initial dose:

3.7

mg/m^2

Intravenous (IV)

usual dose: 5.5-7.4 mg per m2 IV once every 7 days
Max: 18.5 mg per m2 once every seven days
The patient should not take a high dose if the white cell count reduces to 3000 cells per mm3

420

mg

Oral

once a day

in combination with Obinutuzumab or rituximab.

25

mg

Capsule

Oral

two times a day in 28-day cycles

Continue the therapy until unacceptable toxicity or progressive disease occurs

used as a single agent for B-cell chronic lymphocytic leukemia treatment
The escalate dosing to maximum recommended single dose of 30 mg for over 3 to 7 days
At initiation of dosing escalation is required or dose held for ≥7 days during treatment
Escalation method:
• 3 mg given IV for 2hrs daily until infusion reactions are Grade< 2
• then 10 mg given IV for 2hrs daily until infusion reactions are Grade <2
• then 30 mg per day given IV for 2hrs 3x a week on alternate days like Monday, Wednesday, and Friday
• The total duration of therapy is 12 weeks including dose escalation

Dose Adjustments

Renal Dose Adjustments
There is no data available
Liver Dose Adjustments
There is no data available

150

mg

Tablet

Orally 

twice a day

If severe symptomatic pneumonitis occurs, discontinue the usage of idelalisib

Indicated for monotherapy:

100mg orally every 12 hours

In combination with Obinutuzumab
Cycle 1-Days 1-28: 100mg orally every 12 hours
Cycle 2-Days 1-28: Acalabrutnib-100mg orally every 12 hours

Day 1: Obinutuzumab-100mg intravenous infusion
Day 2: Obinutuzumab-900mg intravenous infusion
Days 8 and 15: Obinutuzumab-1000mg intravenous infusion

Cycle 3-7:
Day 1-28: Acalabrutnib-100mg orally every 12 hours
Day 1: Obinutuzumab-1000mg intravenous infusion

Cycle 8 and later cycles:
Day 1-28: Acalabrutnib-100mg orally every 12 hours

Management of grade adverse ≥3 reactions
• Grade ≥3 nonhematologic toxicities: The drug should be interrupted if the patient experiences grade≥3 nonhematologic toxicities. Once the toxicity resolves to Grade ≤1, the dose should be resumed at 100 mg orally twice a day
• Grade 3 thrombocytopenia with bleeding: The drug should be interrupted if the patient experiences Grade 3 thrombocytopenia with bleeding. Once the toxicity resolves to Grade ≤1, the dose should be resumed at 100 mg orally twice a day
• Grade 4 thrombocytopenia: The drug should be interrupted if the patient experiences Grade 4 thrombocytopenia. Once the toxicity resolves to Grade ≤1, the dose should be resumed at 100 mg orally twice a day
• Grade 4 neutropenia lasting >7 days: If the patient experiences Grade 4 neutropenia lasting longer than seven days, the drug should be interrupted. Once the toxicity resolves to Grade ≤1, the dose should be resumed at 100 mg orally twice a day
• First to the second occurrence: If the same toxicity occurs for a second time, the drug should be interrupted. Once the toxicity resolves to Grade ≤1, the dose should be resumed at 100 mg orally twice a day
• Third occurrence: If the same toxicity occurs for a third time, the drug should be interrupted. Once the toxicity resolves to Grade ≤1, the dose should be reduced to 100 mg orally every day
• Fourth occurrence: If the same toxicity occurs for a fourth time, the drug should be discontinued

Previously untreated
Cycle 1: 300 mg intravenously on 1st day followed by 1000 mg 1 week later 8th day
Next 28-day cycles: 1,000 mg on 1st day for minimum 3-12 cycles until a best response is achieved

Relapsed CLL
ofatumumab is indicated in combination with cyclophosphamide and fludarabine for relapsed CLL
300 mg intravenously as 1st dose followed by 2nd dose a week later
2nd dose: 1000 mg intravenously, then
3rd dose: 1000 mg on 1st day of a subsequent 28-day cycle up to 6 cycles

Extended treatment
1st dose: 300 mg intravenously on 1st day, followed by a week later
2nd dose: 1000 mg for a week on 8th day, continued for 7 days and then
3rd dose: 1000 mg intravenously and then every 8th week for 2 years

Refractory CLL
1st dose: 300 mg intravenously, followed by the next dose a week later
2nd to 8th dose: 2000 mg intravenously every week for 7 doses
After 4 weeks: 9th to 12th dose: 4 doses of 2000 mg intravenously every 4 weeks
The total regimen contains 12 doses

100 mg/m2 Intravenous infusion on days 1 and 2 of a 28-day cycle, to be repeated up to 6 times.
Dosage modifications
Nonhematologic toxicity
above Grade 3 clinical toxicity: On the first and second days of each cycle, reduce the dosage to 50 mg/m2.
Dose increase might be considered.
Hematologic toxicity
Above Grade 3: Decrease dosage to 50 mg/m2 on Days 1 and 2.
If grade 3 toxicity develops again, lower the dosage to 25 mg/m2 on Days 1 and 2.

Give for 6 treatment cycles (each cycle of 28-day)
Cycle 1
100 mg Intravenous on day 1
900 mg Intravenous on day 2
1000 mg Intravenous on Days 8 and 15
Cycles 2 to 6
1000 mg Intravenous on day 1