Imbruvica dosage

[Green202]

Hello

Do you know people with CLL who only take 1 capsule of Imbruvica 140 mg per day?

[AussieNeil Administrator]

We do have members on a reduced dose of Ibrutinib/Imbruvica, including 140mg per day. but unfortunately, the few trial studies on how patients do on reduced doses have not provided particularly helpful information on who can safely take a reduced dose:

healthunlocked.com/cllsuppo...

I presume the reason for your question is out of concern for your friend in Turkey?

There are possibly quite serious dangers when going on a reduced dose, particularly in the first year or so of treatment. Only around 10% of patients on Ibrutinib reach uMRD

(no detectable cancer) after 4 years on a full dose. On its own, Ibrutinib just keeps CLL under control and going off it for more than a week or so can sometimes cause a rapid and frightening relapse: healthunlocked.com/cllsuppo... The major concern would be that a reduced dose may increase the risk of the CLL becoming resistant to Ibrutinib, necessitating a search for another expensive drug.

If your friend needs to take a reduced dose, then he also needs to have regular monitoring (blood tests, node size checks), to ensure that the reduced dose is continuing to reduce his CLL tumour burden.

Neil

[SLLJOHN]

I was prescribed a gradually reduced dosage after12months on 420 mg down to140mg about 18 months ago. I had too many side effects including Afib. I am monitored every 3 months and will likely move to Alcalaibrutinib once it is properly licensed in UK (Europe) on the logic it would help the Afib.

[bkoffman CLL CURE Hero]

140mg is too low a dose for most as you need 2.5mg/kilogram daily to saturate thee BTK receptors.

[lartington in reply to bkoffman]

Good morning, my husband is taking one tablet ONLY per day. On the box it clearly states 280mg, he is in remission.

[bkoffman CLL CURE Hero in reply to lartington]

280 is an adequate dose for anyone weights less that 112 kilos which is most of us

[SycamoreN]

Hello, I started Ibrutinib in 2014 on 420 mg, it was reduced to 280 mg in 2016 due to arrhythmia, and further reduced to 140 mg since May this year. I've been doing very well on this latest reduction.

[BeckyLUSA]

I have been on 140 mg for almost a year, due to grade 2 GI side effects. However, I had been on it at full dose for 2+ years. My numbers have not gone up and while not MRD neg, my CLL is well under control. I must state however, that I was also on Venetoclax and as trial protocol dictated, just stopped it last month. We shall see what happens now.

BeckyL USA

[rubberlegs68]

I have been on a reduced dose of 140mg for about 2 years. Each reduction was due to low neutrophils. My numbers have been holding steady. Previous treatment was FCR with remission of about 3 years.

[michaeledward]

It is my understanding that, in the absence of intolerable side effects, 420 mg of Ibrutinib is the proper dose. I go to NIH every 6 months and last year after my hematologist lowered my Ibrutinib dose to 140 mg, the doctor at NIH asked me why the dosage was reduced. My answer was that I assumed it was a "routine" reduction to which the NIH doctor replied: "There are no 'routine' reductions from the recommended dose of 420 mg. Absent intolerable effects, the 420 mg dosage should not be reduced." Thereafter, the NIH doctor telephoned my hematologist and she restored my dosage to 420 mg.

[Hidden]

Hi Green202,

At present I'm on a maintenance dose of I tablet of Ibrutinib a day. During my treatment I took three tablets a day. In remission I took none. The CLL returned nearly two years later and I'm on just the one tablet. so far so good.

Best wishes,

Peter

[Gustac]

My husband was on 420 mg for approx. 2 years, it developed a bad cough. He is now on 140 mg for the past month or so and seems to be holding. His numbers are w/in the normal range. We will see what the future tells.......