Calquence
Calquence (acalabrutinib) is an oral medication used to treat blood and bone marrow cancers called mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), and small lymphocytic lymphoma (SLL). Depending on your situation, it can be used alone or with another treatment called Gazyva (obinutuzumab). Calquence (acalabrutinib) is a first-choice treatment option for people with CLL.
What is Calquence (acalabrutinib)?
What is Calquence (acalabrutinib) used for?
- Mantle cell lymphoma (MCL)
- Chronic lymphocytic leukemia (CLL)
- Small lymphocytic lymphoma (SLL)
How Calquence (acalabrutinib) works
Calquence (acalabrutinib) is a specific type of kinase inhibitor called a Bruton tyrosine kinase (BTK) inhibitor. BTK is a protein that helps MCL, CLL, and SLL cancer cells grow uncontrollably and survive. By targeting and blocking BTK, Calquence (acalabrutinib) stops cancer cell growth.
Drug facts
Side effects of Calquence (acalabrutinib)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Anemia (low red blood cells; up to 53%)
- Low white blood cells (up to 48%)
- Low platelets (up to 44%)
- Respiratory tract infection (up to 35%)
- Headache (up to 39%)
- Diarrhea (up to 35%)
- Muscle and joint pain (up to 32%)
- Tiredness (up to 28%)
- Rash (up to 25%)
- Nausea (up to 22%)
- Bruising (up to 21%)
- Bleeding (up to 20%)
*Side effects listed were reported in people taking Calquence (acalabrutinib) alone. Side effects might differ when taken with Gazyva (obinutuzumab).
Less Common Side Effects
- Stomach pain
- Constipation
- Vomiting
- Urinary tract infection
- Nosebleed
- Dizziness
- Abnormal liver labs
Calquence (acalabrutinib) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious infections: body aches, chills, fever, headache, new cough, sore throat, feeling tired
- Serious bleeding: bleeding or bruising that doesn’t stop or go away; large amount of bleeding; throwing up blood; blood in the urine; bloody or black, tarry stool
- Heart rhythm problems: fast heartbeat, chest pain, fainting, dizziness, shortness of breath
The following Calquence (acalabrutinib) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Diarrhea
- Headache
- Joint pain
- Muscle pain
Pros and cons of Calquence (acalabrutinib)
Pros
- Can take with or without food
- Comes as a pill, so it’s more convenient than an injection
- More precise in the way it targets cancer cells, compared to traditional chemotherapy
Cons
- Need to take twice a day
- Might not be a good option if you have a history of heart rhythm problems or severe liver problems
- Only available as a brand medication
Pharmacist tips for Calquence (acalabrutinib)
- You can take Calquence (acalabrutinib) with or without food. Take the medication at the same time each day, and swallow the pill whole with water. Don’t chew, crush, or split the pill since this can raise your risk of harm from touching or taking damaged pills.
- Calquence (acalabrutinib) tablets and capsules aren’t interchangeable, meaning you can’t substitute one for the other. Each time you get a refill of your medication, make sure you have the same form of Calquence (acalabrutinib) that you’ve been taking. If there’s a need to switch to a different form of Calquence (acalabrutinib), discuss with your healthcare provider about whether the change is appropriate for you.
- It’s important to tell your provider and pharmacist about all the medications you take, including supplements and over-the-counter (OTC) medications. Certain medications can interact with Calquence (acalabrutinib). They can affect how well Calquence (acalabrutinib) works or how safe it is for you. Your provider can guide you to safer medication alternatives or recommend how to best take your medications.
- Due to the risk of bleeding with Calquence (acalabrutinib), let your healthcare provider know if you have had a recent surgery or plan to have surgery. You might need to stop taking Calquence (acalabrutinib) for a period of time before and after any surgical procedures.
- If you’re a female who can become pregnant, use birth control during Calquence (acalabrutinib) treatment and for at least 1 week after the last dose. Contact your provider as soon as possible if you become pregnant. This medication can harm an unborn baby.
- Ask your provider or pharmacist about the best way to handle and throw away Calquence (acalabrutinib) safely. Anticancer medications can be very harmful to people who handle or come into contact with them.
Common questions about Calquence (acalabrutinib)
If you forget to take Calquence (acalabrutinib) and it’s within 3 hours of your usual time you take your medication, you can take Calquence (acalabrutinib) as soon as you remember. But if you forget to take the medication by more than 3 hours, skip the missed dose. Take your next Calquence (acalabrutinib) dose at your next regularly scheduled time. Don’t take any extra tablets or double up your dose to make up for the one you missed. This can lead to serious side effects.
No, Calquence (acalabrutinib) is not a chemotherapy medication. It doesn’t kill cancer cells in your body like chemotherapy medications do. Instead, Calquence (acalabrutinib) is a type of targeted therapy. It targets a protein in your body called BTK that helps cancer cells grow out of control. By doing so, Calquence (acalabrutinib) blocks the cancer from growing.
How long you take Calquence (acalabrutinib) depends on several factors, including how well the medication is working to treat your cancer and how well you tolerate it. In general, you’ll likely continue to take Calquence (acalabrutinib) as long as the medication is helping to fight your cancer. If your cancer gets worse or if you can’t tolerate Calquence (acalabrutinib) and its side effects (e.g., headache, tiredness, low blood cell counts), your oncologist will discuss with you about what this means for you and if there are other treatment options you can try. Don’t stop taking Calquence (acalabrutinib) without first talking to your provider.
It depends on how severe your liver problems are. If you have mild-to-moderate liver problems, you might be able to take Calquence (acalabrutinib). But if you have severe liver problems, it’s best to avoid taking Calquence (acalabrutinib). This is because it’s not known if the medication is safe to use in people with severe liver damage. Let your oncologist know if you have liver problems so they can make sure Calquence (acalabrutinib) is safe for you to take.
Calquence (acalabrutinib) isn’t recommended for use if you’re pregnant. This medication might harm your unborn baby or cause problems during delivery. If you're female and able to become pregnant, you might need to do a pregnancy test before you start taking Calquence (acalabrutinib) to make sure you’re not pregnant. Let your provider know right away if you become pregnant while taking this medication.
It isn’t recommended to breastfeed while taking Calquence (acalabrutinib). We don’t know if the medication can pass into your breast milk, but there’s a risk of serious harm to nursing infants if it does. Because of this risk, you shouldn’t breastfeed while taking Calquence (acalabrutinib) and for 2 weeks after your last dose. Talk with your provider about other ways to feed your baby during treatment.
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Risks and warnings for Calquence (acalabrutinib)
Calquence (acalabrutinib) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Serious infections
Calquence (acalabrutinib) can raise your risk of developing serious infections like pneumonia. These infections can sometimes be life-threatening, especially if they’re not treated right away. To help prevent certain types of infections, your healthcare provider might prescribe antibiotic, antifungal, or antiviral medications. Let your provider know as soon as possible if you develop a fever, chills, fatigue, cough, or have other signs of an infection.
Bleeding problems
- Risk factors: Taking antiplatelet or blood thinner medications | Recent surgery
In studies, up to 3% of people taking Calquence (acalabrutinib) experienced serious and sometimes life-threatening bleeding (hemorrhage). In these situations, it can be harder to stop bleeding. You might be at higher risk of serious bleeding if you’re also taking a blood thinner or antiplatelet medication. The risk for a serious bleed is also higher after surgery, so let your provider know if you have a procedure scheduled.
Seek immediate medical help if you experience any symptoms of bleeding. These can include unusual bruising or bleeding, bleeding that takes longer to stop, bleeding from the nose or gums, coughing or vomiting up blood, blood in the stool or black stool, or blood in the urine. You might also feel confused and weak.
Low blood cell counts
Calquence (acalabrutinib) can cause the levels of your red blood cells, white blood cells, and platelets to drop. When these cell counts are lower than normal, you have a higher risk of anemia, bleeding, bruising, and infections. Your provider will check your blood counts regularly while you’re taking Calquence (acalabrutinib). Let your provider know right away if you experience fevers, chills, or bleeding and bruising that doesn’t stop or go away. Depending on how much your blood cell counts dropped, you might need to have your Calquence (acalabrutinib) dose lowered, or you might need to stop taking this medication.
Development of new cancers
Although rare, Calquence (acalabrutinib) can cause new cancers to develop. These new cancers can include skin cancer and cancers in other areas of the body. If you’re outside in the sun, use sun protection, like sunscreen and long-sleeved clothing. Talk to your provider if you notice any changes in your skin so they can check for skin cancer.
Heart rhythm problems
- Risk factors: High blood pressure | History of irregular heartbeat | Infection
Some people taking Calquence (acalabrutinib) experienced an abnormal heart rhythm (arrhythmia). While most events aren’t serious, some cases can be life-threatening or require that you go to the hospital. Let your provider know if you experience an unusually fast or slow heartbeat, chest pain, or dizziness. These can be symptoms of a change in your heart rhythm.
Harm to an unborn baby
Based on animal studies, Calquence (acalabrutinib) can harm an unborn baby. Because of this risk, females who can become pregnant and are taking Calquence (acalabrutinib) should use birth control during treatment and for at least 1 week after the last dose. Let your provider know right away if you become pregnant during this time.
Calquence (acalabrutinib) dosage
Typical dosage for Calquence (acalabrutinib)
The typical starting dose is 100 mg taken by mouth twice a day (about 12 hours apart).
Your dose might be different if you experience certain side effects. It might also differ if you’re taking certain medications that might interact with Calquence (acalabrutinib) (more information provided in Tips).
What are alternatives to Calquence (acalabrutinib)?
Calquence (acalabrutinib) images
