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CLL Support Association
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Ceflex and Imbruvica

Hi all,

Has anybody taken an antibiotic while on Imbruvica? I’ve been on imbruvica for 10 days, and so far I’m doing fine, but a a small growth (like a pimple) has gotten infected. Nurse prescribed ceflex (antibiotic). A bit worried about taking both meds. Thank you.

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Hi Roni...I haven't had (knock on wood) to take an antibiotic since starting Imbruvica, but I know you will get some replies from those that have. I'll be interested in knowing too. I just thought of something. Call the pharmacy that sent the Imbruvica and speak to a pharmacist. I've done that with Diploma that sent mine. They will be able to tell you. Carole

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Makes sense, thank you!

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I would talk to your CLL doctor, many antibiotics have some reaction with Imbruvica (ibrutinib) and a few require an Imbruvica (ibrutinib) dose reduction...

~chris

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Will do, thank you!

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I sure know about dose reductions. Currently on 140 mg with prednisone. Keeping rash at bay and I feel decent. Back at the gym. Will see what first blood draw shows. Carole

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My wife is on Ibrutinib for nearly 4years and has needed antibiotics several times. The advice she was given is not to take klacid as it contra-indicates.

Michael

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Hi Irischll,

Thank you for responding... I don’t know if klacid is like ceflex, but I’ll keep that in mind.

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IHi Roni74, I have had these antibiotics at some time over the 44 months on Ibrutinib and had no problems.

Jacqueline

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That’s very reassuring. And I’m so glad you’re not having issues. Thank you, Flutterbye...

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I am on Co-Trimoxazol whilst I am on Ibrutinib. Some anti-biootics you can use and some you cant, your doctor will know

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Hi Zaaz,

Thanks for your reply, I appreciate it....

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Roni74: I have been on antibiotics several times due to sinus infections. Latest is amoxicillin-clav . Have not had any problems. Wishing you well.

Bill1288

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I have been taking Keflex 500 mg 4 x daily due to an infected scrape on my arm. No problems with reactions to Imbruvica. I am prone to infection from minor injuries and use a prescription antibiotic ointment Mupirocin along with the usual first aid practices.

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There is a website, someone else might be able to give you the address, where you can type in the name of the drug and it will tell you if there is a problem with drug interactions. Has been helpful for me in the past.

BeckyL USA

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My husbands dr put him on a daily antibiotic with the Imbruvica

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amoxicillin when I need it - I've been on Imbruvica for 3 years now and have had no problems.

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I have learned to let my CLL specialist (or drug supplier) become my "go-to" person for all these types of questions, because they need to take the lead whenever there may be a conflict. My other Drs don't especially like this but when there is a conflict, it's easier to find a "better" antibiotic solution than to change your CLL drug. There are antibiotics that you should not take with Imbruvica, but you must let your CLL supplier take you through the list. My supplier is ONCO-360, and I became very friendly with all the pharmacists that worked there while I was "ramping up my knowledge" about CLL. I called them at all hours of the day (And Night), whenever i needed an answer, instead of waiting for one of my Drs to get back to me when they got back to the office. Good luck - and feel better.

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I do the same, Jay. I find that pharmacists have better knowledge of drugs than doctors through my experience. You won't find many pharmacies such a Walgreen, Walmart, CVS, that even know about Imbruvica, but as you said your supplier does know. I got mine through Diplomat pharmacy and they can also be called 24/7. Since they work with this drug all day, they know what interacts well or what not to take. Carole

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I have read many of your notes, and it seems you are very well versed in CLL. I was wondering if you have any ideas regarding my upcoming trip to eastern Europe. Should I put this question out to everyone? Thanks. Jay

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I don't travel much, so better put it out to our people. Carole

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My husband has been on doxycycline, Levaquin and a Rocefin shot since on imbruvica. These were for an infection after a dental cleaning and 2 bouts of bronchitis. The last bout was probably bronchial pneumonia by the time we got him to doc. All turned out well.

Although the smallest bite, redbug, seed tick or even mosquitoes can begin infected areas. Just be really careful with insect exposure and if they turn bright red quickly, don’t hesitate to see the doctor.

Blessings,

Farrpottery

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You could go to pdr.net/drug-summary/Imbruv... to view all sorts of important information about Ibrutinib. Keep scrolling down to the heading "Contraindications/Precautions" for a very long list of drugs that can interact with Ibrutinib.

If the reaction shows "Major" or "Moderate," it should be avoided with Ibrutinib. Your doctor would be able to help set priorities, which might be that you should stop or reduce the dose of Ibrutinib if it is important that you take the other drug for another condition. I just noticed that this particular list doesn't show drugs with a "Minor" rating, which indicates the interaction would likely not be strong enough to affect how Ibrutinib is processed.

Another site that lists drugs that are contraindicated with Ibrutinib, and includes Major, Moderate, and Minor categories, is medicines.org.uk/emc/produc... Scroll down to section 4.5 "Interaction with other medicinal products and other forms of interaction."

I carry these lists with me to all doctor appointments in case a drug is considered. When a dermatologist recently wanted to prescribe an antibiotic for a staph infection, she called my oncologist for his advice after reading the list. I was totally impressed and grateful for her diligence and care.

It is good to be diligent and vigilant.

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