Venetoclax is an antineoplastic medication that the Food and Drug Administration (FDA) approved on October 16, 2020. It is used to treat certain types of blood cancers, including chronic lymphocytic leukaemia (CLL) and acute myeloid leukaemia (AML), by inhibiting the BCL-2 protein from promoting cancer cell death.

Venetoclax treats chronic lymphocytic leukaemia (CLL), including CLL with 17p deletion and acute myeloid leukaemia (AML) in adults who cannot undergo intensive chemotherapy. It also helps treat certain types of non-Hodgkin lymphoma when combined with other medications. By inhibiting the BCL-2 protein, Venetoclax promotes cancer cell death.

Venetoclax is usually administered orally. Do not break, chew, or crush the tablets. It comes with a prescribed dosing schedule, and patients should consult their healthcare provider to determine the correct dosage and follow the prescribed regimen carefully. If a dose is missed, do not double the dose. Consult your healthcare provider for guidance.

Side effects are unwanted symptoms caused by medicines. Although all drugs can cause side effects, not everyone experiences them.

Common side effects of Venetoclax:

• Nausea
• Diarrhea
• Fatigue
• Anemia
• Low white blood cell count (neutropenia)
• Low platelet count (thrombocytopenia)

Serious side effects of Venetoclax:

• Tumor lysis syndrome (TLS)
• Kidney failure
• Need for dialysis treatment
• Risk of death

• Tumor Lysis Syndrome (TLS): Venetoclax can cause TLS, including fatal events and kidney failure. Monitor for TLS, especially during the ramp-up phase, and use prophylactic measures like hydration and antihyperuricemics.
• Neutropenia: Venetoclax can cause severe neutropenia, increasing infection risk. Monitor blood counts and adjust the dose as needed. Use antimicrobials and growth factors for severe cases.
• Infections: Serious infections, including pneumonia and sepsis, may occur. Monitor for infections and withhold Venetoclax for Grade 3 or higher infections.
• Immunisation: Avoid live attenuated vaccines before, during, and after treatment until B-cell recovery. Vaccines may be less effective.
• Embryo-Fetal Toxicity: Venetoclax may harm the fetus. Women of reproductive potential should avoid pregnancy during treatment and be aware of potential risks to the fetus.

Patients should be closely monitored for tumour lysis syndrome (TLS), especially during the ramp-up phase, and receive appropriate prophylactic treatment. Regular blood counts should be done to detect neutropenia, and dose adjustments may be necessary. Venetoclax should not be combined with live attenuated vaccines during treatment, and women of reproductive potential should avoid pregnancy.

Follow your healthcare provider’s dosing instructions and attend all scheduled blood tests to monitor for side effects. If you miss a dose, do not double it. Contact your healthcare provider for guidance. Stay hydrated and take any prescribed medications to prevent tumour lysis syndrome (TLS). Notify your doctor immediately if you experience symptoms like fever, chills, or unusual tiredness. Women should avoid pregnancy during treatment and use effective contraception.

1. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/208573s013lbl.pdf

2. Juárez-Salcedo LM, Desai V, Dalia S. Venetoclax: evidence to date and clinical potential. Drugs Context. https://pmc.ncbi.nlm.nih.gov/articles/PMC6788387/

3. Waggoner M, Katsetos J, Thomas E, Galinsky I, Fox H. Practical Management of the Venetoclax-Treated Patient in Chronic Lymphocytic Leukemia and Acute Myeloid Leukemia. https://pmc.ncbi.nlm.nih.gov/articles/PMC9214960/

This information is for educational purposes only and is not a substitute for professional medical advice. Always consult a healthcare provider before starting or stopping any medication.