Acalabrutinib

Other Names: Calquence®

Possible Side Effects

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you feel tired and weak (fatigue), and raise your risk of bleeding.
  • Headache
  • Tiredness
  • Loose Bowel Movements (diarrhea)
  • Muscle pain/ache
  • Bruising 

Note: Each of the side effects above was reported in 20% or greater of patients treated with acalabrutinib. Not all possible side effects are included above. 

Warnings and Precautions

  • Severe bone marrow depression
  • Severe infections, including viral, bacterial and fungal, which can very rarely be life-threatening 
  • Abnormal heart beat
  • This drug may raise your risk of getting a second cancer such as skin cancer.
  • Abnormal bleeding, which can very rarely be life threatening - symptoms may be coughing up blood, throwing up blood (may look a lot like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding. 

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical tram. 

Important Information

  • You may need to hold acalabrutinib for 3 to 7 days prior to, and for 3 to 7 days after some minor/major surgical procedures due to the risk of bleeding. Talk to your doctor and/or nurse for precautions you may need to take. Also, if you must have emergency surgery, tell the doctor that you are on acalabrutinib. 
  • Avoid sun exposure and apply sunscreen routinely when outdoors. 

How to Take Your Medication

  • Swallow the medicine whole with or without food daily, approximately 12 hours apart. Do not chew, break, or open it. 
  • If you take antacids, take this drug at least 2 hours before or 2 hours after you take the antacid. 
  • If you take and acid reducer such as Pepcid®, or Tagame®l, take this drug 2 hours before you take the acid reducer. 
  • Missed dose: If a dose is missed by more than 3 hours, skip the missed dose and take your next dose at the scheduled time and contact your physician. Do not take 2 doses at the same time or extra doses. 
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves. 
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor about the necessary precautions to take during this time. 
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine. 

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities. 
  • To decrease infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever. 
  • To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss. 
  • Be very careful when using knives or tools.
  • Use and electric shaver instead of a razor.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea. 
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain. 

Food and Drug Interactions

  • There are no known interactions of acalabrutinib with food.
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are known drug interactions with acalabrutinib. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions. 
  • Drugs  that treat heartburn and stomach upset such Maalox®, Mylanta®, Protonix®, Nexium®, Prilosec®, Pepcid®, Tagamet®, and Zantac® may lower the effect of your cancer treatment if taken with acalabrutinib. Call your doctor to find out what drug you may take with acalabrutinib to help with heartburn or stomach upset.
  • Avoid the use of St. John's Wort while taking acalabrutinib as this may lower the levels of the drug in your body, which can make it less effective. 

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • A headache that does not go away
  • Fatigue that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Coughing up blood
  • Easy bleeding or bruising
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with a lack of strength or a feeling of being dizzy
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools (bright red, or black/tarry)
  • Pain that does not go away or is not relieved by prescribed medicine
  • If you think you may be pregnant or have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: It is not known if this drug may harm an unborn child. For this reason, be sure to talk with your doctor if you are pregnant or planning to become pregnant while receiving this drug. Let your doctor know right away if you think you may be pregnant, or may have impregnated your partner.
  • Breastfeeding warning: Women should not breast feel during treatment and for 2 weeks after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby. 
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking. 

New November 2017