Brukinsa is taken orally, usually in the form of a tablet. The typical recommended dose is 160 mg taken twice daily, although the dosage may vary based on the specific condition being treated, the patient’s response, and other factors like comorbidities or drug interactions. The tablets should be taken with a full glass of water, with or without food.

Oral Route: Oral administration of Brukinsa tablet should be swallowed whole. Do not crush, chew, or break the tablets.

Missed dose: If a dose is skipped, it should be administered as soon as remembered, except in cases where it is about time for the next one. In such cases, one should skip the missed dose and take the next dose at the recommended time. Do not make up for a missed dose by doubling the dose.

Consistency: Taking the medication Brukinsa regularly and at the same time each day ensures steady blood levels of the drug.

Brukinsa drug selectively inhibits Bruton’s tyrosine kinase, a protein critical to B-cell receptor signalling. It is an important signaling pathway responsible for the proliferation and survival of normal and malignant B-cells. The molecule BTK is activated with the appearance of antigens when B-cells are exposed to them resulting in subsequent signaling that creates growth and survival of a cell or immune response.

The BTK pathway is typically hyperactivated in B-cell malignancies, such as mantle cell lymphoma and CLL, resulting in uncontrolled growth of cancerous B-cells. By inhibiting BTK, Brukinsa blocks these survival signals from transmitting into the cells, thus resulting in apoptosis of the malignant B-cells and thereby tumor inhibition.

Although generally well-tolerated, Brukinsa may cause side effects. Some side effects may be serious. Common and less common side effects include:

Diarrhea: One of the most frequently reported side effects, which often improves over time.

Fatigue: Some patients become tired or experience low energy while on Brukinsa.

Bruising or bleeding: Because BTK inhibition can affect blood clotting, some people experience easy bruising or abnormal bleeding.

Upper respiratory infections: Some patients may experience symptoms like a cough, sore throat, or nasal congestion.

Infections: Brukinsa may suppress the immune system, leading to an increased risk of infections. Patients should be monitored for signs of infections, including fever, chills, or sore throat.

Risk of Infection: Brukinsa can lead to immunosuppression and, therefore, increase susceptibility to infections. Monitoring for signs of infection, such as fever and chills, is a must.

Bleeding Risk: All those with a history of bleeding disorders or on anticoagulants should be kept under close observation for symptoms of bleeding, including bruises without an obvious cause, bleeding gums, or presence of blood in the urine or stool.

Liver function: Monitor more closely those with a known history of liver disease or those with abnormal liver function tests. Liver enzyme levels may require monitoring during treatment.

Heart conditions: Patients with a history of arrhythmias or other heart conditions should inform the healthcare provider before starting this medication. Although Brukinsa is considered safer than other BTK inhibitors in terms of cardiac issues, caution is required.

Pregnancy and breastfeeding: Brukinsa is contraindicated in pregnancy because of the potential for harm to the fetus. It is unknown whether the drug is excreted in human milk; therefore, breastfeeding should be avoided during treatment.

Drug interactions: Brukinsa may interact with other drugs, including some antifungals, antibiotics, and other cancer therapies. The patient should inform healthcare providers of all medications currently taken.

1. Strong CYP3A Inhibitors: Medications such as ketoconazole and ritonavir can increase the levels of Brukinsa in the blood, leading to an elevated risk of side effects like bleeding or infections.
2. Strong CYP3A Inducers: Drugs like rifampin and carbamazepine may decrease the effectiveness of Brukinsa by lowering its blood concentration.
3. Anticoagulants and Antiplatelet Drugs: Using Brukinsa with blood thinners, like warfarin or aspirin, may increase the risk of bleeding complications.
4. Antifungal and Antiviral Medications: Some antifungals or antivirals can interact with Brukinsa and either raise its levels, increasing the risk of adverse effects, or reduce its effectiveness.

Always consult with your healthcare provider to ensure safe use when combining Brukinsa with other medications.

The recommended dose of Brukinsa for most adults suffering from mantle cell lymphoma (MCL) or chronic lymphocytic leukemia (CLL) is 160 mg twice a day. Dosage can be adjusted based on the response to treatment and any side effects encountered by the patient.

Dosage adjustment may be necessary for patients with liver or kidney impairment and for patients who are undergoing other medications that may influence the metabolism of Brukinsa.

Brukinsa is a prescription-only medication, and the drug can only be prescribed by a healthcare provider experienced in the treatment of hematologic malignancies. A doctor will evaluate the patient’s condition, treatment history, and underlying medical conditions before prescribing Brukinsa. Follow-up visits and blood tests may be necessary to check on the effectiveness of treatment and detect any possible side effects.

1. What is Brukinsa used for?
   Brukinsa is a prescription medication used to treat certain types of blood cancers, specifically mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL).

2. How does Brukinsa work?
   Brukinsa is a Bruton’s tyrosine kinase (BTK) inhibitor that works by blocking a protein that helps cancer cells grow and survive, thereby slowing the progression of the disease.

3. What is the typical dosage for Brukinsa?
   The usual starting dose is 160 mg taken orally twice daily for MCL, or 320 mg in two divided doses daily for CLL. Your doctor may adjust the dose based on your response and any side effects.

4. Can Brukinsa be taken with food?
   Yes, Brukinsa can be taken with or without food. However, it’s best to take it consistently the same way each day.

5. What are the common side effects of Brukinsa?
   Common side effects include diarrhea, fatigue, nausea, headache, and bruising. Most side effects are manageable but should still be reported to your doctor.

6. Are there any serious side effects associated with Brukinsa?
   Serious side effects can include bleeding problems, infections, heart rhythm changes (arrhythmias), and liver issues. It’s crucial to monitor for these and seek medical attention when needed.

7. Can Brukinsa be used in elderly patients?
   Yes, elderly patients can use Brukinsa, but they may be more sensitive to its side effects and may require dosage adjustments based on their overall health.

8. How long can I expect to be on Brukinsa?
   Duration of therapy with Brukinsa varies and will depend on how well you respond to treatment and the specific cancer being treated. Your healthcare provider will guide you.

9. What should I do if I miss a dose of Brukinsa?
   If you miss a dose, take it as soon as you remember on the same day. If it is almost time for your next dose, skip the missed dose. Do not double up.

10. Can Brukinsa be used in combination with other medications?
    Brukinsa can be used with certain other therapies, but be sure to inform your doctor about all medications, including over-the-counter drugs and supplements, to avoid potential interactions.

11. Is Brukinsa safe in pregnancy or breastfeeding?
    Brukinsa is not recommended during pregnancy or while breastfeeding due to potential harm to the fetus or infant. Discuss with your doctor if you are pregnant or plan to become pregnant.

12. How is Brukinsa administered?
    Brukinsa is administered orally in capsule form and should be taken according to your healthcare provider’s instructions.

13. What should I do if I experience severe side effects?
    If you experience severe side effects, such as difficulty breathing, signs of bleeding, or jaundice (yellowing of the skin or eyes), seek medical attention immediately.

14. Does Brukinsa require regular monitoring?
    Yes, patients on Brukinsa typically require regular lab tests to monitor blood counts, liver function, and other parameters to ensure safety and efficacy.

15. What should I tell my doctor before starting Brukinsa?
    Inform your doctor about any prior treatment for cancer, medical conditions, allergies, and any medications you are currently taking.

16. Can I drink alcohol while taking Brukinsa?
    It’s advisable to limit alcohol consumption while on Brukinsa, as alcohol can exacerbate side effects and impact your overall health during treatment.

17. What if I have liver problems? Can I still take Brukinsa?
    Patients with liver problems may require dosage adjustments. It’s critical to inform your doctor about any liver issues before starting treatment.

18. How should Brukinsa be stored?
    Store Brukinsa at room temperature, away from moisture and heat, and keep it out of reach of children.

19. Is Brukinsa covered by insurance?
    Coverage for Brukinsa varies by insurance plan and provider. Check with your insurance company to determine your coverage options and any potential costs.

20. Where can I find more information about Brukinsa?
    More information can be found in the medication guide provided with your prescription, and you can also consult reputable medical websites or speak with your healthcare provider.