Ibrutinib and antibiotics

[Mayor44]

If I get an infection and need to take antibiotics, must I first go off Ibrutinib? Are there any antibiotics that can be taken at the same time as Ibrutinib?

[Cllcanada Top Poster CURE Hero]

Yes... there are...but the family of antibiotics called fluoroquinilones or quinilones, particularly CIPRO, requires an Imbruvica (ibrutinib) dose reduction... and there are other antibiotics listed on the drug label.

All antibiotic prescriptions need to be consulted by the prescribing doctor with your Imbruvica (ibrutinib) CLL doctor... its important.

Don't expect a GP to know this stuff.. they don't.

I had Imbruvica (ibrutinib) very early on, and it can minic a UTI... there never was one... but I was given 7 days of Cipro, nobody knew about this at the time, and it caused awful urethra bleeds... my urologist commented he had never seen so much scar tissue... 😣

~chris

[FarmerGirl00 in reply to Cllcanada]

Do you have any citations about Cipro & Ibrutinib so I can show my doctor? Thanks

[Cllcanada Top Poster CURE Hero in reply to FarmerGirl00]

Drug label section 2.4

Reduce IMBRUVICA dose to 140 mg if a moderate CYP3A inhibitor must be used (e.g., fluconazole, darunavir, erythromycin, diltiazem, atazanavir, aprepitant, amprenavir, fosamprenavir, crizotinib, imatinib, verapamil, and ciprofloxacin) [see Drug Interactions (7.1)].

accessdata.fda.gov/drugsatf...

There is a new drug label and it has been generalized.

[FarmerGirl00 in reply to Cllcanada]

Thanks. When I cited info to my doc, he got on the internet and looked up some articles on the medical journals and validated your information. He now is aware of the potential problems.

[FarmerGirl00 in reply to FarmerGirl00]

I should mention I am on a clinical FLAIR trial, so everything has to strictly documented if any changes happen in treatment. So I needed to justify my concerns. Again, thanks for the great info you provide

[MrMidnight]

I have been on a new-generation form of Ibrutinib (BGB-3111) for more than a year and have needed antibiotics once a month (for sinusitis, throat and chest infections) until three months ago, when I think my neutrophils have come up to a reasonable level. There was no suggestion I needed to stop Ibrutinib. I have taken Augmentin and Doxycycline. At one point, for variety, my GP wanted me to take Erythromycin but the haematologist said that was not a good idea. Apparently it raises Ibrutinib levels in the blood, or some such. I agree with Cllcanada below... don't expect your GP to know this stuff. It's a specialist area.

[gnlwood]

I've had no problem with any antibiotics except the Cipro-type can't be taken. Have taken Ceftin, Kefkex, Augmenting, and Amoxicillin wig the ibrutinib.

[richutchens]

I had a cold last week and my doctor at Mayo prescribed 500 mg ZOK x 3

[Mcpill]

I have taken Zithromax Z-Pak (azithromycin) without a problem. Did not need to reduce Ibrutinib dose. I had taken this before I was on Ibutinib and it has always worked quickly for me. so I was happy to be able to still use it.

[marlapoi]

Hi,

My husband take Ibrutinib since last september. He have to take Cefzil for 10 days to fight ear infection. Is it ok to take that antibiotic with Ibrutinib?