skin cancer), to use sunscreen, protective clothing. Avoid prolonged exposure to sunlight • To report palpitations, lightheaded- ness, dizziness, fainting, shortness of breath, or chest discomfort • Take at least 2 hours prior to taking cimetidine (Tagamet), famotidine (Pep- cid, in Duexis), nizatidine (Axid), or ra- nitidine (Zantac) • To report if pregnancy is planned or suspected, not to breastfeed during or for 2 wk following last dose • To notify other clinicians of prescrip- tion OTC drugs and dietary or herbal supplements
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PHARMACOKINETICS Onset rapid, peak 45 min, duration unknown, half-life 0.9 hr, active metabo- lite 6 hr, 97.5% protein binding
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• Adult: PO 100 mg bid (approximately 12 hr apart) until disease progression
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• Hepatic dose: Avoid use
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