UNMATCHED BTKi
DOSING
FLEXIBILITY 1-3


Additional flexibility: straightforward dose modifications
without exchanges1

- Simply reduce the number of BRUKINSA capsules
- Ability to reduce the dose in small increments
- Rates of dose reductions (0.8%-11%) were low across BRUKINSA studies

- BRUKINSA does not require a new prescription or dose exchange for dose reductions
- Can be taken with or without food. Can be taken with a high-fat meal—BRUKINSA drug concentration (AUC) is not affected
- Advise patients to swallow capsules whole with water—do not open, break, or chew capsules
- If a dose of BRUKINSA is missed, it should be taken as soon as possible with a return to the normal schedule the following day
BRUKINSA should be taken until disease progression or unacceptable toxicity.
AUC=area under the concentration-time curve; BTKi=Bruton’s tyrosine kinase inhibitor.
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No dose adjustments required with these common medications
Proton pump inhibitors
Including, but not limited to:
- Omeprazole
- Esomeprazole
- Lansoprazole
H2-receptor antagonists
Including, but not limited to:
- Famotidine
- Ranitidine
- Nizatidine
Anticoagulants
- Heparins
- Direct thrombin inhibitors
- Factor Xa inhibitors
- Vitamin K antagonists
Antiplatelets
- Aspirin
- P2Y12 inhibitors
- Phosphodiesterase inhibitors
- PAR-1 antagonists
BRUKINSA was allowed to be coadministered in clinical trials with antiplatelets and anticoagulants (as long as INR was ≤1.5 and aPTT ≤1.5 x ULN).4-6
Coadministration of BRUKINSA with antiplatelet or anticoagulant medications may increase the risk of hemorrhage. Monitor for signs and symptoms of bleeding.1
WITH BRUKINSA, DOSE MODIFICATIONS ARE AS STRAIGHTFORWARD AS REDUCING THE
NUMBER OF PILLS, WITH THE ABILITY TO DOSE REDUCE IN SMALL INCREMENTS1
≥Grade 3 events requiring dose modifications
- Grade 3 or Grade 4 febrile neutropenia
- Platelet count decreased to 25,000-50,000/mm3 with significant bleeding
- Neutrophil count decreased to <500/mm3*
- Platelet count decreased to <25,000/mm3*
- Severe or life-threatening non-hematological toxicities†


*Lasting more than 10 consecutive days.
†Evaluate the benefit-risk before resuming treatment at the same dosage for Grade 4 non-hematological toxicity.
aPTT=activated partial thromboplastin time; INR=International Normalized Ratio; PAR-1=protease-activated receptor 1; ULN=upper limit of normal.
Asymptomatic lymphocytosis should not be regarded as an adverse reaction, and these patients should continue taking BRUKINSA.