Restart Ibrutinib 3 days after (still bleeding) tooth extraction?

[misterbee]

I'm a CLL patient on Ibrutinib for 2 years and doing good. Three days ago I had a molar extraction. My doctor told me to stop Ibrutinib 3 days before and three days after extraction. I'm at the point where I should start Ibrutinib again tonight, but the tooth is still bleeding/oozing. Bleeding stopped OK on day 2, but started again in the evening and especially during the night. I've been very careful to avoid exertion, hard foods, brushing etc etc. I will call my oral surgeon Monday AM for advice, but he's certainly not a Ibrutinib expert. Also contacted my ONC, but haven't heard back. Not sure if this is related to thin blood, poor coagulation or what. Big question is, do I restart Ibrutinib after six days? It's kind of scary being off the medication, because it's keeping me alive! Will restarting make healing/bleeding worse? Anyone else have a similar experience?

[Newdawn Administrator]

I’d be wary about re-starting the Ibrutinib without confirmation from your oncologist/haematologist. A day either way shouldn’t be critical and some people cease the Ibrutinib for much longer for more serious surgery without issue. Is it possible to contact your haematology unit/ward for advice? Usually there’s an emergency contact number when we are on treatment.

Newdawn

[misterbee in reply to Newdawn]

Thanks for the advice!

[SofiaDeo]

I agree with Newdawn, confirm it's OK to restart, and don't be surprised if a blood draw is requested, to check platelets. It's hard to predict who might or might not having oozing/bleeding issues.

[misterbee in reply to SofiaDeo]

Thank you!

[Juliemediastream]

Hi I’m in a similar situation. Just had minor surgery and have now been of Ibrutinib for 3 weeks. I have appointment with oncology on Friday so just waiting to see if I can re-start Ibrutinib or not.

[stevesmith1964]

Hi, I have 3 extracts planned , advised by my consultant to stop my acalbrutinib for 5 days before and after. Also when I was on ibrutinib I stopped for 12 days to confirm it was causing mild knee pain. These short breaks shouldn’t have any impact on prognosis etc.

[misterbee in reply to stevesmith1964]

Thanks for responding!