Venetoclax.
I will start Venetoclax in 3 weeks.
When is the best time of day to take the pills.
With a meal or after ?
Which kind of food is better to take Venetoclax with ?
I an TP53 depleated and failed Ibrutinib after 3 months due to very sever side effects, such as A-FIB , uncontrolled Parkinsonian tremor , asceptic hemingitis, constant fever and sever bones' pain. 2 weeks after stopping IB my lymph nodes are back.
Thanks
Gidi
I take mine at, or within a half hour of 11:00 am every day together with a very light lunch because I do not have much of an appetite anymore. I always take it with water.
A small salad, a half tuna or turkey sandwich or a small pasta marinara suits me just fine.
Nick
This is from the Venetoclax prescribing information:
accessdata.fda.gov/drugsatf...
12.3 Pharmacokinetics
Absorption
Following multiple oral administrations under fed conditions, maximum plasma concentration of venetoclax was reached 5-8 hours after dose. Venetoclax steady state AUC increased proportionally over the dose range of 150-800 mg. Under low-fat meal conditions, venetoclax mean (± standard deviation) steady state C max was 2.1 ± 1.1 μg/mL and AUC0-24 was 32.8 ± 16.9μg•h/mL at the 400 mg once daily dose.
Food Effect
Administration with a low-fat meal increased venetoclax exposure by approximately 3.4-fold and administration with a high-fat meal increased venetoclax exposure by 5.1- to 5.3-fold compared to fasting conditions. Venetoclax should be administered with a meal [see Dosage and Administration (2.2)].
Thank you MelioraDay. Do you take Venetoclax with a low-fat or a high-fat meal ? I am so scared of diarreah 
best
Gidi
I take my Venetoclax right after breakfast. The fat content varies. On the weekend I usually have eggs with bacon or ham. During the week I have a protein bar for breakfast. I always take my fish oil capsule with breakfast as well. I've had no side effects at all with Venetoclax. Hopefully you will have the same experience and I wish you well!
I was told not to take fish oil with either Ibrutinib or Venetoclax. Be sure your specialist knows you are taking it.
They know and they had no problem with it. There is nothing in the prescribing information for Venetoclax about that. It could be that they were concerned about increased bleeding risk with fish oil if your platelets are low. It's always important for your specialist to know everything you are taking including over the counter medications or supplements
Hi Gidi, is this a trial or not? If it is a trial they may specify when to take it. I’m on a trial that includes Venetoclax and they specify for my trial that it has to be taken with of within half an hour of food. I take mine at the end of breakfast. I’d definitely ask your prescribing doctor if I were you.
best, rob
I take mine first thing in the morning - with some water. I'm also on Ibrutinib and was told not to take them together so I take the Ibrutinib at night before bedtime. I hope the Venetoclax will be your answer. Best wishes.
I am taking it on a trial as well, along with Ibrutinib. I take mine in the morning and eat immediately afterwards, not very much fat in the AM. Usually cereal and fruit and milk or Belvitas. I did have a few GI issues and my GI doc told me to drink at least 4 ounces of water with each pill you swallow. I can't drink that much first thing in the morning, but I do drink two full glasses of water (16oz total) with the 7 pills that I have to take. This is much more than a "full glass of water" which is what most guidelines tell you to do. I have also found eating half a banana and a little orange juice with the drugs helps me to get them down more easily and helps with potassium and magnesium, levels which can be a problem with Venetoclax. You don't want to let your potassium or magnesium levels get to low. That happened to me when they added the Venetoclax. And prescription levels of those two are not fun to take!
I thought you should not have oranges with Venetoclax
Seville Oranges, Grapefruit, Star Fruit and Pomelo should not be eaten if on Venetoclax, based on my trial documentation. So, no things made from them either such as Marmelade. Other oranges are OK. best, rob
I take my Imbruvica plus Venetoclax before bed with a B-12 and a natural prostate pill.
When I take with food I get difficulty with my food digestion. My doctor is ok with me taking it before bed- even thought I am suppose to take it with food,
Hoffy
I take my Venetoclax around 7 pm. I am still working, so I like to be at home when I take it. I usually take it with a meal...or else I eat fairly soon afterwards. I do sometimes have stomach issues, but not all the time. I had one potassium test that was high, so I have been careful with bananas and oranges. My last test was normal, so the first could have been a fluke, not uncommon.
I have had few side effects. I was on Imbruvica for 2.5 years before switching to Venetoclax. It takes a bit for your body to adjust. I lost 12 pounds in one month about 2 months after I had completed the switch. I had really severe edema on imbruvica. It is so wonderful not to have that problem anymore.
Good luck!
Susan
I was attending the Murano study and was told to take my Venetoclax half an hour after breakfast. I had no side effects at all.
Best wishes, Korstiaan
How long have you been taking venetoclax?
That was about 2 years (Sept 2015 - Nov 2017).
In October 2019 I started a new treatment, again with Venetoclax-Rituximab.
Hi Korstiaan. So you got a 2-year remission with no drugs after your 2 years on venetoclax monotherapy, but then needed to go back on treatment (V+R), after 2 years? I am on venetoclax right now (just started). Not clear whether or when rituximab will be added, due to the pandemic. So I am curious about people's results after 2 years of venetoclax monotherapy. Good luck to you!
kim
No, in the periode Sept 2015 - Nov 2017 I also got the combination Venetoclax-Rituximab (Murano study). For your information, the Rituximab starts after the ramp up to 400mg Venetoclax and is given 6 times (every 4 weeks).
I wish you a succesful treatment!
Korstiaan
I just completed my rituxan 6 month treatment. Started veneclax as i finished. Amazing results. Almost 0 readings . 004 cor my leukocytes.
Good morning Philelliot , i am just starting the venetoclax after 5 months of gazyva ... did you have any problems when increasing the dosage week after week till you reached 400 mg. per day ??? and how are you doing now ??? hope you are well . blessings , james
A friend currently doing dose ramping told me that the Venetoclax drug insert states...
With a meal and 56 oz of water a day.
~chris
Water is the main ingredient to limit side effects. Plenty 56 oz. A day. When i dont drink 56 i know it.
I have been taking mine after a mug of tea and breakfast - usually porridge or muesli and yoghurt. And a large glass of water. Some days I get quite bad nausea about 2 hours afterwards and this makes me feel sluggish. My doc suggested taking pills with my evening meal instead. Only a few days into this but no problems so far.
Is 400 mg of venetoclax always better?
Good News! BTK inhibitor therapy is effective in patients with CLL resistant to venetoclax 
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