Reducing ibrutinib for 14 days

[cartwheels]

I have a stubborn case of eppidemis which although no longer swollen etc still gives me trouble with painful like cysts so my doctor and consultant have come up with a plan of a 14 day course of ciprofloxacin which of course is not recommended whilst on ibrutinib although i have been on it before to shift a lung infection with no problems but as this is a 14 day course they recommend I miss my ibrutinib every 3 rd day so as to make it safe I'm reluctant to do this as I have never missed a day of ibrutinib in 3.5 years and I'm in remission with good bloods what are your thoughts

[lankisterguy Volunteer]

Hi cartwheels,

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Your doctors have 14 years more medical training than most of us on this site, and we cannot give medical advice.

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Before you consider not following your doctor's advice you should either ask for an explanation or for a 2nd opinion.

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I also realize you are concerned about pausing Ibrutinib, and there is some evidence that in the early years of Ibrutinib treatment that pauses (typically NO Ibrutinib for 7 to 14 days) reduces the PFS (Progression Free Survival) but the reported OS (Overall Survival) was not affected. Some people that reach U-MRD (UnMeasureable Minimal Residual Disease) after several years on Ibrutinib are able to stop treatment and have multiple years of remission without treatment.

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See these:

healio.com/news/hematology-...

mdedge.com/hematology-oncol...

patientpower.info/side-effe...

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Since your doctor is not completely stopping all Ibrutinib for the 14 days, and you will be restarting the full dose, the risk may be far less than all the studies reported above. And you may be able to cure the more immediate skin problems.

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Len

[Hermance]

I reduced my Ibrutinib from 420 mg to 210 mg for several months and my WBC did not budge. Somewhere I read a study that says the minimum dosage is 2.5mg per kilo of body weight.

[Anilbhard]

I don’t remember as I required this medicine 3 years back but think my Oncologist didn’t stop Ibnutrib.

Reg missing taking daily dose of Ibnutrib, there is no issue as I am on this medicine since Jan 2017 and may be for ard 5-6 months , spread over these years I didn’t take Ibnutrib, but it didnt had much effect. So if your doc says to stop it intermittently, then do so without any worry.

Take care

[moty3012]

Hi

i am on ibrutinib for 2 years. because of medical condition my doctor reduced the medicine to 2 pills total 280 mg. the side effects were gone and the CLL is on remission. be well