Side Effects of Imbruvica: What You Need to Know

Imbruvica is a prescription drug that’s used to treat certain blood cancers, such as some kinds of leukemia, and immune system reactions. Imbruvica can cause side effects that range from mild to serious. Examples include diarrhea and infections.

Imbruvica is used in certain situations to treat the following conditions:

• mantle cell lymphoma* in adults
• chronic lymphocytic leukemia or small lymphocytic lymphoma in adults
• Waldenström’s macroglobulinemia in adults
• marginal zone lymphoma* in adults
• chronic (long-lasting) graft-versus-host disease in adults and children ages 12 months and older

* For this use, Imbruvica received accelerated approval from the Food and Drug Administration (FDA). Accelerated approval is based on information from early studies. The FDA’s decision for full approval will be made after additional studies are completed.

The active ingredient in Imbruvica is ibrutinib. (An active ingredient is what makes a drug work.) The drug comes in forms that you take by swallowing: capsules, tablets, and a liquid suspension (a type of liquid mixture).

Keep reading to learn about the common, mild, and serious side effects that Imbruvica can cause. For a general overview of the drug, including details about its uses, see this article.

Some people may experience mild or serious side effects during their Imbruvica treatment. Below are a few of the more common side effects reported by people who took Imbruvica in studies. These side effects can vary depending on the condition the drug is being used to treat.

More common side effects in people taking Imbruvica for cancer include:

• neutropenia (low levels of white blood cells called neutrophils)
• diarrhea*
• thrombocytopenia (low levels of blood cells called platelets)*

More common side effects in people taking Imbruvica for chronic (long-lasting) graft versus host disease include:

* To learn more about this side effect, see “Side effects explained” below.

Imbruvica can cause mild side effects. These side effects can vary depending on the condition the drug is being used to treat.

Examples of mild side effects that have been reported with Imbruvica when used to treat cancer include:

Examples of mild side effects that have been reported with Imbruvica when used to treat chronic (long-lasting) graft versus host disease include:

* To learn more about this side effect, see “Side effects explained” below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And do not stop using Imbruvica unless your doctor recommends it.

Imbruvica may cause mild side effects other than the ones listed above. See the Imbruvica prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Imbruvica, visit MedWatch.

In rare cases, serious side effects can occur with Imbruvica. These side effects are expected to be the same regardless of the condition being treated.

Serious side effects that have been reported with Imbruvica include:

• anemia (low levels of red blood cells)
• bleeding
• heart problems, such as an abnormal heart rhythm
• high blood pressure
• neutropenia (low levels of white blood cells called neutrophils)
• other forms of cancer, including skin cancer
• tumor lysis syndrome (when cancer cells release their contents into the blood after being broken down in the body)
• allergic reaction*†
• thrombocytopenia* (low levels of blood cells called platelets)
• infections*

If you develop serious side effects while taking Imbruvica, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see “Side effects explained” below.
† An allergic reaction is possible after using Imbruvica. But this side effect wasn’t reported in studies.

Get answers to some frequently asked questions about Imbruvica’s side effects.

Could Imbruvica cause any eye-related side effects?

Yes, Imbruvica can cause eye-related side effects (also called ocular side effects). In studies, eye side effects were more common in people taking Imbruvica for cancer.

Examples of eye side effects that have been reported with Imbruvica include:

• blurry vision
• conjunctivitis (pink eye)
• dry eye
• reduced clarity or sharpness of vision
• watery eyes

If you’re concerned about eye-related side effects from Imbruvica, talk with your doctor. They can discuss your risks for these side effects. They can also suggest ways to manage them if they happen.

Does Imbruvica have any long-term side effects?

Most of Imbruvica’s side effects are short term. Side effects usually go away either shortly after your body gets used to Imbruvica or after you stop taking the drug.

But some of Imbruvica’s side effects might last longer. For example, heart problems such as abnormal heart rhythm could cause long-term heart damage. Or you may develop other forms of cancer, including skin cancer, that can require long-term treatment.

If you’re concerned about long-term side effects of Imbruvica, talk with your doctor.

Will stopping my Imbruvica treatment cause any side effects?

It’s possible. Side effects after stopping Imbruvica weren’t reported during studies of the drug.

But since Imbruvica was released onto the market, there have been reports of withdrawal side effects in people who stopped taking the drug. Withdrawal side effects can occur when you stop taking a drug that your body has become dependent on. With dependence, your body needs the drug to function like usual.

Possible symptoms of withdrawal from Imbruvica include:

If you’re concerned about having side effects after stopping Imbruvica, talk with your doctor.

Do the side effects of Imbruvica vary depending on the strength or form I take?

With most drugs, higher doses increase the risk of side effects, but it’s not known if this is true for Imbruvica. Studies of Imbruvica didn’t compare differences in side effects based on the strength or form of the drug.

Below is a chart showing the different forms of Imbruvica and the available strengths of each.

Form	Strengths
tablets	140 milligrams (mg), 280 mg, 420 mg, and 560 mg
capsules	70 mg and 140 mg
liquid suspension	70 mg per milliliter (mg/mL)

If you have questions about your risk for side effects from Imbruvica based on the form or strength you use, talk with your doctor.

Does Imbruvica cause hair loss?

It isn’t likely. Hair loss wasn’t a side effect reported in studies of Imbruvica. But cancer drugs other than Imbruvica can cause hair loss. In fact, hair loss is a common side effect of chemotherapy.

If you’re concerned about hair loss from Imbruvica or other treatments you may be using for your condition, talk with your doctor. They can discuss ways to prevent or manage this potential side effect.

Learn more about some of the side effects Imbruvica may cause.

Thrombocytopenia

Thrombocytopenia (low levels of blood cells called platelets) is a common side effect of Imbruvica. Platelets are a type of blood cell that help your blood clot.

Low platelet levels can lead to bruising and bleeding problems, such as having a bloody nose, gums, or urine.

What might help

Your doctor will likely check your platelet level regularly during treatment to watch for this side effect. But if you notice any unusual bruising or bleeding while taking Imbruvica, tell your doctor right away.

If you have a severely low platelet count, you may need to have a blood transfusion. Your doctor will recommend the best treatment for you based on your platelet count.

Infections

Mild infections are a common side effect of Imbruvica. In rare cases, taking Imbruvica may also lead to serious infections.

Possible mild infections that have been reported with Imbruvica include:

• pneumonia
• skin infection
• upper respiratory infection, such as the common cold
• urinary tract infection (UTI), which can occur in your bladder, kidneys, ureters, or urethra (tube that helps move urine out of the bladder)

Examples of serious infections that may occur from using Imbruvica include:

• progressive multifocal leukoencephalopathy (a virus that attacks the protective layer around your nerve cells)
• pneumocystis jirovecii pneumonia (a lung infection caused by a fungus)

Symptoms of mild and serious infections can vary depending on the specific infection you have. But common symptoms of infection are:

• chills
• confusion
• fatigue (low energy)
• fever

What might help

Tell your doctor right away if you have any symptoms of infection while taking Imbruvica. You’ll likely be prescribed medications to help treat the infection. And your doctor may monitor you closely to make sure the infection improves with treatment.

Diarrhea

Diarrhea is a common side effect of Imbruvica. It can cause your body to lose too much water and electrolytes, which can lead to dehydration.

What might help

The tips below can help you manage diarrhea from Imbruvica:

• Avoid greasy or spicy foods. Instead, eat bland foods that won’t upset your stomach. An example is the BRAT diet, which consists of bananas, rice, applesauce, and toast.
• Stay hydrated by drinking water or sports drinks that have electrolytes, such as Gatorade.
• If your doctor or pharmacist says it’s safe, you can also take certain over-the-counter drugs to relieve diarrhea. These include Pepto-Bismol (bismuth subsalicylate) and Imodium (loperamide).

If you have diarrhea while taking Imbruvica, talk with your doctor. And tell them right away about any diarrhea you have that doesn’t go away after about a week.

Allergic reaction

Like most drugs, Imbruvica can cause an allergic reaction in some people. But this side effect wasn’t reported in studies.

Symptoms can be mild or serious and can include:

• skin rash
• itchiness
• flushing (warmth or redness/deepening of skin color for a brief time)
• swelling under your skin, usually in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

• an antihistamine you swallow, such as Benadryl (diphenhydramine)
• a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you had a mild allergic reaction to Imbruvica, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Imbruvica, they may have you switch to a different treatment.

• what dose of drug you were taking when you had the side effect
• how soon after starting that dose you had the side effect
• what your symptoms were from the side effect
• how it affected your daily activities
• what other medications you were also taking
• any other information you feel is important

Imbruvica may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Imbruvica. The list below includes factors to consider.

Heart problems or risk for heart disease. Taking Imbruvica can lead to heart problems, such as an abnormal heart rhythm. Before starting the drug, tell your doctor if you have heart problems or are at risk for heart disease. Conditions that may raise your risk for heart disease include diabetes, high cholesterol, and high blood pressure. If you have any of these conditions, your doctor will likely monitor you closely for other heart problems during your Imbruvica treatment.

Bleeding problems. Before starting your Imbruvica treatment, tell your doctor about any bleeding problems you may have. Imbruvica can cause bleeding. Using the drug if you already have bleeding problems can raise your risk for this side effect even more.

Liver problems. If you have liver problems, your body may not be able to fully break down Imbruvica. This can cause increased levels of the drug in your body, which can raise your risk for side effects. Before taking Imbruvica, talk with your doctor about any liver problems you have.

Allergic reaction. If you’ve had an allergic reaction to Imbruvica or any of its ingredients, you should not take Imbruvica. Ask your doctor what other medications are better options for you.

Recent or upcoming surgeries. Before starting Imbruvica, tell your doctor if you’ve recently had or plan to have any type of surgery or dental procedure. Imbruvica can raise your risk for bleeding. So your doctor may need to temporarily stop your Imbruvica treatment to help prevent serious bleeding during surgery. But do not stop taking Imbruvica unless your doctor says it’s safe to do so.

Infection. Before starting Imbruvica, tell your doctor if you have any current infections. Imbruvica can raise your risk for mild and serious infections, such as skin infection and pneumonia. If you have a current infection, your doctor will likely treat the infection before you start your Imbruvica treatment.

Alcohol and Imbruvica

It should be safe to drink alcohol during your Imbruvica treatment.

If you drink alcohol, talk with your doctor about the amount that’s safe for you to drink while taking Imbruvica.

Pregnancy and breastfeeding while taking Imbruvica

You should not use Imbruvica during pregnancy or while breastfeeding.

Imbruvica hasn’t been studied in pregnancy, but it’s thought to cause fetal harm based on animal studies. Because of this risk, your doctor will give you a pregnancy test before starting Imbruvica treatment to make sure you are not pregnant.

If you can become pregnant, you should use effective birth control while taking Imbruvica and for at least 1 month after your last dose.

If you are a male* with a partner who can become pregnant, you should also use effective birth control while taking Imbruvica and for at least 1 month after your last dose.

It’s not known if Imbruvica can pass into breast milk. To be safe, you should not breastfeed while using Imbruvica and for at least 1 week after your last dose.

Before starting Imbruvica, tell your doctor if you’re pregnant, breastfeeding, or planning to become pregnant or to breastfeed.

* Sex and gender exist on spectrums. Use of the term “male” in this article refers to sex assigned at birth.

Imbruvica is a drug used to treat certain cancers or immune system reactions in adults and some children. Some people may have mild or serious side effects from Imbruvica. Most serious side effects of Imbruvica are rare, but they can be life threatening if not treated.

If you have questions about Imbruvica’s side effects, talk with your doctor or pharmacist. Below are a few examples of questions you may want to ask:

• What can I do to help manage side effects from Imbruvica?
• Do I have a higher risk for side effects from Imbruvica based on the strength or form of the drug I take?
• Can the side effects I have from Imbruvica affect the dosage I’m prescribed?
• Should I avoid any foods that might worsen the side effects of Imbruvica?

To learn more about Imbruvica, see these articles:

• All About Imbruvica
• Imbruvica and Cost: What You Need to Know
• Dosage Details for Imbruvica

To get information on different conditions and tips for improving your health, subscribe to any of Austra Health’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.