Venetoclax

[Kyson3090]

Hi I noticed in a previous post on venetoclax where someone changed their dosage time from day to night and how they did it. Anyone know how to do this.

Thanks

[AussieNeil Partner Administrator]

You accomplish a shift in your medication taking time gradually, by using the window in which you are allowed to take your medication. Per venclexta.com/previously-un... , you should take your venetoclax within 8 hours of the time you usually take it, before you miss that dose and wait until the next day. So if you normally have your Venetoclax at 8AM, you could have it at Noon the next day, 4PM the following day and 8PM thereafter. To reduce the possibility of side effects, or a worsening of those you already may have, do a smaller shift per day, say 3 or 2 hours.

Neil

[Smakwater]

Kyson3090,

I started taking the venetoclax between dinner and bedtime which was the answer for me. I would eat around 7:00 PM, take venetoclax about 8:00 PM, and bed time was between 9:30 PM and 10:30 PM. It is also very important to be adequately hydrated at all times

From a previous post -

I made the switch with my doctor's direction. It was explained to me that it is not acceptable to double dose venetoclax in a 24 hour period, and there is an 8 hour dose skipping measure to reset scheduling a dose.

Therefore if you adjust the time that you move a dose forward you do it any time after the 24 hour period, but, before an additional 8 hours pass (inside 32 hours).

E.g, If you took venetoclax at 9:30 AM on Monday, you would take your next dose after 9:30 AM and before 5:30 PM on Tuesday (say 4:59 PM).

You would then establish the reset dose at the new schedule time after 4:59: PM on Wednesday (say 8:00 PM).

I hope that I explained this is in a helpful way. If need, message me for clarification.

healthunlocked.com/cllsuppo...

Neil provide a link which provides the manufacturers instruction for dosing that details appropriate timing for dosage movement.

JM

[Teddo in reply to Smakwater]

Smakwater-

How do you stay hydrated if you turn in not long after taking the med? I am on w+w, and have assumed meds would be taken in the morning followed by ample hydrating throughout the day.

Thanks

[SofiaDeo in reply to Teddo]

Since you are supposed to take V with food & water, I would interpret that as Dinner (if approximately same time every day) should be the latest one takes it. Unless there is a compelling reason why the docs thought later was OK. If waiting an hour post dinner works for you, that's great. I personally am planning only 2 hour increments in changing my daily Venclexta dose time when I am able to change from AM (necessitated by ramp up post dose 6-8 hour recommended blood draw) and my final preferred dose time which will be approximately 6 pm. It will provide a smoother drug steady state concentration during the change. Most likely it isn't clinically necessary, but I eat every few hours from about 9-10am till 6pm, so I will time it around food. I haven't yet had nausea taking it, but I get nauseous easily when on neutropenia prophylaxis meds & really don't want to have a larger blood spike from going, say, 28 hours from last taking the med instead of 26 hours.

[Kyson3090 in reply to SofiaDeo]

Good luck with however you end up doing it. I am going to see my oncologist on Friday and ask him the best way to change from am to pm. It just seems strange that everything was ok for 4 weeks and then the last month has been a nightmare. Hope things work out for you.

[SofiaDeo in reply to Kyson3090]

I think the most important thing regarding the change is not so much the timing, but the type of food you eat, when taking the medicine, IMO it should be somewhat consistent. Venclexta has a really long half life (16-19 hours) and it takes about a week for the drug to reach a "steady state" concentration in your blood. So switching times 2-4 hours out to take the dose later isn't going to affect blood concentrations much. Eating a high fat meal, however, increases the total amount of drug absorbed over approximately 30-50% from the studies. So any "nausea" potentially might be influenced by fatty food, the drug itself, plus other factors like other meds you take. Nausea is usually very subjective & everyone is different.

Here's a link that explains the concept of "steady state" better; ignore the calculations, just think about the examples in the first & last paragraphs.

certara.com/knowledge-base/...

[Kyson3090 in reply to SofiaDeo]

Thank you I will read that and I see my oncologist tomorrow. Will be interesting to see what he comes up with. To be honest sometimes the people who are going through it can have a lot more knowledge 😁Bron

[Smakwater in reply to Teddo]

Teddo,

I actually started out taking venetoclax in the morning, however, the nausea would follow throughout the day. I suspect that we all respond a bit differently.

The hydration is a continuous process. I was advised to drink approximately 72 ounces of water throughout the day. In addition, I did keep a bottle of water near where I slept. If you maintain this practice, I suspect that you will wake up to urinate twice before 6:00 AM as I did. I would drink that bottle of water during those two wake up calls as well.

JM

[Kyson3090 in reply to Smakwater]

Thank you 💗 yes the water thing is a pain but I have always drunk lots of water. I too drink it at night and have at least 3 trips to the toilet 😩 I see my oncologist on Friday so am hoping he can come up with something.Thank you

[Kyson3090 in reply to Smakwater]

Hi I only just saw this post before I replied to your other post thank you it was very helpful and thanks for taking the time to help me. Much appreciated 👍

[Smakwater in reply to Kyson3090]

let us know what you come up with.

[Kyson3090 in reply to Smakwater]

Sure will 👍