Leukemias, lymphomas, and other hematologic cancers:
Indications for CALQUENCE:
Mantle cell lymphoma (MCL) in adult patients who have received at least one prior therapy.
Adult:
Swallow whole with water. 100mg approx. every 12hrs until disease progression or unacceptable toxicity. Concomitant moderate CYP3A inhibitors: 100mg once daily. Concomitant strong CYP3A inducers: avoid; if needed, increase dose to 200mg twice daily. Dose modifications for adverse reactions: see full labeling.
Children:
Not established.
Warnings/Precautions:
Risk of hemorrhage; consider the benefit/risk of withholding treatment for 3–7 days pre-and post-surgery. Monitor for infections; consider prophylaxis if at risk for opportunistic infections. Monitor for cytopenias; obtain CBCs monthly. Risk of second primary malignancies (eg, skin cancer or other carcinomas); advise patients to protect from sun exposure. Monitor for atrial fibrillation/flutter; manage appropriately. Pregnancy. Nursing mothers: not recommended (during and for at least 2 weeks after final dose).
Pharmacologic Class:
Bruton tyrosine kinase (BTK) inhibitor.
Interactions:
Avoid concomitant strong CYP3A inhibitors (eg, itraconazole); if short-term use (eg, anti-infectives for ≤7days), interrupt acalabrutinib therapy. Concomitant moderate CYP3A inhibitors: reduce acalabrutinib dose (see Adult). Avoid concomitant strong CYP3A inducers (eg, rifampin); if unavoidable, increase acalabrutinib dose (see Adult). Increased risk of hemorrhage with concomitant antiplatelets or anticoagulants; monitor. Antagonized by gastric acid reducing agents (eg, PPI [avoid], H2-receptor antagonist, or antacid); if needed, consider ranitidine, famotidine, or calcium carbonate. Separate dosing by at least 2hrs with antacids. Take acalabrutinib 2hrs before H2-receptor antagonist use.
Adverse Reactions:
Anemia, thrombocytopenia, headache, neutropenia, diarrhea, fatigue, myalgia, bruising; hemorrhage, infections, second primary malignancy, atrial fibrillation/flutter.
Generic Availability:
NO
How Supplied:
Caps—60
