Calquence/Acalbrutinib and Fatigue

[Katie-LMHC-Artist]

I experience increased fatigue daily four hours after taking my first pill at 6:00 am. I have to take a nap for at least 1/2 hour. The rest of the day, my fatigue is less. I am aware that low blood cells can cause fatigue. I am curious as to why four hours after taking my morning pill.

[AussieNeil Partner Administrator]

Hi Katie,

It's a pity that you can't switch the time you take your acalabrutinib to in the evening, given you need to take it twice per day. But then I see that 5 months ago, you were experiencing more muscle pain

More seriously, how has your haemoglobin been tracking since you started treatment? Anaemia can cause tiredness, but that's ongoing, not just for a set time after taking your acalabrutinib. It's not unusual to feel more tired during treatment, so I assume this need for a nap is something new?

I wondered if there might be a connection with the peak blood serum level causing maximum CLL cell death and the resulting demand on your body working on the elimination of dying CLL cells and body repair. Given acalabrutinib is slow acting, inhibiting CLL cells from receiving stay alive signals through their B cell receptors and forcing them out of the nodes, spleen and bone marrow, into the blood, where they take some time to eventually die, I doubt that's the reason.

From medicine.com/drug/acalabrut...

Time to Peak

Acalabrutinib: 0.9 hours (range: 0.5 to 1.9 hours); ACP-5862: 1.6 hours (range: 0.9 to 2.7 hours).

Half-Life Elimination

Acalabrutinib: 1 hour; ACP-5862 (active metabolite): 3.5 hours.

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Neil

[Katie-LMHC-Artist in reply to AussieNeil]

Thank you for the information. I will print out your reply and take to my next CLL Specialist appointment. My local hematologist is supportive, but my specialist/researcher should be able to look at my lab work and discuss it with me. Knowing the timing of when the severe fatigue will come is somewhat helpful. In addition, I do have sporadic fatigue. Some evenings I can stay up and other evenings I have to go to bed really early. I have had to explain to my clients that I have to work P/T right now due to my symptoms. My clients are all aware I am taking a cancer inhibitor. Thanks again!

[Nucleusman]

I get fatigue too on Calquence and dose reduced to one a day as am in remission . Just fight it. Not sure if due to a combination of other drugs

[Katie-LMHC-Artist in reply to Nucleusman]

Thank you for sharing. I like knowing why it is happening. I am also starting to accept it. Perhaps if I am able to take one dose at night, eventually I will manage the fatigue better during the day.

[Hidden]

Müdigkeit unter dem Medikament ist nicht ungewöhnlich, das habe ich bei mir auch bemerkt. Ich brauche am Tag circa eine halbe Stunde Mittagsschlaf, ansonsten hilft Koffein beziehungsweise schwarzer Tee sehr gut! Müdigkeit unter der Medikation ist aber auch als nicht untypische Nebenwirkung beschrieben! Es ist auch nicht ungewöhnlich, dass ein Gewöhnungseffekt eintritt und die Müdigkeit wieder verschwindet! Viel Erfolg!

[Katie-LMHC-Artist in reply to Hidden]

Danke für das Teilen. Wenn die Müdigkeit kommt, mache ich ein halbes Nickerchen und dann geht es mir gut. Ich versuche immer noch, als Verhaltensmediziner zu arbeiten, und ich muss mit der Müdigkeit kämpfen, wenn sie erst nach meiner Sitzung mit dem Klienten auftritt. Ich bin dankbar, dass ich von zu Hause aus Telemedizin betreiben kann. Aufgrund der Müdigkeit, die innerhalb von 4 Stunden nach Einnahme der ersten Pille einsetzt, versuche ich, meinen Arbeitsplan anzupassen. Danke für Ihre Rückmeldung. Ich hoffe, ich konnte dir meine Antwort übersetzen!!!