Long COVID Patterns in the RECOVER-Adult Study
November 21, 2025
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Brand Name :
Imbruvica
(United States) [Available]Synonyms :
ibrutinib
Class :
Anticancer & protein kinase inhibitors
Brand Name :
Imbruvica
(United States) [Available]Synonyms :
ibrutinib
Class :
Anticancer & protein kinase inhibitors
Dosage forms & Strengths
Tablet, Oral
140 mg
280 mg
420 mg
560 mg
Capsule, Oral
70 mg
140 mg
Chronic Graft Versus Host Disease
420
mg
Oral
once a day
continued until recurrence of underlying malignancy
Chronic Lymphocytic Leukemia (Cll)
420
mg
Oral
once a day
in combination with Obinutuzumab or rituximab.
560
mg
oral
once a day
continued based of assessment of patient condition.
420
mg
Oral
once a day
in combination with rituximab.
Dose Adjustments
No dose adjustment recommended for renal impairment.
Reduce the dose to 140 mg OD for mild hepatic impairment.
Reduce the dose to 70 mg OD for moderate hepatic impairment.
Avoid use for severe hepatic impairment.
Chronic Graft Versus Host Disease
420
mg
Capsule
Orally
once a day
continue the dose until recurrence of underlying malignancy
No safe and efficacious dosage is available
Chronic Graft Versus Host Disease
No safe and efficacious dosage is available
ibrutinib through pharmacodynamic antagonism, reduces the impact of the live rotavirus oral vaccine on the body
may enhance the concentration of serum when combined with ibrutinib
may enhance the concentration of serum when combined with ibrutinib
may enhance the concentration of serum when combined with ibrutinib
may enhance the concentration of serum when combined with ibrutinib
may enhance the concentration of serum when combined with ibrutinib
nafcillin will decrease the effect of action of ibrutinib by affecting enzyme CYP3A4 metabolism.
CYP3A strong enhancers of the small intestine may reduce the bioavailability of ibrutinib
may increase the level of effectiveness through P-glycoprotein MDR1 efflux transporter
the interaction may enhance the hypertensive effect
the interaction with ibrutinib may increase the risk of hemorrhage in patients with low platelets count
the interaction may increase the active metabolite serum concentration of artesunate
ibrutinib may increase the cardiotoxic and hepatotoxic effects of avelumab
the interaction with ibrutinib may enhance the risk of osteonecrosis
may increase the serum level of CYP3A4 substrates
may reduce the serum levels of CYP3A4 substrates
may enhance the serum levels of CYP3A4 substrates
may enhance the serum levels of CYP3A4 substrates
may reduce the serum levels of CYP3A4 substrates
ibrutinib may increase the hepatotoxic effects of pembrolizumab
may increase the hypertension effects of solriamfetol
May have an increasingly adverse effect when combined with Antiplatelet agents
May have an increasingly adverse effect when combined with Antiplatelet agents
May have an increasingly adverse effect when combined with Antiplatelet agents
May have an increasingly adverse effect when combined with Antiplatelet agents
May have an increasingly adverse effect when combined with Antiplatelet agents
it increases the toxicity of antiplatelet agents
it increases the toxicity of antiplatelet agents
it increases the toxicity of antiplatelet agents
may have an increasingly adverse effect when combined with anticoagulants
may have an increasingly adverse effect when combined with anticoagulants
may have an increasingly adverse effect when combined with anticoagulants
may have an increasingly adverse effect when combined with anticoagulants
may have an increasingly adverse effect when combined with anticoagulants
ibrutinib: they may diminish the serum concentration of CYP3A4 Inducers
ibrutinib: they may diminish the serum concentration of CYP3A4 Inducers
ibrutinib: they may diminish the serum concentration of CYP3A4 Inducers
ibrutinib: they may diminish the serum concentration of CYP3A4 Inducers
ibrutinib: they may diminish the serum concentration of CYP3A4 Inducers
it increases the toxicity of antiplatelet agents
may increase the serum concentration of methotrexate
may increase the serum concentration of trimetrexate
the effect of ibrutinib is decreased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism
it increases the toxicity of antiplatelet agents
it increases the toxicity of antiplatelet agents
may increase the effect of each other through anticoagulation
When ibrutinib is used together with oliceridine, this leads to reduction in oliceridine’s metabolism
Actions and Spectrum:
Action:
Ibrutinib works through BTK which is a crucial component of B-cell receptor signaling as well as costimulatory pathways. BTK is involved in B cell signaling and functions in B cell proliferation, survival, and migration, thus targeted therapy with inhibitors of the BTK pathway is effective in B cell malignancy. It forms irreversible covalent bonds with a cysteine residue on the BTK kinase domain that prevents BCR activation stimulated downstream signaling for B cell survival and proliferation. This inhibition eventually results in apoptotic death of the malignant transformed B cells and consequently prevents tumor formation.
Spectrum:
Ibrutinib is considered a standard of care in CLL, serving both refractory and relapsed settings. It has been promising in terms of its overall response rates and efficacy has been proven in different clinical trials.
Frequency defined:
>20-10%
Hypertension (19%)
Skin rash (35%)
Peripheral edema (35%)
Dehydration (12%)
Hyperuricemia (16%)
Hypoalbuminemia (14%)
Abdominal pain (24%)
Constipation (25%)
Dyspepsia (19%)
Stomatitis (29%)
1-10%
Atrial fibrillation (8%)
Cardiac failure (2%)
Weight loss (10%)
Gastrointestinal hemorrhage (4%)
Postmarketing
Acute hepatic failure
Hepatic cirrhosis
Hepatic failure
Anaphylactic shock
Renal failure syndrome
Black Box Warning
None
Contraindication /Caution:
Pregnancy/Lactation
Pregnancy consideration: ibrutinib is assigned under pregnancy category C based on animal studies.
Lactation: No data available for excretion in breast milk, it should be avoided due to potential side effects.
Pregnancy category:
Pharmacology
Ibrutinib is an oral, small-molecule, second-generation Bruton’s tyrosine kinase (BTK) inhibitor.
Pharmacodynamics:
An important component of the BCR signalling system is the enzyme Bruton’s tyrosine kinase, which is the target of the small molecule inhibitor ibrutinib. It has been discovered that BTK plays a role in B cell survival, proliferation, and development at all its stages. Early BCR stimulation results in the phosphorylation of the BTK, which then sends signals that cause B cell activation, proliferation, and survival.
Pharmacokinetics:
Absorption
Ibrutinib is absorbed orally in the form of capsules, and it takes 1-2 hours for plasma levels to peak.
Distribution
Ibrutinib enters tissues with a moderate distribution and is mostly protein-bound (>97%) to serum albumin, which restricts its ability to enter other tissues, particularly the central nervous system.
Metabolism
The liver is the primary site of ibrutinib metabolism, where the enzyme CYP3A4 forms metabolites. Metabolization through other routes is negligible.
Excretion and Elimination
About 80% of the metabolites of ibrutinib are eliminated by faeces, with a little fraction exiting the body through urine.
Administration
The administration method is oral.
Depending on the indication being treated, different ibrutinib dosages are advised.
Patient Information Leaflet
Generic Name: ibrutinib (Rx)
Pronounced: eye-BROO-ti-nib
Why do we use ibrutinib?
Ibrutinib is an oral, small-molecule, second-generation Bruton’s tyrosine kinase (BTK) inhibitor. It is mainly used for different conditions related to cancer treatment since it prevents the proliferation of cells that lead to the formation of tumors.
This agent is prescribed for the treatment of MCL in the relapsed setting or as first-line therapy for patients unfit for standard treatment.
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