Recommended Dosing with Brukinsa

Dosing flexibility1

Twice daily, 4 capsules, taken 2 in the morning and 2 in the evening, or once daily 4 capsules taken at one time.Twice daily, 4 capsules, taken 2 in the morning and 2 in the evening, or once daily 4 capsules taken at one time.
  • BRUKINSA can be taken as 160 mg twice a day or 320 mg once a day
  • BRUKINSA can be co-administered with proton pump inhibitors and H2-receptor antagonists
  • BRUKINSA can be taken with or without food (advise patients to swallow capsules whole—do not open, break, or chew)
  • BRUKINSA was allowed to be co-administered with anticoagulation therapies in clinical trials (as long as INR was ≤1.5 and aPTT ≤1.5 x ULN)2,3

BRUKINSA should be taken until disease progression or unacceptable toxicity

Recommended dose modifications for ≥Grade 3 adverse reactions1

Event

  • Grade 3 or higher non-hematological toxicities
  • Grade 3 febrile neutropenia
  • Grade 3 thrombocytopenia with 
    significant bleeding
  • Grade 4 neutropenia
    (lasting more than 10 consecutive days)
  • Grade 4 thrombocytopenia
    (lasting more than 10 consecutive days)


Dose Modification (starting dose: 160 mg twice daily or 320 mg once daily)

1st
Occurrence
Interrupt BRUKINSA
Once toxicity has resolved to recovery to
Grade 1 or lower or baseline: resume at 160 mg twice daily or 320 mg once daily
2nd
Occurrence
Interrupt BRUKINSA
Once toxicity has resolved to recovery to
Grade 1 or lower or baseline: resume at 80 mg twice daily or 160 mg once daily
3rd
Occurrence
Interrupt BRUKINSA
Once toxicity has resolved to recovery to
Grade 1 or lower or baseline: resume at 80 mg once daily
4th
Occurrence
Discontinue BRUKINSA


Recommended dose modification for use with CYP3A inhibitors or inducers1

Coadministered drug Recommended use
Strong CYP3A inhibitor 80 mg once daily

Interrupt dose as recommended for adverse reactions
Moderate CYP3A inhibitor 80 mg twice daily

Modify dose as recommended for adverse reactions
Moderate or strong CYP3A inducer Avoid concomitant use

aPTT=activated partial thromboplastin time; INR=International Normalized Ratio; ULN=upper limit of normal.


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