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
What are the side effects of Calquence (acalabrutinib)?
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%)
Other Side Effects
- Stomach pain
- Constipation
- Vomiting
- Urinary tract infection
- Nosebleed
- Dizziness
- Abnormal liver labs
Serious Side Effects
- 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
Source: DailyMed
The following 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.
Frequently asked questions about Calquence (acalabrutinib)
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What are the 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 forms
Typical dosing 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)?
Mantle cell lymphoma (MCL)
Chronic lymphocytic leukemia (CLL)
Small lymphocytic lymphoma (SLL)
Chronic lymphocytic leukemia (CLL) or small lymphocytic leukemia (SLL) in adults
Waldenström's macroglobulinemia (WM) in adults
Chronic graft versus host disease (cGVHD) in adults and children 1 year and older
Mantle cell lymphoma (MCL) after at least one prior therapy
Advanced marginal zone lymphoma (MZL) for people who didn’t respond well to other anticancer medications
Chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL)
Advanced follicular lymphoma (FL)
Calquence (acalabrutinib) images
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References
Best studies we foundAmerican Cancer Society. (n.d.). Chronic lymphocytic leukemia (CLL).
American Cancer Society. (2022). Low white blood cell counts (neutropenia).
American Cancer Society. (2021). How targeted therapies are used to treat cancer.
American Cancer Society. (2020). Low platelet count (bleeding).
American Cancer Society. (2020). Low red blood cell counts (anemia).
American Cancer Society. (2019). How chemotherapy drugs work.
American Cancer Society. (2019). Targeted therapy safety.
American Cancer Society. (2019). Types of B-cell lymphoma.
Burger, J. A. (2020). BTK Inhibitors: Present and future. Cancer Journal.
Cancer.Net. (2019). Safe storage and disposal of cancer medications.
Centers for Disease Control and Prevention. (2022). Know the signs and symptoms of infection.
Food and Drug Administration. (2022). Drug development and drug interactions | table of substrates, inhibitors and inducers.
Lymphoma Research Foundation. (n.d.). Chronic lymphocytic leukemia/ small lymphocytic lymphoma.
Lymphoma Research Foundation. (n.d.). Mantle cell lymphoma.
Lymphoma Research Foundation. (n.d.). Marginal zone lymphoma.
Lymphoma Research Foundation. (n.d.). Waldenström macroglobulinemia.
MedlinePlus. (2022). Graft-versus-host disease.
National Cancer Institute. (2022). Targeted therapy to treat cancer.
National Comprehensive Cancer Network. (2022). Chronic lymphocytic leukemia.
National Heart, Lung, and Blood Institute. (2022). What is anemia?
NCI Dictionary of Cancer Terms. (n.d.). Chronic lymphocytic leukemia/small lymphocytic lymphoma.
Tasso, B., et al. (2021). The development of BTK inhibitors: A five-year update. Molecules.
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