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CLL Support Association
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Sex Life

Hello, my partner is on Ibrutinib (also known as Imbruvica) - started one week ago. I have two questions.

1. Will the drug affect our sex life? Do we need to take extra precautions eg. Condoms?

2. He has been told to avoid grapefruit and oranges (he ate something that he didn't realise had oranges in it, and reacted immediately with shaking and numb hands for an hour). Are there any other foods he needs to avoid?

He has started to keep a diary on any reactions/what caused them/when it happened.

Many thanks,


12 Replies

Yes condoms....Ibrutinib is not carcinogenic like most chemo, but they recommend them due to fluid transfer and increased risk of infection in both directions...

No..Bitter oranges, aka Seville... star fruit, pomegranates, St. John's Wort, Regular oranges should be fine.

All supplements must be OK'ed by your treating doctor...

Generally better to take pills on an empty stomach, food effects absorbtion..



Hi Chris, I didn’t know pomegranate was on the list of forbidden foods.

I’ve been eating them whilst on my daily 420mg of ibrutinib, with no apparent adverse effects. They’re not mentioned on the drug information sheet which comes with the capsules - only grapefruit, seville oranges and St John’s Wort.

Please could you tell me your source for avoiding pomegranates, thanks.



I'm surprised that tangelos are not on the list - a cross between a tangerine and a grapefruit or pomelo. I have often seen pomegranates included on the avoid list for some chemos, so I'm not surprised to see it on the list for Imbruvica.


In addition to what Chris stated my list includes Pomelos and grapefruit. Most significant for me no Seville oranges means no Marmalade. I did not know about pomegranates, which is on Chris' list. Learn something new every day.

I normally have an an orange included in my breakfast, never suffered any identifiable reaction.



Thanks but what about sex life? Is it advised to use condoms? fluid exchange etc? We're past the stage of pregnancy so that's not an issue.


I have had two very bad reactions to citric fruit eaten an hour before taking my pills. On each occasion I was rushed to hospital by ambulance. I now take nothing citric, it was tangerines in the second instance and naval orange in the first. My symptoms were extreme pain in the chest and stomach bloating so bad that I thought I was going to pop. The pain lasted twenty four hours. As far as sex is concerned I would avoid pregnancy by whatever means you choose. I started IB five and a half years ago but at seventy two I am well past my sell by date for sex.


Hi berrytog, You're ONLY seventy!!!! You're too old for sex when you're dead :-) , no sooner than that! Thanks for the feedback. No chance of pregnancy as partner has had the snip. I was more concerned with infections/toxicity in fluids etc.


I wasn't advised to use condoms, just measures to avoid pregnancy as there's some evidence that Ibrutinib can cause birth problems. Not using condoms hasn't caused us any issues.

They're not sure if Ibrutinib is present in semen (I haven't heard of any of us on trials being asked for that test either) but the half life in blood is about 5 hours so you're probably extra safe if you schedule your partners pill times accordingly.



The only things I was told to avoid were Seville oranges and grapefruit. When I asked the Specialty Pharmacy about other types of oranges the answer was " better safe than sorry ... no oranges". The other fruits mentioned in earlier replies ...never mentioned.


Makes me sort of happy I no longer have a sex life,wearing condoms would be like wearing socks to bed,can't feel the sheets lol


I have been I imbruvica and sex has been fine. Improvement due to nodes shrinking and not pushing in the prostate.

Be well. Have fun !!

1 like

I am taking a tea that has peaches and pomegranate. Green tea and ginger as I have gained weight and eat too much. The tea helps curb my appetite.


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