Five Ibrutinib-Associated Side Effects That All Clinicians Should Be Aware of

Levy, Ilana; Polliack, Aaron; Tadmor, Tamar

doi:10.1159/000497356

Cited by 5 publications

(1 citation statement)

References 7 publications

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“…Patients are frequently unaware of potential drug-herb interactions, and some dismiss herbal supplements as medications. Significantly, clinicians are un-informed about simultaneous administration of herbal supplements that may result in plausible toxicities such as fungal infections, bleeding, sudden cardiac death, unexpected exacerbation of IBR-induced haemolytic anaemia, and severe hepatotoxicity [39,40]. Hepatoprotective, cardioprotective, and anxiolytic food supplements containing SA should be prescribed to chronic lymphocytic leukaemia (CLL) patients who require long-term treatment or consume it themselves.…”

Section: Discussionmentioning

confidence: 99%

Cytochrome P450 3A2 and PGP-MDR1-Mediated Pharmacokinetic Interaction of Sinapic Acid with Ibrutinib in Rats: Potential Food/Herb–Drug Interaction

et al. 2022

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Ibrutinib (IBR) metabolism (primarily by CYP3A enzyme) is the main route of excretion for IBR, which could lead to drug–drug/herb–drug interactions with herbal medicines, nutritional supplements, and other foods. Sinapic acid (SA) is a bioactive phytonutrient that is used as a dietary supplement to treat a variety of illnesses. Pharmacokinetic interactions may occur when IBR interacts with SA, which influences the pharmacokinetic processes such as absorption, distribution, metabolism, and excretion. Therefore, it is obligatory to investigate the safety apprehensions of such parallel usage and to evaluate the possible impact of SA on the pharmacokinetics of IBR and propose a possible interaction mechanism in an animal model. The IBR concentration in plasma samples was determined using a validated UHPLC-MS/MS method after administration of a single oral dosage of IBR (50 mg/kg) in rats with or without SA pretreatment (40 mg/kg p.o. each day for 7 days, n = 6). The co-administration of IBR with SA displayed significant increases in Cmax ~18.77%, AUC0–T ~28.07%, MRT ~16.87%, and Kel ~24.76%, and a significant decrease in the volume of distribution Vz/F_obs ~37.66%, the rate of clearance (Cl/F) ~21.81%, and T½ ~20.43%, respectively, were observed as compared to rats that were administered IBR alone, which may result in increased bioavailability of IBR. The metabolism of IBR in the liver and intestines is significantly inhibited when SA is given, which may lead to an increase in the absorption rate of IBR. These findings need to be investigated further before they can be used in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Cytochrome P450 3A2 and PGP-MDR1-Mediated Pharmacokinetic Interaction of Sinapic Acid with Ibrutinib in Rats: Potential Food/Herb–Drug Interaction

et al. 2022

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Ibrutinib-associated osteonecrosis of the jaw

Singh,

Na,

Huryn

et al. 2024

Oral Oncology Reports

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Paronychia and Periungual Granulation as a Novel Side Effect of Ibrutinib: A Case Report

Yorulmaz¹,

Yalçın²

2019

Skin Appendage Disord

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Ibrutinib is an oral covalent inhibitor of the Bruton’s tyrosine kinase pathway and is approved for the treatment of B-cell malignancies including chronic lymphocytic leukaemia, mantle cell lymphoma, and Waldenström’s macroglobulinaemia. It is generally a drug of choice for high-risk patients with indolent lymphomas. The safety profile of ibrutinib appears to be tolerable, with well-known side effects such as infections and haematologic complications. Additionally, dermatological adverse reactions with ibrutinib therapy have been reported to encompass maculopapular rash and hair/nail abnormalities. Here, we present a case of ibrutinib-induced paronychia and periungual granulation in a 40-year-old woman. To the best of our knowledge, this is the third description of ibrutinib-induced paronychia and periungual granulation.

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Five Ibrutinib-Associated Side Effects That All Clinicians Should Be Aware of

Cited by 5 publications

References 7 publications

Cytochrome P450 3A2 and PGP-MDR1-Mediated Pharmacokinetic Interaction of Sinapic Acid with Ibrutinib in Rats: Potential Food/Herb–Drug Interaction

Cytochrome P450 3A2 and PGP-MDR1-Mediated Pharmacokinetic Interaction of Sinapic Acid with Ibrutinib in Rats: Potential Food/Herb–Drug Interaction

Ibrutinib-associated osteonecrosis of the jaw

Paronychia and Periungual Granulation as a Novel Side Effect of Ibrutinib: A Case Report

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