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Zanubrutinib (Brukinsa)

About This Drug

Zanubrutinib is used to treat cancer. It is given orally (by mouth). 

Possible Side Effects

  • Bone marrow suppression. 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 tired and weak (fatigue), and raise your risk of bleeding.
  • Diarrhea (loose bowel movements)
  • Bruising
  • Upper respiratory tract infection
  • Rash
  • Cough

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

Warnings and Precautions 

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

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

Important Information

  • Zanubrutinib may need to be held 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 zanubrutinib.
  • Avoid sun exposure and apply sunscreen routinely when outdoors. Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeved shirts, and pants.

How to Take Your Medication

  • Swallow the medicine whole with water. You can take the medicine with or without food. Do not chew, break, or open capsules.
  • Missed dose: If you miss a dose, take it as soon as possible on the same day and return to the normal schedule the following day. 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 and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature.
  • Disposal of unused medicine: Do not flush any expired and/or unused medicine down the toilet or drain unless you are specifically instructed to do so on the medication label. Some facilities have take-back programs and/or other options. If you do not have a take-back program in your area, then please 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 the risk of 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 the risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an 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 of water in the body from losing too much fluid).
  • If you have 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.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.

Food and Drug Interactions

  • 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 zanubrutinib. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions.
  • Avoid the use of St. John’s Wort while taking zanubrutinib as this may lower the levels of the drug in your body, which can make it less effective.
  • This drug may interact with grapefruit and grapefruit juice. Talk to your doctor as this could make side effects worse. 

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 100.4° F (38° C) or higher
  • Chills
  • Tiredness that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
  • Wheezing or trouble breathing
  • Coughing up yellow, green, or bloody mucus
  • New rash and/or itching
  • Rash that is not relieved by prescribed medicines
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools (bright red, or black/tarry)
  • Feeling that your heart is beating fast or in a not normal way (palpitations)
  • If you think you may be pregnant

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of childbearing potential should use effective methods of birth control during your cancer treatment and for at least 1 week after treatment. Men with female partners of childbearing potential should use effective methods of birth control during your cancer treatment and for at least 1 week after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: Women should not breastfeed during treatment and for at least 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 2019

This patient information was developed by Via Oncology, LLC © 2020. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.