Imbruvica 140mg Capsule consists of the active ingredient Ibrutinib. It is indicated to treat blood cancers such as mantle cell lymphoma (MCL), chronic lymphocytic leukaemia (CLL), small lymphocytic lymphoma (CLL), Waldenstrom’s macroglobulinemia, and Marginal zone lymphoma (MZL). 

These are cancers of the white blood cells called lymphocytes that are part of the immune system. They differ from each other by the location where the cancer occurs, the type of lymphocytes affected, and certain other factors.

Imbruvica 140mg Capsule is also used to treat chronic graft versus host disease (cGvHD) after the failure of systemic therapy. During allogeneic stem cell transplantation, the patient receives stem cells from the donor. GvHD occurs when donor cells attack the patient's cells as foreign. 

Before taking Imbruvica 140mg Capsule, you need to talk with your physician if you have bleeding problems, infection, liver problems, heart problems, or intolerance to some sugars. This medication is not recommended for adolescents and children. 

It is vital to let the physician know if you have recently had or are about to have any surgical procedure. Your physician may stop Imbruvica 140mg Capsule for any planned surgical or medical procedure. Use effective birth control during the treatment and for at least one month after the final dose. 

Avoid having grapefruit or oranges in any form during this treatment; they may raise the amount of drug in the blood. Drink plenty of fluid to prevent dehydration. Inform your physician if you have diarrhoea that does not go away.

The Imbruvica 140 mg uses include:

• To treat mantle cell lymphoma
• In the treatment of chronic lymphocytic leukaemia (Blood cancer)
• To treat small lymphocytic lymphoma
• In the treatment of Waldenstrom’s macroglobulinemia
• To treat chronic graft vs. host disease after failure of systemic therapy

Imbruvica (Ibrutinib) 140mg Capsule is a Bruton’s tyrosine kinase (BTK) inhibitor used to treat blood cancers such as chronic lymphocytic leukaemia (CLL), mantle cell lymphoma (MCL), and Waldenström’s macroglobulinemia (WM). By blocking BTK signaling, it disrupts cancer cell survival, slows disease progression, and promotes apoptosis or programmed cell death. This targeted approach helps reduce tumour burden, improve patient outcomes, and enhance overall survival rates. Imbruvica is taken orally and provides a less invasive alternative to traditional chemotherapy, offering sustained disease control with long-term use.

Imbruvica is primarily metabolized by the cytochrome P450 enzyme 3A (CYP3A), making it highly susceptible to interactions with CYP3A inhibitors and inducers.

• CYP3A Inhibitors: Strong inhibitors such as ketoconazole, itraconazole, voriconazole, posaconazole, clarithromycin, and telithromycin can significantly increase ibrutinib levels, raising the risk of toxicity. Concomitant use should be avoided, and if short-term use (≤7 days) is necessary, Imbruvica therapy may be temporarily interrupted. Moderate CYP3A inhibitors require dose reduction and close monitoring for toxicity. Patients should also avoid grapefruit and Seville oranges, as they contain moderate CYP3A inhibitors.
• CYP3A Inducers: Strong inducers like carbamazepine, rifampin, phenytoin, and St. John’s Wort drastically reduce ibrutinib plasma levels by approximately 10-fold, potentially reducing its effectiveness. These should be avoided, and alternative agents with less CYP3A induction should be considered.

Patients taking Imbruvica alongside these medications should be monitored closely for altered drug efficacy or increased toxicity risks.

• Store the capsules in the original packaging at room temperature (20-25°C).
• Retain in original packaging.
• Keep out of reach of children

Consume this medicine at the same time each day. While taking Imbruvica 140mg Capsule, do not consume grapefruit or orange in any form during the treatment. Drink plenty of fluid to prevent dehydration. Do not break or chew the capsule.

Side effects are unwanted symptoms caused by medicines. Even though all drugs cause side effects, not everyone gets them. The Imbruvica side effects include:
Serious side effects of Imbruvica 140mg Capsule 120's are:

• Bleeding problems
• Infections
• Decrease in blood cell counts
• Heart problems
• High BP
• Secondary cancer
• Tumor lysis syndrome
• Severe allergic reactions

Common side effects of Imbruvica 140mg Capsule 120's are:

• Nausea, vomiting, diarrhoea
• Tiredness
• Muscle and bone pain
• Rash and bruising
• Mouth sores
• Pneumonia
• Fever, chills
• Breathlessness
• Constipation
• Dizziness
• Body pain
• Swollen ankles and feet
• Increased creatinine levels in the blood
• Heavier periods and blood in urine
• Blurred vision
• Weakness and numbness

Contact your doctor immediately if you experience bleeding, infection, shortness of breath, or chest discomfort. Report to your doctor if you have had a history of heart failure or hepatitis infection. It is not recommended to take this medicine before or after surgery as it causes a delay in wound healing. Discuss effective contraceptive options with your healthcare provider and use them during treatment and for a month after the last dose of Imbruvica 140mg capsule.

1. Janssen-Cilag International Ltd, Electronic Medicines Compendium (EMC), [Revised on Dec 2021] [Accessed on 18th March 2023], https://www.medicines.org.uk/emc/files/pil.10040.pdf
2. Janssen Biotech, Inc, US Food and Drug Administration, [Revised on May 2022] [ 18th March 2023], https://www.imbruvica.com/files/prescribing-information.pdf
3. H.G. Watson, J.I.O. Craig, L.M. Manson, Blood disease, Davidson’s Principles and Practice of Medicine, 22nd Edition, 2014, 989-1056.
4. Sapna Parmar, Khilna Patel, Javier Pinilla-Ibarz, Ibrutinib (Imbruvica): A Novel Targeted Therapy for Chronic Lymphocytic Leukemia, Drug Forecast, Published on July 2014; Accessed on  18th March 2023]; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103574/pdf/ptj3907483.pdf
5. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/205552Orig2lbl.pdf 
6. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=205552