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Ibrutinib is an orally bioavailable, small-molecule inhibitor of Bruton’s tyrosine kinase (BTK) with potential antineoplastic activity. Upon oral administration, ibrutinib binds to and irreversibly inhibits BTK activity, thereby preventing both B-cell activation and B-cell-mediated signaling. This leads to an inhibition of the growth of malignant B cells that overexpress BTK. BTK, a member of the src-related BTK/Tec family of cytoplasmic tyrosine kinases, is required for B-cell receptor signaling, plays a key role in B-cell maturation, and is overexpressed in a number of B-cell malignancies. The expression of BTK in tumor cells is also associated with increased proliferation and survival.
Ibrutinib is an oral inhibitor of Bruton’s tyrosine kinase that is used in the therapy of refractory chronic lymphocytic leukemia (CLL) and mantle cell lymphoma. Ibrutinib has not been associated with serum enzyme elevations during therapy but has been linked to rare cases of clinically apparent acute liver injury and to the reactivation of hepatitis B.
Ibrutinib is a member of the class of acrylamides that is (3R)-3-[4-amino-3-(4-phenoxy phenyl)pyrazolo[3,4-d]pyrimidin-1-yl]piperidine in which the piperidine nitrogen is replaced by an acryloyl group. A selective and covalent inhibitor of the enzyme Bruton’s tyrosine kinase, it is used for the treatment of B-cell malignancies. It has a role as an EC 2.7.10.2 (non-specific protein-tyrosine kinase) inhibitor and an antineoplastic agent. It is a pyrazolopyrimidine, an aromatic amine, an aromatic ether, a member of acrylamides, an N-acylpiperidine, and a tertiary carboxamide.
Mechanism of Action
Ibrutinib is an inhibitor of Bruton’s tyrosine kinase (BTK). It forms a covalent bond with a cysteine residue in the active site of BTK (Cys481), leading to its inhibition. The inhibition of BTK plays a role in the B-cell receptor signaling and thus, the presence of ibrutinib prevents the phosphorylation of downstream substrates such as PLC-γ.
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Ibrutinib is a novel oral tyrosine kinase inhibitor that irreversibly binds and inhibits tyrosine-protein kinase BTK (Bruton tyrosine kinase). BTK has been found to be important in the function of B-cell receptor signaling and therefore in the maintenance and expansion of various B-cell malignancies including chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL). Targeting BTK with ibrutinib has been found to be an effective strategy in treating these malignancies. Phase I clinical testing in non-Hodgkin’s lymphomas and CLL showed that the drug was extremely well tolerated with no major dose-limiting toxicities and a 54% overall response rate. Subsequently, two-phase Ib/II studies were performed on patients with CLL, one in relapsed/refractory CLL and one in previously untreated elderly patients with CLL. Both of these studies continued to show good tolerability of the drug and an overall response rate of about 71% with an extended duration of response. Another phase II study using ibrutinib in relapsed/refractory MCL was conducted and also showed that it was well tolerated with an overall response rate of 68% and an extended duration of response. Due to these results, the U.S. Food and Drug Administration granted accelerated approval for ibrutinib in November 2013 for patients with MCL who had received at least one prior therapy and in February 2014 for patients with CLL who had received at least one prior therapy. This review will discuss the preclinical pharmacology, pharmacokinetics, and clinical efficacy to date of ibrutinib in the treatment of CLL and MCL
In vitro studies have shown induction of CLL cell apoptosis even in presence of prosurvival factors. It has also been reported inhibition of CLL cell survival and proliferation as well as an impairment in cell migration and a reduction in the secretion of chemokines such as CCL3 and CCL4. The latter effect has been shown to produce regression in xenograft mouse models. Clinical studies for relapsed/refractory CLL in phases I and II showed an approximate 71% of overall response rate.. In the case of relapsed/refractory mantle cell lymphoma, approximately 70% of the tested patients presented a partial or complete response.. In clinical trials for relapsed/refractory diffuse large B-cell lymphoma, a partial response was found in between 15-20% of the patients studied; while for patients with relapsed/refractory Waldenstrom’s macroglobulinemia, a partial response was observed in over 75% of the patients tested. Finally, for patients with relapsed/refractory follicular lymphoma, a partial to complete response was obtained in approximately 54% of the patients.
Indications
- Ibrutinib acquired accelerated approval for the treatment of mantle cell lymphoma who have received at least one prior therapy. Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma that develops in the outer edge of a lymph node. MCL is usually diagnosed at late stages and it is easily spread into bone marrow, spleen, liver, and gastrointestinal tract. Ibrutinib is indicated for the treatment of chronic lymphocytic leukemia (CLL) who have at least one prior therapy. CLL is a type of cancer caused by an overproduction of lymphocytes in the bone marrow. Some of the symptoms include swollen lymph nodes and tiredness. Ibrutinib is indicated for the treatment of chronic lymphocytic leukemia (CLL) with 17p deletion. CLL with 17p is a type of leukemia in which a deletion in 17p disrupts the tumor suppressor p53 by deleting one allele of the TP53 gene. The remaining allele is mainly inactivated and thus, this type of leukemia is unresponsive to p53-dependent treatments. Ibrutinib is indicated for the treatment of patients with Waldenstrom’s Macroglobulinemia (WM). WM, also called lymphoplasmacytic lymphoma, is a type of non-Hodgkin lymphoma in which the cancer cells make large amounts of macroglobulin. Macroglobulin is a monoclonal protein that corresponds to the type of IgM antibodies and the unrestricted formation of this protein causes typical symptoms such as excessive bleeding and affects vision and the nervous system.
- Ibrutinib is an antineoplastic agent used to treat chronic lymphocytic leukemia, mantle cell lymphoma, and Waldenstrom’s Macroglobulinemia.
- IMBRUVICA as a single agent is indicated for the treatment of adult patients with relapsed or refractory mantle cell lymphoma (MCL).
- IMBRUVICA as a single agent or in combination with rituximab or obinutuzumab or venetoclax is indicated for the treatment of adult patients with previously untreated chronic lymphocytic leukemia (CLL) (see section 5. 1).
- IMBRUVICA as a single agent or in combination with bendamustine and rituximab (BR) is indicated for the treatment of adult patients with CLL who have received at least one prior therapy.
- IMBRUVICA as a single agent is indicated for the treatment of adult patients with Waldenström’s macroglobulinemia (WM) who have received at least one prior therapy, or in first-line treatment for patients unsuitable for chemoimmunotherapy. IMBRUVICA in combination with rituximab is indicated for the treatment of adult patients with WM.
- Treatment of chronic Graft versus Host Disease (cGvHD)
- Treatment of lymphoplasmacytic lymphoma
- Treatment of mantle cell lymphoma
- Treatment of mature B-cell neoplasms
- Ibrutinib is an oral inhibitor of Bruton’s tyrosine kinase that is used in the therapy of refractory chronic lymphocytic leukemia (CLL) and mantle cell lymphoma.
- Ibrutinib is indicated for the treatment of mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL), Waldenström’s macroglobulinemia (WM), marginal zone lymphoma (MZL), and chronic graft versus host disease (cGVHD)
Contraindications
- Severe myelosuppression including neutropenia, thrombocytopenia, and anemia has been reported in patients who received ibrutinib. Monitor complete blood counts monthly. A dosage adjustment or therapy discontinuation may be necessary for patients who develop hematologic toxicity.
- a bad infection
- anemia
- an increased risk of bleeding
- decreased blood platelets
- low levels of a type of white blood cell called neutrophils
- high blood pressure
- rapid ventricular heartbeat
- atrial fibrillation
- atrial flutter
- chronic heart failure
- a stroke
- bleeding
- liver problems
- recent operation
- pregnancy
- a patient who is producing milk and breastfeeding
- lung tissue problem
- progressive multifocal leukoencephalopathy, a type of brain infection
- Child-Pugh class A liver impairment
- Child-Pugh class B liver impairment
Dosage
Strengths: 70 mg/mL; 140 mg; 70 mg; 280 mg; 420 mg; 560 mg
Lymphoma
- 560 mg orally once a day
- Therapy should be continued until the disease progresses or unacceptable toxicity.
- For the treatment of adult patients with mantle cell lymphoma (MCL) who have received at least one prior therapy
- For the treatment of adult patients with marginal zone lymphoma (MZL) who require systemic therapy and have received at least one prior anti-CD20-based therapy
Chronic Lymphocytic Leukemia
- 420 mg orally once a day
- Therapy should be continued until disease progresses or unacceptable toxicity.
- This drug can be administered as a single agent, in combination with rituximab or obinutuzumab, or in combination with bendamustine and rituximab.
- When administering in combination with rituximab or obinutuzumab, consider administering this drug prior to rituximab or obinutuzumab when given on the same day.
- For the treatment of adult patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL)
- For the treatment of adult patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) with 17p deletion
Non-Hodgkin’s Lymphoma
- 420 mg orally once a day
- Therapy for Waldenstrom’s Macroglobulinemia (WM) should be continued until disease progression or unacceptable toxicity.
- When used for WM, this drug can be administered as a single agent or in combination with rituximab.
- Therapy for cGVHD should be continued until disease progression, recurrence of an underlying malignancy, or unacceptable toxicity
- For the treatment of adult patients with Waldenstrom’s macroglobulinemia (WM)
- For the treatment of adult patients with chronic graft-versus-host disease (cGVHD) after the failure of one or more lines of systemic therapy
Graft Versus Host Disease
- 420 mg orally once a day
- Therapy for Waldenstrom’s Macroglobulinemia (WM) should be continued until disease progression or unacceptable toxicity.
- When used for WM, this drug can be administered as a single agent or in combination with rituximab.
- Therapy for cGVHD should be continued until disease progression, recurrence of an underlying malignancy, or unacceptable toxicity
- For the treatment of adult patients with Waldenstrom’s macroglobulinemia (WM)
- For the treatment of adult patients with chronic graft-versus-host disease (cGVHD) after the failure of one or more lines of systemic therapy
Renal Dose Adjustments
- Mild or moderate renal impairment (CrCl 25 mL/min or greater): No adjustment is recommended.
- Severe renal impairment (CrCl less than 25 mL/min): Data not available
Liver Dose Adjustments
- Mild hepatic impairment (Child-Pugh A): 140 mg orally daily
- Moderate hepatic impairment (Child-Pugh B): 70 mg orally daily
- Severe hepatic impairment (Child-Pugh C): Not recommended.
Dose Adjustments
ADVERSE REACTIONS:
- Interrupt therapy for any Grade 3 or greater nonhematologic toxicity, Grade 3 or greater neutropenia with infection or fever, or Grade 4 hematological toxicity. -When toxicity has resolved to Grade 1 or baseline, therapy may be reinitiated at the starting dose.
- If toxicity reoccurs, reduce the dose by 140 mg per day.
- A second reduction of the dose by 140 mg may be considered if needed.
- If toxicity persists or recurs following 2 dose reductions, discontinue therapy.
DOSE MODIFICATION FOR MCL AND MZL AFTER RECOVERY (Starting Dose = 560 mg):
- The first occurrence of toxicity: Restart at 560 mg daily
- The second occurrence of toxicity: Restart at 420 mg daily
- The third occurrence of toxicity: Restart at 280 mg daily
- The fourth occurrence of toxicity: Discontinue therapy
DOSE MODIFICATION FOR CLL/SLL, WM, AND CGVHD AFTER RECOVERY (Starting Dose = 420 mg):
- The first occurrence of toxicity: Restart at 420 mg daily
- The second occurrence of toxicity: Restart at 280 mg daily
- The third occurrence of toxicity: Restart at 140 mg daily
- The fourth occurrence of toxicity: Discontinue therapy
CONCOMITANT USE WITH CYP450 3A4 INHIBITORS:
PATIENTS WITH B-CELL MALIGNANCIES:
- Concomitant administration of moderate CYP450 3A inhibitor: Administer 280 mg orally once daily; modify dose as recommended
- Voriconazole 200 mg orally twice daily or posaconazole suspension 100 mg orally once daily, 100 mg orally twice daily, or 200 mg orally twice daily: Administer 140 mg orally once daily; modify dose as recommended
- Posaconazole suspension 200 mg orally 3 times daily or 400 mg orally 2 times daily or posaconazole 300 mg IV once daily or posaconazole delayed-release tablets 300 mg orally once daily: Administer 70 mg orally once daily
- Other strong CYP450 3A inhibitors: Avoid concomitant use; if these inhibitors will be used short-term (such as anti-infectives for 7 days or less): Interrupt therapy
PATIENTS WITH CHRONIC GRAFT VERSUS HOST DISEASE:
- Concomitant administration of moderate CYP450 3A Inhibitor: Administer usual dose (420 mg orally once a day); modify dose as recommended.
- Concomitant administration of voriconazole 200 mg orally 2 times a day or posaconazole suspension 100 mg orally once daily, 100 mg orally twice daily, or 200 mg orally twice daily: Administer 280 mg orally once daily; modify dose as recommended.
- Concomitant administration of posaconazole suspension 200 mg orally 3 times daily or 400 mg orally 2 times daily or posaconazole 300 mg IV once daily or posaconazole delayed-release tablets 300 mg orally once daily: Administer 140 mg orally once daily; interrupt dose as recommended
- Other strong CYP450 3A inhibitors: Avoid concomitant use; if these inhibitors will be used short-term (such as anti-infectives for 7 days or less): Interrupt therapy
- After discontinuation of a CYP450 3A inhibitor, resume the previous dose of this drug.
- Administer this drug at approximately the same time each day.
- Instruct patients to swallow capsules or tablets whole with water, and not to open, break, or chew the capsules. Do not cut, crush, or chew the tablets.
- Instruct the patient that this drug must not be taken with grapefruit juice or Seville oranges.
- Administer a missed dose as soon as possible on the same day with a return to the normal dosing schedule the following day; do not administer extra doses to make up for the missed dose.
Side Effects
The Most Common
- diarrhea
- nausea
- constipation
- vomiting
- stomach pain
- heartburn or indigestion
- decreased appetite
- excessive tiredness or weakness
- muscle, bone, and joint pain
- muscle spasms
- swelling of the hands, feet, ankles, or lower legs
- rash
- itching
- sores in the mouth and throat
- anxiety
- difficulty falling asleep or staying asleep
- cough, runny or stuffed nose
- blurred vision
- dry or watery eyes
- pink eye
- swelling of the face, throat, tongue, lips, and eyes
- difficulty swallowing or breathing
- hives
- unusual bruising or bleeding
- pink, red, or dark brown urine
- bloody or black, tarry stools
- nose bleeding
- bloody vomit; or vomiting blood or brown material that resembles coffee grounds
- seizures
- fast or irregular heartbeat
- shortness of breath
- chest discomfort
- dizziness, lightheadedness or feeling faint
- vision changes
- headache (that lasts a long time)
- fever, chills, cough, red, warm skin, or other signs of infection
- confusion
- changes in your speech
- decreased urination
- painful, frequent, or urgent urination
More common
- Back pain
- bladder pain
- bloating or swelling of the face, arms, hands, lower legs, or feet
- bloody or black, tarry stools
- bloody or cloudy urine
- blurred vision
- body aches or pain
- chest pain or tightness
- chills
- confusion
- cough
- decreased frequency or amount of urine
- difficult, burning, or painful urination
- dizziness or lightheadedness
- drowsiness
- dry mouth
- fainting
- fast or irregular heartbeat
- fever
- frequent urge to urinate
- headache
- hoarseness
- increased thirst
- irregular heartbeat
- itching
- loss of appetite
- lower back or side pain
- nausea
- rapid weight gain
- seizures
- severe headache
- severe stomach pain
- sore throat
- tingling of the hands or feet
- trouble breathing
- ulcers, sores, or white spots in the mouth
- unusual bleeding or bruising
- unusual tiredness or weakness
- unusual weight gain or loss
- vomiting
- vomiting of blood or material that looks like coffee grounds
- wrinkled skin
Rare
- Persistent non-healing sore
- pink skin growth
- reddish skin patch or irritated area
- shiny skin bump
- white, yellow or waxy scar-like area on the skin
- Blistering, peeling, or loosening of the skin
- dark urine
- diarrhea
- dilated neck veins
- difficulty swallowing
- a general feeling of tiredness or weakness
- hives, skin rash
- joint pain, stiffness, or swelling
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
- light-colored stools
- muscle pain
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- red skin lesions, often with a purple center
- red, irritated eyes
- yellow eyes or skin
Drug Interaction
| DRUG | INTERACTION |
|---|---|
| Abaloparatide | The therapeutic efficacy of Abaloparatide can be decreased when used in combination with Ibrutinib. |
| Abametapir | The serum concentration of Ibrutinib can be increased when it is combined with Abametapir. |
| Abatacept | The metabolism of Ibrutinib can be increased when combined with Abatacept. |
| Abciximab | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Abciximab. |
| Abiraterone | The metabolism of Ibrutinib can be decreased when combined with Abiraterone. |
| Acalabrutinib | The metabolism of Ibrutinib can be decreased when combined with Acalabrutinib. |
| Acebutolol | The metabolism of Ibrutinib can be decreased when combined with Acebutolol. |
| Acenocoumarol | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Acenocoumarol. |
| Acetaminophen | The metabolism of Ibrutinib can be decreased when combined with Acetaminophen. |
| Acetazolamide | The metabolism of Ibrutinib can be decreased when combined with Acetazolamide. |
| Acetylsalicylic acid | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Acetylsalicylic acid. |
| Adalimumab | The metabolism of Ibrutinib can be increased when combined with Adalimumab. |
| Adenovirus | The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Ibrutinib. |
| Aldesleukin | The metabolism of Ibrutinib can be decreased when combined with Aldesleukin. |
| Alefacept | The risk or severity of adverse effects can be increased when Alefacept is combined with Ibrutinib. |
| Alemtuzumab | The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ibrutinib. |
| Alfentanil | The metabolism of Ibrutinib can be decreased when combined with Alfentanil. |
| Allogeneic | The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Ibrutinib. |
| Allopurinol | The risk or severity of adverse effects can be increased when Allopurinol is combined with Ibrutinib. |
| Almotriptan | The metabolism of Ibrutinib can be decreased when combined with Almotriptan. |
| Alogliptin | The metabolism of Ibrutinib can be decreased when combined with Alogliptin. |
| Alpelisib | The metabolism of Ibrutinib can be decreased when combined with Alpelisib. |
| alpha-Linolenic | alpha-Linolenic acid may increase the antiplatelet activities of Ibrutinib. |
| Alprazolam | The metabolism of Ibrutinib can be decreased when combined with Alprazolam. |
| Alteplase | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Alteplase. |
| Altretamine | The risk or severity of adverse effects can be increased when Altretamine is combined with Ibrutinib. |
| Ambrisentan | The metabolism of Ibrutinib can be decreased when combined with Ambrisentan. |
| Aminophenazone | The metabolism of Ibrutinib can be decreased when combined with Aminophenazone. |
| Amiodarone | The metabolism of Ibrutinib can be decreased when combined with Amiodarone. |
| Amitriptyline | The metabolism of Amitriptyline can be decreased when combined with Ibrutinib. |
| Amoxapine | The metabolism of Amoxapine can be decreased when combined with Ibrutinib. |
| Amphetamine | The metabolism of Ibrutinib can be decreased when combined with Amphetamine. |
| Amprenavir | The metabolism of Ibrutinib can be decreased when combined with Amprenavir. |
| Amsacrine | The risk or severity of adverse effects can be increased when Amsacrine is combined with Ibrutinib. |
| Anagrelide | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Anagrelide. |
| Anakinra | The metabolism of Ibrutinib can be increased when combined with Anakinra. |
| Ancrod | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Ancrod. |
| Anifrolumab | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Anifrolumab. |
| Anistreplase | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Anistreplase. |
| Anthrax immune | The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Ibrutinib. |
| Anthrax vaccine | The risk or severity of infection can be increased when Anthrax vaccine is combined with Ibrutinib. |
| Antilymphocyte | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Antilymphocyte immunoglobulin (horse). |
| Antipyrine | The metabolism of Ibrutinib can be decreased when combined with Antipyrine. |
| Antithrombin Alfa | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Antithrombin Alfa. |
| Antithrombin III | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Antithrombin III human. |
| Antithymocyte | The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Ibrutinib. |
| Apalutamide | The metabolism of Ibrutinib can be increased when combined with Apalutamide. |
| Apixaban | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Apixaban. |
| Apomorphine | The metabolism of Ibrutinib can be decreased when combined with Apomorphine. |
| Apremilast | The metabolism of Ibrutinib can be increased when combined with Apremilast. |
| Aprepitant | The metabolism of Ibrutinib can be decreased when combined with Aprepitant. |
| Ardeparin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Ardeparin. |
| Arformoterol | The metabolism of Ibrutinib can be decreased when combined with Arformoterol. |
| Argatroban | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Argatroban. |
| Aripiprazole | The metabolism of Ibrutinib can be decreased when combined with Aripiprazole. |
| Aripiprazole | The metabolism of Aripiprazole lauroxil can be decreased when combined with Ibrutinib. |
| Armodafinil | The metabolism of Ibrutinib can be increased when combined with Armodafinil. |
| Arsenic trioxide | The risk or severity of adverse effects can be increased when Arsenic trioxide is combined with Ibrutinib. |
| Artemether | The metabolism of Ibrutinib can be decreased when combined with Artemether. |
| Artenimol | The metabolism of Ibrutinib can be decreased when combined with Artenimol. |
| Articaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Articaine. |
| Astemizole | The metabolism of Ibrutinib can be decreased when combined with Astemizole. |
| ACOVID-19 Vaccine | The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Ibrutinib. |
| Asunaprevir | The metabolism of Ibrutinib can be decreased when combined with Asunaprevir. |
| Atazanavir | The metabolism of Ibrutinib can be decreased when combined with Atazanavir. |
| Atenolol | The metabolism of Ibrutinib can be decreased when combined with Atenolol. |
| Atomoxetine | The metabolism of Ibrutinib can be decreased when combined with Atomoxetine. |
| Atorvastatin | The metabolism of Ibrutinib can be decreased when combined with Atorvastatin. |
| Avanafil | The serum concentration of Avanafil can be increased when it is combined with Ibrutinib. |
| Axitinib | The metabolism of Axitinib can be decreased when combined with Ibrutinib. |
| Azacitidine | The risk or severity of adverse effects can be increased when Azacitidine is combined with Ibrutinib. |
| Azathioprine | The risk or severity of adverse effects can be increased when Azathioprine is combined with Ibrutinib. |
| Azelastine | The metabolism of Ibrutinib can be decreased when combined with Azelastine. |
| Bacillus | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Ibrutinib. |
| Bacillus antigen | The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Ibrutinib. |
| Bacillus calmette | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Ibrutinib. |
| Baricitinib | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Baricitinib. |
| Basiliximab | The risk or severity of adverse effects can be increased when Basiliximab is combined with Ibrutinib. |
| BCG vaccine | The risk or severity of infection can be increased when BCG vaccine is combined with Ibrutinib. |
| Beclomethasone | The risk or severity of adverse effects can be increased when Beclomethasone dipropionate is combined with Ibrutinib. |
| Belatacept | The risk or severity of adverse effects can be increased when Belatacept is combined with Ibrutinib. |
| Belimumab | The risk or severity of adverse effects can be increased when Belimumab is combined with Ibrutinib. |
| Belinostat | The risk or severity of adverse effects can be increased when Belinostat is combined with Ibrutinib. |
| Belumosudil | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Belumosudil. |
| Bemiparin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Bemiparin. |
| Bendamustine | The risk or severity of adverse effects can be increased when Bendamustine is combined with Ibrutinib. |
| Bendroflumethiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Ibrutinib. |
| Benzatropine | The metabolism of Ibrutinib can be decreased when combined with Benzatropine. |
| Benzocaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Benzocaine. |
| Benzthiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Ibrutinib. |
| Benzyl alcohol | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Benzyl alcohol. |
| Bepridil | The metabolism of Ibrutinib can be decreased when combined with Bepridil. |
| Berotralstat | The metabolism of Ibrutinib can be decreased when combined with Berotralstat. |
| Betamethasone | The risk or severity of adverse effects can be increased when Betamethasone is combined with Ibrutinib. |
| Betamethasone | The metabolism of Ibrutinib can be increased when combined with Betamethasone phosphate. |
| Betaxolol | The metabolism of Ibrutinib can be decreased when combined with Betaxolol. |
| Betrixaban | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Betrixaban. |
| Bexarotene | The risk or severity of adverse effects can be increased when Bexarotene is combined with Ibrutinib. |
| Bicalutamide | The metabolism of Ibrutinib can be decreased when combined with Bicalutamide. |
| Bifonazole | The metabolism of Ibrutinib can be decreased when combined with Bifonazole. |
| Bimekizumab | The metabolism of Ibrutinib can be increased when combined with Bimekizumab. |
| Biperiden | The metabolism of Ibrutinib can be decreased when combined with Biperiden. |
| Bivalirudin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Bivalirudin. |
| Bleomycin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Ibrutinib. |
| Blinatumomab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Ibrutinib. |
| Boceprevir | The metabolism of Ibrutinib can be decreased when combined with Boceprevir. |
| Bordetella | The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Ibrutinib. |
| Bortezomib | The risk or severity of adverse effects can be increased when Bortezomib is combined with Ibrutinib. |
| Bosutinib | The metabolism of Ibrutinib can be decreased when combined with Bosutinib. |
| Brentuximab | The metabolism of Ibrutinib can be decreased when combined with Brentuximab vedotin. |
| Brexpiprazole | The metabolism of Brexpiprazole can be decreased when combined with Ibrutinib. |
| Brodalumab | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Brodalumab. |
| Bromocriptine | The metabolism of Ibrutinib can be decreased when combined with Bromocriptine. |
| Budesonide | The risk or severity of adverse effects can be increased when Budesonide is combined with Ibrutinib. |
| Bupivacaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Bupivacaine. |
| Buprenorphine | The metabolism of Ibrutinib can be decreased when combined with Buprenorphine. |
| Bupropion | The metabolism of Ibrutinib can be decreased when combined with Bupropion. |
| Buspirone | The metabolism of Ibrutinib can be decreased when combined with Buspirone. |
| Busulfan | The risk or severity of adverse effects can be increased when Busulfan is combined with Ibrutinib. |
| Butacaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Butacaine. |
| Butamben | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Butamben. |
| Cabazitaxel | The metabolism of Cabazitaxel can be decreased when combined with Ibrutinib. |
| Cabergoline | The metabolism of Ibrutinib can be decreased when combined with Cabergoline. |
| Canakinumab | The metabolism of Ibrutinib can be increased when combined with Canakinumab. |
| Candicidin | The metabolism of Ibrutinib can be decreased when combined with Candicidin. |
| Cangrelor | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Cangrelor. |
| Cannabidiol | The metabolism of Ibrutinib can be decreased when combined with Cannabidiol. |
| Capecitabine | The risk or severity of adverse effects can be increased when Capecitabine is combined with Ibrutinib. |
| Caplacizumab | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Caplacizumab. |
| Capsaicin | The metabolism of Ibrutinib can be decreased when combined with Capsaicin. |
| Carbamazepine | The metabolism of Carbamazepine can be decreased when combined with Ibrutinib. |
| Carbimazole | The therapeutic efficacy of Carbimazole can be decreased when used in combination with Ibrutinib. |
| Carboplatin | The risk or severity of adverse effects can be increased when Carboplatin is combined with Ibrutinib. |
| Carfilzomib | The risk or severity of adverse effects can be increased when Carfilzomib is combined with Ibrutinib. |
| Carmustine | The risk or severity of adverse effects can be increased when Carmustine is combined with Ibrutinib. |
| Carvedilol | The metabolism of Ibrutinib can be decreased when combined with Carvedilol. |
| Celecoxib | The metabolism of Ibrutinib can be decreased when combined with Celecoxib. |
| Celiprolol | The metabolism of Ibrutinib can be decreased when combined with Celiprolol. |
| Cenobamate | The metabolism of Ibrutinib can be decreased when combined with Cenobamate. |
| Ceritinib | The metabolism of Ibrutinib can be decreased when combined with Ceritinib. |
| Cerivastatin | The metabolism of Ibrutinib can be decreased when combined with Cerivastatin. |
| Certolizumab | The metabolism of Ibrutinib can be increased when combined with Certolizumab pegol. |
| Cevimeline | The metabolism of Ibrutinib can be decreased when combined with Cevimeline. |
| Chlorambucil | The risk or severity of adverse effects can be increased when Chlorambucil is combined with Ibrutinib. |
| Chloramphenicol | The metabolism of Ibrutinib can be decreased when combined with Chloramphenicol. |
| Chloroprocaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Chloroprocaine. |
| Chloroquine | The metabolism of Ibrutinib can be decreased when combined with Chloroquine. |
| Chlorothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Ibrutinib. |
| Chlorpheniramine | The metabolism of Ibrutinib can be decreased when combined with Chlorpheniramine. |
| Chlorpromazine | The metabolism of Ibrutinib can be decreased when combined with Chlorpromazine. |
| Chlorzoxazone | The metabolism of Ibrutinib can be decreased when combined with Chlorzoxazone. |
| Cholecalciferol | The metabolism of Ibrutinib can be decreased when combined with Cholecalciferol. |
| Ciclesonide | The risk or severity of adverse effects can be increased when Ciclesonide is combined with Ibrutinib. |
| Cilostazol | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Cilostazol. |
| Cimetidine | The metabolism of Ibrutinib can be decreased when combined with Cimetidine. |
| Cinacalcet | The metabolism of Ibrutinib can be decreased when combined with Cinacalcet. |
| Cinchocaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Cinchocaine. |
| Cinnarizine | The metabolism of Ibrutinib can be decreased when combined with Cinnarizine. |
| Ciprofloxacin | The metabolism of Ibrutinib can be decreased when combined with Ciprofloxacin. |
| Cisapride | The metabolism of Ibrutinib can be decreased when combined with Cisapride. |
| Cisplatin | The risk or severity of adverse effects can be increased when Cisplatin is combined with Ibrutinib. |
| Citalopram | The metabolism of Ibrutinib can be decreased when combined with Citalopram. |
| Cladribine | The risk or severity of adverse effects can be increased when Cladribine is combined with Ibrutinib. |
| Clarithromycin | The metabolism of Ibrutinib can be decreased when combined with Clarithromycin. |
| Clemastine | The metabolism of Ibrutinib can be decreased when combined with Clemastine. |
| Clevidipine | The metabolism of Ibrutinib can be decreased when combined with Clevidipine. |
| Clindamycin | The metabolism of Ibrutinib can be decreased when combined with Clindamycin. |
| Clobazam | The metabolism of Ibrutinib can be decreased when combined with Clobazam. |
| Clobetasol | The risk or severity of adverse effects can be increased when Clobetasol propionate is combined with Ibrutinib. |
| Clofarabine | The risk or severity of adverse effects can be increased when Clofarabine is combined with Ibrutinib. |
| Clofazimine | The metabolism of Ibrutinib can be decreased when combined with Clofazimine. |
| Clomipramine | The metabolism of Clomipramine can be decreased when combined with Ibrutinib. |
| Clonidine | The metabolism of Clonidine can be decreased when combined with Ibrutinib. |
| Clopidogrel | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Clopidogrel. |
| Clostridium | The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Ibrutinib. |
| Clozapine | The metabolism of Ibrutinib can be decreased when combined with Clozapine. |
| Cobicistat | The metabolism of Ibrutinib can be decreased when combined with Cobicistat. |
| Cocaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Cocaine. |
| Codeine | The metabolism of Ibrutinib can be decreased when combined with Codeine. |
| Colchicine | The metabolism of Ibrutinib can be decreased when combined with Colchicine. |
| Conivaptan | The metabolism of Ibrutinib can be decreased when combined with Conivaptan. |
| Copanlisib | The metabolism of Copanlisib can be decreased when combined with Ibrutinib. |
| Corticotropin | The risk or severity of adverse effects can be increased when Corticotropin is combined with Ibrutinib. |
| Cortisone acetate | The risk or severity of adverse effects can be increased when Cortisone acetate is combined with Ibrutinib. |
| Corynebacterium | The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Ibrutinib. |
| Crizotinib | The metabolism of Ibrutinib can be decreased when combined with Crizotinib. |
| Curcumin | The metabolism of Ibrutinib can be decreased when combined with Curcumin. |
| Cyanocobalamin | The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Ibrutinib. |
| Cyclopenthiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Ibrutinib. |
| Cyclophosphamide | The metabolism of Cyclophosphamide can be decreased when combined with Ibrutinib. |
| Cyclosporine | Ibrutinib may increase the immunosuppressive activities of Cyclosporine. |
| Cyclothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Ibrutinib. |
| Cyproterone acetate | The metabolism of Ibrutinib can be decreased when combined with Cyproterone acetate. |
| Cytarabine | The risk or severity of adverse effects can be increased when Cytarabine is combined with Ibrutinib. |
| Dabigatran | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Dabigatran. |
| Dabigatran etexilate | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Dabigatran etexilate. |
| Dabrafenib | The metabolism of Ibrutinib can be decreased when combined with Dabrafenib. |
| Dacarbazine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Ibrutinib. |
| Daclatasvir | The metabolism of Daclatasvir can be decreased when combined with Ibrutinib. |
| Dacomitinib | The metabolism of Dacomitinib can be decreased when combined with Ibrutinib. |
| Dactinomycin | The risk or severity of adverse effects can be increased when Dactinomycin is combined with Ibrutinib. |
| Dalfopristin | The metabolism of Ibrutinib can be decreased when combined with Dalfopristin. |
| Dalteparin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Dalteparin. |
| Danaparoid | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Danaparoid. |
| Danazol | The metabolism of Ibrutinib can be decreased when combined with Danazol. |
| Dapagliflozin | The metabolism of Ibrutinib can be decreased when combined with Dapagliflozin. |
| Dapsone | The metabolism of Ibrutinib can be decreased when combined with Dapsone. |
| Darbepoetin | The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Ibrutinib. |
| Darifenacin | The metabolism of Ibrutinib can be decreased when combined with Darifenacin. |
| Darunavir | The metabolism of Ibrutinib can be decreased when combined with Darunavir. |
| Dasabuvir | The metabolism of Dasabuvir can be decreased when combined with Ibrutinib. |
| Dasatinib | The metabolism of Ibrutinib can be decreased when combined with Dasatinib. |
| Daunorubicin | The metabolism of Ibrutinib can be decreased when combined with Daunorubicin. |
| Debrisoquine | The metabolism of Ibrutinib can be decreased when combined with Debrisoquine. |
| Decitabine | The risk or severity of adverse effects can be increased when Decitabine is combined with Ibrutinib. |
| Defibrotide | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Defibrotide. |
| Deflazacort | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Deflazacort. |
| Delavirdine | The metabolism of Ibrutinib can be decreased when combined with Delavirdine. |
| Denosumab | The risk or severity of adverse effects can be increased when Denosumab is combined with Ibrutinib. |
| Desipramine | The metabolism of Ibrutinib can be decreased when combined with Desipramine. |
| Desirudin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Desirudin. |
| Desoximetasone | The risk or severity of adverse effects can be increased when Desoximetasone is combined with Ibrutinib. |
| Desvenlafaxine | The metabolism of Ibrutinib can be decreased when combined with Desvenlafaxine. |
| Deucravacitinib | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Deucravacitinib. |
| Deutetrabenazine | The metabolism of Deutetrabenazine can be decreased when combined with Ibrutinib. |
| Dexamethasone | The metabolism of Ibrutinib can be decreased when combined with Dexamethasone. |
| Dexamethasone | The metabolism of Ibrutinib can be increased when combined with Dexamethasone acetate. |
| Dexchlorphenira | The metabolism of Ibrutinib can be decreased when combined with Dexchlorpheniramine maleate. |
| Dexfenfluramine | The metabolism of Ibrutinib can be decreased when combined with Dexfenfluramine. |
| Dexmedetomidine | The metabolism of Ibrutinib can be decreased when combined with Dexmedetomidine. |
| Dexrazoxane | The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Ibrutinib. |
| Dextran | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Dextran. |
| Dextroamphetamine | The metabolism of Ibrutinib can be decreased when combined with Dextroamphetamine. |
| Dextromethorphan | The metabolism of Ibrutinib can be decreased when combined with Dextromethorphan. |
| Dextropropoxyphene | The metabolism of Ibrutinib can be decreased when combined with Dextropropoxyphene. |
| Diacerein | The metabolism of Ibrutinib can be decreased when combined with Diacerein. |
| Diazepam | The metabolism of Ibrutinib can be decreased when combined with Diazepam. |
| Dicoumarol | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Dicoumarol. |
| Diethylstilbestrol | The metabolism of Ibrutinib can be decreased when combined with Diethylstilbestrol. |
| Difluocortolone | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Difluocortolone. |
| Dihydrocodeine | The metabolism of Ibrutinib can be decreased when combined with Dihydrocodeine. |
| Dihydroergotamine | The metabolism of Ibrutinib can be decreased when combined with Dihydroergotamine. |
| Diltiazem | The metabolism of Ibrutinib can be decreased when combined with Diltiazem. |
| Dimethyl fumarate | The risk or severity of adverse effects can be increased when Dimethyl fumarate is combined with Ibrutinib. |
| Dimethyl sulfoxide | The metabolism of Ibrutinib can be decreased when combined with Dimethyl sulfoxide. |
| Dinutuximab | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Dinutuximab. |
| Diphenhydramine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Diphenhydramine. |
| Dipyridamole | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Dipyridamole. |
| Diroximel | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Diroximel fumarate. |
| Disulfiram | The metabolism of Ibrutinib can be decreased when combined with Disulfiram. |
| Docetaxel | The metabolism of Ibrutinib can be decreased when combined with Docetaxel. |
| Doconexent | Doconexent may increase the antiplatelet activities of Ibrutinib. |
| Dolasetron | The metabolism of Ibrutinib can be decreased when combined with Dolasetron. |
| Domperidone | The metabolism of Ibrutinib can be decreased when combined with Domperidone. |
| Donepezil | The metabolism of Ibrutinib can be decreased when combined with Donepezil. |
| Doravirine | The metabolism of Doravirine can be decreased when combined with Ibrutinib. |
| Dosulepin | The metabolism of Ibrutinib can be decreased when combined with Dosulepin. |
| Doxazosin | The metabolism of Ibrutinib can be decreased when combined with Doxazosin. |
| Doxepin | The metabolism of Ibrutinib can be decreased when combined with Doxepin. |
| Doxorubicin | The metabolism of Ibrutinib can be decreased when combined with Doxorubicin. |
| Dronabinol | The metabolism of Ibrutinib can be decreased when combined with Dronabinol. |
| Dronedarone | The metabolism of Ibrutinib can be decreased when combined with Dronedarone. |
| Drotrecogin alfa | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Drotrecogin alfa. |
| Duloxetine | The metabolism of Ibrutinib can be decreased when combined with Duloxetine. |
| Dutasteride | The metabolism of Ibrutinib can be decreased when combined with Dutasteride. |
| Dyclonine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Dyclonine. |
| Ebola Zaire | The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Ibrutinib. |
| Eculizumab | The risk or severity of adverse effects can be increased when Eculizumab is combined with Ibrutinib. |
| Edetic acid | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Edetic acid. |
| Edoxaban | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Edoxaban. |
| Efalizumab | The risk or severity of adverse effects can be increased when Efalizumab is combined with Ibrutinib. |
| Efavirenz | The metabolism of Ibrutinib can be decreased when combined with Efavirenz. |
| Elagolix | The metabolism of Elagolix can be decreased when combined with Ibrutinib. |
| Elbasvir | The metabolism of Ibrutinib can be decreased when combined with Elbasvir. |
| Eletriptan | The metabolism of Ibrutinib can be decreased when combined with Eletriptan. |
| Elexacaftor | The metabolism of Elexacaftor can be decreased when combined with Ibrutinib. |
| Eliglustat | The metabolism of Ibrutinib can be decreased when combined with Eliglustat. |
| Elvitegravir | The metabolism of Ibrutinib can be decreased when combined with Elvitegravir. |
| Emapalumab | The metabolism of Ibrutinib can be increased when combined with Emapalumab. |
| Enasidenib | The metabolism of Ibrutinib can be decreased when combined with Enasidenib. |
| Encainide | The metabolism of Ibrutinib can be decreased when combined with Encainide. |
| Encorafenib | The metabolism of Encorafenib can be decreased when combined with Ibrutinib. |
| Enoxaparin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Enoxaparin. |
| Entacapone | The metabolism of Ibrutinib can be decreased when combined with Entacapone. |
| Enzalutamide | The serum concentration of Ibrutinib can be decreased when it is combined with Enzalutamide. |
| Epinastine | The metabolism of Ibrutinib can be decreased when combined with Epinastine. |
| Epinephrine | The metabolism of Ibrutinib can be decreased when combined with Epinephrine. |
| Epirubicin | The risk or severity of adverse effects can be increased when Epirubicin is combined with Ibrutinib. |
| Eplerenone | The metabolism of Ibrutinib can be decreased when combined with Eplerenone. |
| Epoprostenol | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Epoprostenol. |
| Eptifibatide | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Eptifibatide. |
| Ergotamine | The metabolism of Ibrutinib can be decreased when combined with Ergotamine. |
| Eribulin | The risk or severity of adverse effects can be increased when Eribulin is combined with Ibrutinib. |
| Erlotinib | The metabolism of Ibrutinib can be decreased when combined with Erlotinib. |
| Erythromycin | The metabolism of Ibrutinib can be decreased when combined with Erythromycin. |
| Erythropoietin | The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Ibrutinib. |
| Escitalopram | The serum concentration of Ibrutinib can be increased when it is combined with Escitalopram. |
| Esmolol | The metabolism of Ibrutinib can be decreased when combined with Esmolol. |
| Estradiol | The metabolism of Ibrutinib can be decreased when combined with Estradiol. |
| Estradiol acetate | The metabolism of Estradiol acetate can be decreased when combined with Ibrutinib. |
| Estradiol benzoate | The metabolism of Estradiol benzoate can be decreased when combined with Ibrutinib. |
| Estradiol cypionate | The metabolism of Estradiol cypionate can be decreased when combined with Ibrutinib. |
| Estradiol dienanthate | The metabolism of Estradiol dienanthate can be decreased when combined with Ibrutinib. |
| Estradiol valerate | The metabolism of Estradiol valerate can be decreased when combined with Ibrutinib. |
| Estramustine | The risk or severity of adverse effects can be increased when Estramustine is combined with Ibrutinib. |
| Etanercept | The metabolism of Ibrutinib can be increased when combined with Etanercept. |
| Ethambutol | The metabolism of Ibrutinib can be decreased when combined with Ethambutol. |
| Ethanol | The metabolism of Ibrutinib can be decreased when combined with Ethanol. |
| Ethinylestradiol | The metabolism of Ibrutinib can be decreased when combined with Ethinylestradiol. |
| Ethyl chloride | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Ethyl chloride. |
| Etidocaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Etidocaine. |
| Etoposide | The metabolism of Ibrutinib can be decreased when combined with Etoposide. |
| Etoricoxib | The metabolism of Ibrutinib can be decreased when combined with Etoricoxib. |
| Everolimus | The metabolism of Ibrutinib can be decreased when combined with Everolimus. |
| Famtozinameran | The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Ibrutinib. |
| Fedratinib | The metabolism of Ibrutinib can be decreased when combined with Fedratinib. |
| Felodipine | The metabolism of Ibrutinib can be decreased when combined with Felodipine. |
| Fenfluramine | The metabolism of Ibrutinib can be decreased when combined with Fenfluramine. |
| Fesoterodine | The metabolism of Ibrutinib can be decreased when combined with Fesoterodine. |
| Fexinidazole | The metabolism of Ibrutinib can be decreased when combined with Fexinidazole. |
| Filgotinib | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Filgotinib. |
| Finasteride | The metabolism of Ibrutinib can be decreased when combined with Finasteride. |
| Fingolimod | Ibrutinib may increase the immunosuppressive activities of Fingolimod. |
| Flecainide | The metabolism of Flecainide can be decreased when combined with Ibrutinib. |
| Floxuridine | The risk or severity of adverse effects can be increased when Floxuridine is combined with Ibrutinib. |
| Fluconazole | The metabolism of Ibrutinib can be decreased when combined with Fluconazole. |
| Flucytosine | The risk or severity of adverse effects can be increased when Flucytosine is combined with Ibrutinib. |
| Fludarabine | The risk or severity of adverse effects can be increased when Fludarabine is combined with Ibrutinib. |
| Fludrocortisone | The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Ibrutinib. |
| Fluindione | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Fluindione. |
| Flunarizine | The metabolism of Ibrutinib can be decreased when combined with Flunarizine. |
| Flunisolide | The risk or severity of adverse effects can be increased when Flunisolide is combined with Ibrutinib. |
| Fluocinolone | The risk or severity of adverse effects can be increased when Fluocinolone acetonide is combined with Ibrutinib. |
| Fluocinonide | The risk or severity of adverse effects can be increased when Fluocinonide is combined with Ibrutinib. |
| Fluocortolone | The risk or severity of adverse effects can be increased when Fluocortolone is combined with Ibrutinib. |
| Fluorometholone | The risk or severity of adverse effects can be increased when Fluorometholone is combined with Ibrutinib. |
| Fluorouracil | The risk or severity of adverse effects can be increased when Fluorouracil is combined with Ibrutinib. |
| Fluoxetine | The serum concentration of Ibrutinib can be increased when it is combined with Fluoxetine. |
| Flupentixol | The risk or severity of myelosuppression can be increased when Flupentixol is combined with Ibrutinib. |
| Fluphenazine | The metabolism of Ibrutinib can be decreased when combined with Fluphenazine. |
| Fluprednisolone | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Fluprednisolone. |
| Flutamide | The metabolism of Ibrutinib can be decreased when combined with Flutamide. |
| Fluticasone | The metabolism of Ibrutinib can be decreased when combined with Fluticasone. |
| Fluticasone | The metabolism of Ibrutinib can be decreased when combined with Fluticasone furoate. |
| Fluticasone | The metabolism of Ibrutinib can be decreased when combined with Fluticasone propionate. |
| Fluvastatin | The metabolism of Ibrutinib can be decreased when combined with Fluvastatin. |
| Fluvoxamine | The metabolism of Ibrutinib can be decreased when combined with Fluvoxamine. |
| Follitropin | The therapeutic efficacy of Follitropin can be decreased when used in combination with Ibrutinib. |
| Fondaparinux | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Fondaparinux. |
| Formoterol | The metabolism of Ibrutinib can be decreased when combined with Formoterol. |
| Fosaprepitant | The metabolism of Ibrutinib can be decreased when combined with Fosaprepitant. |
| Fosnetupitant | The metabolism of Ibrutinib can be decreased when combined with Fosnetupitant. |
| Fosphenytoin | The metabolism of Ibrutinib can be increased when combined with Fosphenytoin. |
| Fostamatinib | The metabolism of Ibrutinib can be decreased when combined with Fostamatinib. |
| Fusidic acid | The metabolism of Ibrutinib can be decreased when combined with Fusidic acid. |
| Galantamine | The metabolism of Ibrutinib can be decreased when combined with Galantamine. |
| Gallium nitrate | The risk or severity of adverse effects can be increased when Gallium nitrate is combined with Ibrutinib. |
| Gefitinib | The metabolism of Ibrutinib can be decreased when combined with Gefitinib. |
| Gemcitabine | The risk or severity of adverse effects can be increased when Gemcitabine is combined with Ibrutinib. |
| Gemtuzumab | The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Ibrutinib. |
| Givosiran | The serum concentration of Ibrutinib can be increased when it is combined with Givosiran. |
| Glatiramer | The risk or severity of adverse effects can be increased when Glatiramer is combined with Ibrutinib. |
| Glyburide | The metabolism of Ibrutinib can be decreased when combined with Glyburide. |
| Glycerol | The metabolism of Ibrutinib can be decreased when combined with Glycerol phenylbutyrate. |
| Golimumab | The metabolism of Ibrutinib can be increased when combined with Golimumab. |
| Guselkumab | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Guselkumab. |
| Haemophilus | The therapeutic efficacy of Haemophilus influenzae type B strain 20752 capsular polysaccharide tetanus toxoid conjugate antigen can be decreased when used in combination with Ibrutinib. |
| Halofantrine | The metabolism of Ibrutinib can be decreased when combined with Halofantrine. |
| Haloperidol | The metabolism of Ibrutinib can be decreased when combined with Haloperidol. |
| Heparin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Heparin. |
| Hepatitis A Vaccine | The therapeutic efficacy of Hepatitis A Vaccine can be decreased when used in combination with Ibrutinib. |
| Hepatitis B | The therapeutic efficacy of Hepatitis B Vaccine (Recombinant) can be decreased when used in combination with Ibrutinib. |
| Human adenovirus | The risk or severity of infection can be increased when Human adenovirus e serotype 4 strain cl-68578 antigen is combined with Ibrutinib. |
| Hydralazine | The metabolism of Ibrutinib can be decreased when combined with Hydralazine. |
| Hydrochlorothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Hydrochlorothiazide is combined with Ibrutinib. |
| Hydrocortisone | The metabolism of Ibrutinib can be decreased when combined with Hydrocortisone. |
| Hydrocortisone a | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Hydrocortisone acetate. |
| Hydrocortisone | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Hydrocortisone butyrate. |
| Hydrocortisone | The metabolism of Hydrocortisone cypionate can be decreased when combined with Ibrutinib. |
| Hydrocortisone | The metabolism of Hydrocortisone phosphate can be decreased when combined with Ibrutinib. |
| Hydrocortisone e | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Hydrocortisone succinate. |
| Hydroflumethiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Hydroflumethiazide is combined with Ibrutinib. |
| Hydroxychloroquine | The risk or severity of adverse effects can be increased when Hydroxychloroquine is combined with Ibrutinib. |
| Hydroxyprogester | The metabolism of Ibrutinib can be decreased when combined with Hydroxyprogesterone caproate. |
| Hydroxyurea | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Ibrutinib. |
| Hydroxyzine | The metabolism of Ibrutinib can be decreased when combined with Hydroxyzine. |
| Ibritumomab tiuxetan | The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Ibrutinib. |
| Icosapent | Icosapent may increase the antiplatelet activities of Ibrutinib. |
| Icosapent ethyl | Icosapent ethyl may increase the antiplatelet activities of Ibrutinib. |
| Idarubicin | The risk or severity of adverse effects can be increased when Idarubicin is combined with Ibrutinib. |
| Idelalisib | The metabolism of Ibrutinib can be decreased when combined with Idelalisib. |
| Ifosfamide | The metabolism of Ibrutinib can be decreased when combined with Ifosfamide. |
| Iloperidone | The metabolism of Ibrutinib can be decreased when combined with Iloperidone. |
| Iloprost | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Iloprost. |
| Imatinib | The metabolism of Ibrutinib can be decreased when combined with Imatinib. |
| Imipramine | The metabolism of Ibrutinib can be decreased when combined with Imipramine. |
| Indinavir | The metabolism of Ibrutinib can be decreased when combined with Indinavir. |
| Indomethacin | The risk or severity of adverse effects can be increased when Indomethacin is combined with Ibrutinib. |
| Inebilizumab | The risk or severity of infection can be increased when Ibrutinib is combined with Inebilizumab. |
| Infliximab | The metabolism of Ibrutinib can be increased when combined with Infliximab. |
| Irbesartan | The metabolism of Ibrutinib can be decreased when combined with Irbesartan. |
| Irinotecan | The risk or severity of adverse effects can be increased when Irinotecan is combined with Ibrutinib. |
| Isavuconazole | The metabolism of Ibrutinib can be decreased when combined with Isavuconazole. |
| Isavuconazonium | The metabolism of Ibrutinib can be decreased when combined with Isavuconazonium. |
| Isoniazid | The metabolism of Ibrutinib can be decreased when combined with Isoniazid. |
| Isradipine | The metabolism of Ibrutinib can be decreased when combined with Isradipine. |
| Istradefylline | The metabolism of Istradefylline can be decreased when combined with Ibrutinib. |
| Itraconazole | The metabolism of Ibrutinib can be decreased when combined with Itraconazole. |
| Ivacaftor | The metabolism of Ibrutinib can be decreased when combined with Ivacaftor. |
| Ivosidenib | The metabolism of Ibrutinib can be increased when combined with Ivosidenib. |
| Ixabepilone | The risk or severity of adverse effects can be increased when Ixabepilone is combined with Ibrutinib. |
| Ixekizumab | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Ixekizumab. |
| Janssen COVID | The therapeutic efficacy of Janssen COVID-19 Vaccine can be decreased when used in combination with Ibrutinib. |
| Japanese | The therapeutic efficacy of Japanese encephalitis virus strain sa 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Ibrutinib. |
| Ketazolam | The metabolism of Ibrutinib can be decreased when combined with Ketazolam. |
| Ketoconazole | The metabolism of Ibrutinib can be decreased when combined with Ketoconazole. |
| Labetalol | The metabolism of Ibrutinib can be decreased when combined with Labetalol. |
| Lanreotide | The metabolism of Ibrutinib can be decreased when combined with Lanreotide. |
| Lansoprazole | The metabolism of Ibrutinib can be decreased when combined with Lansoprazole. |
| Lapatinib | The metabolism of Ibrutinib can be decreased when combined with Lapatinib. |
| Leflunomide | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Leflunomide. |
| Lemborexant | The metabolism of Lemborexant can be decreased when combined with Ibrutinib. |
| Lenalidomide | The risk or severity of adverse effects can be increased when Lenalidomide is combined with Ibrutinib. |
| Lepirudin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Lepirudin. |
| Lercanidipine | The metabolism of Ibrutinib can be decreased when combined with Lercanidipine. |
| Letermovir | The metabolism of Ibrutinib can be decreased when combined with Letermovir. |
| Levamlodipine | The metabolism of Levamlodipine can be decreased when combined with Ibrutinib. |
| Levobetaxolol | The metabolism of Levobetaxolol can be decreased when combined with Ibrutinib. |
| Levobupivacaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Levobupivacaine. |
| Levoketoconazole | The metabolism of Ibrutinib can be decreased when combined with Levoketoconazole. |
| Levomilnacipran | The metabolism of Ibrutinib can be decreased when combined with Levomilnacipran. |
| Levonorgestrel | The metabolism of Ibrutinib can be decreased when combined with Levonorgestrel. |
| Levothyroxine | The therapeutic efficacy of Levothyroxine can be decreased when used in combination with Ibrutinib. |
| Lidocaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Lidocaine. |
| Linagliptin | The metabolism of Ibrutinib can be decreased when combined with Linagliptin. |
| Linezolid | The risk or severity of adverse effects can be increased when Linezolid is combined with Ibrutinib. |
| Liothyronine | The therapeutic efficacy of Liothyronine can be decreased when used in combination with Ibrutinib. |
| Liotrix | The therapeutic efficacy of Liotrix can be decreased when used in combination with Ibrutinib. |
| Lipegfilgrastim | Ibrutinib may increase the myelosuppressive activities of Lipegfilgrastim. |
| Lisdexamfetamine | The metabolism of Ibrutinib can be decreased when combined with Lisdexamfetamine. |
| Lisuride | The metabolism of Ibrutinib can be decreased when combined with Lisuride. |
| Lofexidine | The metabolism of Ibrutinib can be decreased when combined with Lofexidine. |
| Lomitapide | The metabolism of Ibrutinib can be decreased when combined with Lomitapide. |
| Lomustine | The risk or severity of adverse effects can be increased when Lomustine is combined with Ibrutinib. |
| Lonafarnib | The metabolism of Ibrutinib can be decreased when combined with Lonafarnib. |
| Lopinavir | The serum concentration of Ibrutinib can be increased when it is combined with Lopinavir. |
| Lorcaserin | The metabolism of Ibrutinib can be decreased when combined with Lorcaserin. |
| Lorlatinib | The metabolism of Lorlatinib can be decreased when combined with Ibrutinib. |
| Lorpiprazole | The metabolism of Lorpiprazole can be decreased when combined with Ibrutinib. |
| Losartan | The metabolism of Ibrutinib can be decreased when combined with Losartan. |
| Lovastatin | The metabolism of Ibrutinib can be decreased when combined with Lovastatin. |
| Lumacaftor | The metabolism of Ibrutinib can be increased when combined with Lumacaftor. |
| Lumefantrine | The metabolism of Ibrutinib can be decreased when combined with Lumefantrine. |
| Magnesium | The serum concentration of Magnesium can be decreased when it is combined with Ibrutinib. |
| Manidipine | The metabolism of Ibrutinib can be decreased when combined with Manidipine. |
| Maprotiline | The metabolism of Ibrutinib can be decreased when combined with Maprotiline. |
| Mavacamten | The serum concentration of Ibrutinib can be decreased when it is combined with Mavacamten. |
| Measles virus | The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Ibrutinib. |
| Mechlorethamine | The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Ibrutinib. |
| Meclizine | The metabolism of Ibrutinib can be decreased when combined with Meclizine. |
| Mefloquine | The metabolism of Ibrutinib can be decreased when combined with Mefloquine. |
| Meloxicam | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Meloxicam. |
| Melphalan | The risk or severity of adverse effects can be increased when Melphalan is combined with Ibrutinib. |
| Meningococcal | The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Ibrutinib. |
| Mephenytoin | The metabolism of Ibrutinib can be decreased when combined with Mephenytoin. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Mepivacaine. |
| Mepolizumab | The risk or severity of adverse effects can be increased when Mepolizumab is combined with Ibrutinib. |
| Meprednisone | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Meprednisone. |
| Mepyramine | The metabolism of Ibrutinib can be decreased when combined with Mepyramine. |
| Mercaptopurine | The risk or severity of adverse effects can be increased when Mercaptopurine is combined with Ibrutinib. |
| Mesoridazine | The metabolism of Ibrutinib can be decreased when combined with Mesoridazine. |
| Metamfetamine | The metabolism of Ibrutinib can be decreased when combined with Metamfetamine. |
| Metamizole | The risk or severity of myelosuppression can be increased when Metamizole is combined with Ibrutinib. |
| Methadone | The metabolism of Ibrutinib can be decreased when combined with Methadone. |
| Methimazole | The metabolism of Ibrutinib can be decreased when combined with Methimazole. |
| Methotrexate | The risk or severity of adverse effects can be increased when Methotrexate is combined with Ibrutinib. |
| Methotrimeprazine | The metabolism of Ibrutinib can be decreased when combined with Methotrimeprazine. |
| Methylene blue | The metabolism of Ibrutinib can be decreased when combined with Methylene blue. |
| Methylergometrine | The metabolism of Ibrutinib can be decreased when combined with Methylergometrine. |
| Methylprednisolone | The risk or severity of adverse effects can be increased when Methylprednisolone is combined with Ibrutinib. |
| Metoclopramide | The metabolism of Ibrutinib can be decreased when combined with Metoclopramide. |
| Metoprolol | The metabolism of Ibrutinib can be decreased when combined with Metoprolol. |
| Metreleptin | The metabolism of Ibrutinib can be increased when combined with Metreleptin. |
| Metronidazole | The metabolism of Ibrutinib can be decreased when combined with Metronidazole. |
| Metyrapone | The metabolism of Ibrutinib can be decreased when combined with Metyrapone. |
| Mexiletine | The metabolism of Ibrutinib can be decreased when combined with Mexiletine. |
| Mianserin | The metabolism of Ibrutinib can be decreased when combined with Mianserin. |
| Miconazole | The metabolism of Ibrutinib can be decreased when combined with Miconazole. |
| Midazolam | The metabolism of Ibrutinib can be decreased when combined with Midazolam. |
| Midostaurin | The metabolism of Ibrutinib can be decreased when combined with Midostaurin. |
| Mifepristone | The metabolism of Ibrutinib can be decreased when combined with Mifepristone. |
| Milnacipran | The metabolism of Ibrutinib can be decreased when combined with Milnacipran. |
| Minaprine | The metabolism of Ibrutinib can be decreased when combined with Minaprine. |
| Mirabegron | The serum concentration of Ibrutinib can be increased when it is combined with Mirabegron. |
| Mirtazapine | The metabolism of Ibrutinib can be decreased when combined with Mirtazapine. |
| Mitomycin | The risk or severity of adverse effects can be increased when Mitomycin is combined with Ibrutinib. |
| Mitotane | The metabolism of Ibrutinib can be increased when combined with Mitotane. |
| Mitoxantrone | The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Ibrutinib. |
| Mobocertinib | The metabolism of Mobocertinib can be decreased when combined with Ibrutinib. |
| Moclobemide | The metabolism of Ibrutinib can be decreased when combined with Moclobemide. |
| Modafinil | The metabolism of Ibrutinib can be increased when combined with Modafinil. |
| Moderna COVID | The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Ibrutinib. |
| Modified vaccinia | The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Ibrutinib. |
| Mometasone fur | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Mometasone furoate. |
| Monomethyl fum | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Monomethyl fumarate. |
| Mosunetuzumab | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Mosunetuzumab. |
| Mumps virus | The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Ibrutinib. |
| Muromonab | The risk or severity of adverse effects can be increased when Muromonab is combined with Ibrutinib. |
| Mycophenolate | The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Ibrutinib. |
| Mycophenolic acid | The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Ibrutinib. |
| Nadolol | The metabolism of Ibrutinib can be decreased when combined with Nadolol. |
| Nadroparin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Nadroparin. |
| Naloxone | The metabolism of Ibrutinib can be decreased when combined with Naloxone. |
| Natalizumab | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Natalizumab. |
| Nateglinide | The metabolism of Ibrutinib can be decreased when combined with Nateglinide. |
| Nebivolol | The metabolism of Ibrutinib can be decreased when combined with Nebivolol. |
| Nefazodone | The metabolism of Ibrutinib can be decreased when combined with Nefazodone. |
| Nelarabine | The risk or severity of adverse effects can be increased when Nelarabine is combined with Ibrutinib. |
| Nelfinavir | The metabolism of Ibrutinib can be decreased when combined with Nelfinavir. |
| Netupitant | The metabolism of Ibrutinib can be decreased when combined with Netupitant. |
| Nevirapine | The metabolism of Ibrutinib can be decreased when combined with Nevirapine. |
| Niacin | The metabolism of Ibrutinib can be decreased when combined with Niacin. |
| Nicardipine | The metabolism of Ibrutinib can be decreased when combined with Nicardipine. |
| Nicergoline | The metabolism of Ibrutinib can be decreased when combined with Nicergoline. |
| Nifedipine | The metabolism of Ibrutinib can be decreased when combined with Nifedipine. |
| Nilotinib | The metabolism of Ibrutinib can be decreased when combined with Nilotinib. |
| Nilvadipine | The metabolism of Ibrutinib can be decreased when combined with Nilvadipine. |
| Nimesulide | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Nimesulide. |
| Nisoldipine | The metabolism of Ibrutinib can be decreased when combined with Nisoldipine. |
| Nitrendipine | The metabolism of Ibrutinib can be decreased when combined with Nitrendipine. |
| Nitric Oxide | The metabolism of Ibrutinib can be decreased when combined with Nitric Oxide. |
| Norethisterone | The metabolism of Ibrutinib can be decreased when combined with Norethisterone. |
| Norfloxacin | The metabolism of Ibrutinib can be decreased when combined with Norfloxacin. |
| Nortriptyline | The metabolism of Nortriptyline can be decreased when combined with Ibrutinib. |
| Noscapine | The metabolism of Ibrutinib can be decreased when combined with Noscapine. |
| Nuvaxovid | The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Ibrutinib. |
| Obinutuzumab | The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Ibrutinib. |
| Ocrelizumab | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Ocrelizumab. |
| Octreotide | The metabolism of Ibrutinib can be decreased when combined with Octreotide. |
| Ofatumumab | The risk or severity of adverse effects can be increased when Ofatumumab is combined with Ibrutinib. |
| Olanzapine | The metabolism of Ibrutinib can be decreased when combined with Olanzapine. |
| Olaparib | The metabolism of Ibrutinib can be decreased when combined with Olaparib. |
| Oliceridine | The metabolism of Oliceridine can be decreased when combined with Ibrutinib. |
| Olutasidenib | The therapeutic efficacy of Ibrutinib can be decreased when used in combination with Olutasidenib. |
| Omega-3 fatty acids | Omega-3 fatty acids may increase the antiplatelet activities of Ibrutinib. |
| Omega-3-a | Omega-3-acid ethyl esters may increase the antiplatelet activities of Ibrutinib. |
| Omega-3- | Omega-3-carboxylic acids may increase the antiplatelet activities of Ibrutinib. |
| Omeprazole | The metabolism of Ibrutinib can be decreased when combined with Omeprazole. |
| Ondansetron | The metabolism of Ibrutinib can be decreased when combined with Ondansetron. |
| Opium | The metabolism of Opium can be decreased when combined with Ibrutinib. |
| Oritavancin | The metabolism of Ibrutinib can be decreased when combined with Oritavancin. |
| Orphenadrine | The metabolism of Ibrutinib can be decreased when combined with Orphenadrine. |
| Osilodrostat | The metabolism of Ibrutinib can be decreased when combined with Osilodrostat. |
| Ospemifene | The metabolism of Ibrutinib can be decreased when combined with Ospemifene. |
| Oxaliplatin | The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Ibrutinib. |
| Oxamniquine | The metabolism of Ibrutinib can be decreased when combined with Oxamniquine. |
| Oxcarbazepine | The metabolism of Ibrutinib can be decreased when combined with Oxcarbazepine. |
| Oxetacaine | The metabolism of Ibrutinib can be decreased when combined with Oxetacaine. |
| Oxprenolol | The metabolism of Ibrutinib can be decreased when combined with Oxprenolol. |
| Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Oxybuprocaine. |
| Oxybutynin | The metabolism of Ibrutinib can be decreased when combined with Oxybutynin. |
| Oxycodone | The metabolism of Ibrutinib can be decreased when combined with Oxycodone. |
| Oxymetholone | The metabolism of Ibrutinib can be decreased when combined with Oxymetholone. |
| Oxymorphone | The metabolism of Ibrutinib can be decreased when combined with Oxymorphone. |
| Ozanimod | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Ozanimod. |
| Paclitaxel | The metabolism of Paclitaxel can be decreased when combined with Ibrutinib. |
| Palbociclib | The metabolism of Ibrutinib can be decreased when combined with Palbociclib. |
| Palifermin | The therapeutic efficacy of Palifermin can be decreased when used in combination with Ibrutinib. |
| Paliperidone | The metabolism of Ibrutinib can be decreased when combined with Paliperidone. |
| Palonosetron | The metabolism of Ibrutinib can be decreased when combined with Palonosetron. |
| Panobinostat | The metabolism of Ibrutinib can be decreased when combined with Panobinostat. |
| Parathyroid | The therapeutic efficacy of Parathyroid hormone can be decreased when used in combination with Ibrutinib. |
| Paritaprevir | The metabolism of Paritaprevir can be decreased when combined with Ibrutinib. |
| Parnaparin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Parnaparin. |
| Paroxetine | The metabolism of Ibrutinib can be decreased when combined with Paroxetine. |
| Pasireotide | The metabolism of Ibrutinib can be decreased when combined with Pasireotide. |
| Pazopanib | The metabolism of Ibrutinib can be decreased when combined with Pazopanib. |
| pegaspargase | The risk or severity of adverse effects can be increased when Pegaspargase is combined with Ibrutinib. |
| Pegcetacoplan | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Pegcetacoplan. |
| Peginesatide | The risk or severity of Thrombosis can be increased when Peginesatide is combined with Ibrutinib. |
| Peginterferon | The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Ibrutinib. |
| Peginterferon alf | The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Ibrutinib. |
| Peginterferon beta | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Peginterferon beta-1a. |
| Pemetrexed | The risk or severity of adverse effects can be increased when Pemetrexed is combined with Ibrutinib. |
| Penbutolol | The metabolism of Ibrutinib can be decreased when combined with Penbutolol. |
| Penicillamine | The risk or severity of adverse effects can be increased when Penicillamine is combined with Ibrutinib. |
| Pentamidine | The metabolism of Ibrutinib can be decreased when combined with Pentamidine. |
| Pentobarbital | The metabolism of Ibrutinib can be increased when combined with Pentobarbital. |
| Pentosan | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Pentosan polysulfate. |
| Pentostatin | The risk or severity of adverse effects can be increased when Pentostatin is combined with Ibrutinib. |
| Pentoxifylline | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Pentoxifylline. |
| Peppermint oil | The metabolism of Ibrutinib can be decreased when combined with Peppermint oil. |
| Perampanel | The metabolism of Ibrutinib can be decreased when combined with Perampanel. |
| Perhexiline | The metabolism of Ibrutinib can be decreased when combined with Perhexiline. |
| Perphenazine | The metabolism of Ibrutinib can be decreased when combined with Perphenazine. |
| Pertussis vaccine | The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Ibrutinib. |
| Phenelzine | The metabolism of Ibrutinib can be decreased when combined with Phenelzine. |
| Phenformin | The metabolism of Ibrutinib can be decreased when combined with Phenformin. |
| Phenindione | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Phenindione. |
| Phenobarbital | The metabolism of Ibrutinib can be increased when combined with Phenobarbital. |
| Phenol | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Phenol. |
| Phenprocoumon | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Phenprocoumon. |
| Phenylalanine | The risk or severity of adverse effects can be increased when Phenylalanine is combined with Ibrutinib. |
| Phenylbutyric acid | The metabolism of Ibrutinib can be decreased when combined with Phenylbutyric acid. |
| Phenytoin | The metabolism of Ibrutinib can be increased when combined with Phenytoin. |
| Pilocarpine | The metabolism of Ibrutinib can be decreased when combined with Pilocarpine. |
| Pimecrolimus | The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Ibrutinib. |
| Pimozide | The metabolism of Ibrutinib can be decreased when combined with Pimozide. |
| Pindolol | The metabolism of Ibrutinib can be decreased when combined with Pindolol. |
| Piperaquine | The metabolism of Ibrutinib can be decreased when combined with Piperaquine. |
| Piperazine | The metabolism of Ibrutinib can be decreased when combined with Piperazine. |
| Pipotiazine | The metabolism of Ibrutinib can be decreased when combined with Pipotiazine. |
| Pirfenidone | The risk or severity of adverse effects can be increased when Pirfenidone is combined with Ibrutinib. |
| Pitolisant | The serum concentration of Ibrutinib can be decreased when it is combined with Pitolisant. |
| Polythiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Ibrutinib. |
| Pomalidomide | The risk or severity of adverse effects can be increased when Pomalidomide is combined with Ibrutinib. |
| Ponatinib | The metabolism of Ponatinib can be decreased when combined with Ibrutinib. |
| Ponesimod | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Ponesimod. |
| Posaconazole | The metabolism of Ibrutinib can be decreased when combined with Posaconazole. |
| Potassium Iodide | The therapeutic efficacy of Potassium Iodide can be decreased when used in combination with Ibrutinib. |
| Potassium | The therapeutic efficacy of Potassium perchlorate can be decreased when used in combination with Ibrutinib. |
| Practolol | The metabolism of Ibrutinib can be decreased when combined with Practolol. |
| Pralatrexate | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Ibrutinib. |
| Pralsetinib | The metabolism of Ibrutinib can be decreased when combined with Pralsetinib. |
| Pramocaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Pramocaine. |
| Prasugrel | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Prasugrel. |
| Praziquantel | The metabolism of Ibrutinib can be decreased when combined with Praziquantel. |
| Prednisolone | The risk or severity of adverse effects can be increased when Prednisolone is combined with Ibrutinib. |
| Prednisolone | The metabolism of Ibrutinib can be increased when combined with Prednisolone phosphate. |
| Prednisone | The risk or severity of adverse effects can be increased when Prednisone is combined with Ibrutinib. |
| Prednisone acetate | The metabolism of Ibrutinib can be increased when combined with Prednisone acetate. |
| Prilocaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Prilocaine. |
| Primaquine | The metabolism of Ibrutinib can be decreased when combined with Primaquine. |
| Primidone | The metabolism of Ibrutinib can be increased when combined with Primidone. |
| Procainamide | The metabolism of Procainamide can be decreased when combined with Ibrutinib. |
| Procaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Procaine. |
| Procarbazine | The risk or severity of adverse effects can be increased when Procarbazine is combined with Ibrutinib. |
| Prochlorperazine | The metabolism of Ibrutinib can be decreased when combined with Prochlorperazine. |
| Progesterone | The metabolism of Ibrutinib can be decreased when combined with Progesterone. |
| Proguanil | The metabolism of Ibrutinib can be decreased when combined with Proguanil. |
| Promazine | The metabolism of Ibrutinib can be decreased when combined with Promazine. |
| Promethazine | The metabolism of Ibrutinib can be decreased when combined with Promethazine. |
| Propafenone | The metabolism of Ibrutinib can be decreased when combined with Propafenone. |
| Proparacaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Proparacaine. |
| Propofol | The metabolism of Ibrutinib can be decreased when combined with Propofol. |
| Propoxycaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Propoxycaine. |
| Propranolol | The metabolism of Ibrutinib can be decreased when combined with Propranolol. |
| Propylthiouracil | The therapeutic efficacy of Propylthiouracil can be decreased when used in combination with Ibrutinib. |
| Protein C | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Protein C. |
| Protein S | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Protein S human. |
| Protirelin | The therapeutic efficacy of Protirelin can be decreased when used in combination with Ibrutinib. |
| Quetiapine | The metabolism of Ibrutinib can be decreased when combined with Quetiapine. |
| Quinidine | The metabolism of Ibrutinib can be decreased when combined with Quinidine. |
| Quinine | The metabolism of Ibrutinib can be decreased when combined with Quinine. |
| Quinupristin | The metabolism of Ibrutinib can be decreased when combined with Quinupristin. |
| Rabeprazole | The metabolism of Ibrutinib can be decreased when combined with Rabeprazole. |
| Rabies immun | The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Ibrutinib. |
| Rabies virus | The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Ibrutinib. |
| Rabies virus | The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Ibrutinib. |
| Raloxifene | The metabolism of Ibrutinib can be decreased when combined with Raloxifene. |
| Raltitrexed | The risk or severity of adverse effects can be increased when Raltitrexed is combined with Ibrutinib. |
| Ranitidine | The metabolism of Ibrutinib can be decreased when combined with Ranitidine. |
| Ranolazine | The metabolism of Ibrutinib can be decreased when combined with Ranolazine. |
| Ravulizumab | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Ravulizumab. |
| Reboxetine | The metabolism of Ibrutinib can be decreased when combined with Reboxetine. |
| Regorafenib | The metabolism of Ibrutinib can be decreased when combined with Regorafenib. |
| Relugolix | The metabolism of Relugolix can be decreased when combined with Ibrutinib. |
| Remdesivir | The metabolism of Ibrutinib can be decreased when combined with Remdesivir. |
| Remoxipride | The metabolism of Ibrutinib can be decreased when combined with Remoxipride. |
| Reserpine | The metabolism of Ibrutinib can be increased when combined with Reserpine. |
| Reteplase | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Reteplase. |
| Revefenacin | The metabolism of Revefenacin can be decreased when combined with Ibrutinib. |
| Reviparin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Reviparin. |
| Ribociclib | The metabolism of Ibrutinib can be decreased when combined with Ribociclib. |
| Rifampicin | The metabolism of Ibrutinib can be increased when combined with Rifampicin. |
| Rifamycin | The metabolism of Ibrutinib can be decreased when combined with Rifamycin. |
| Rifapentine | The metabolism of Ibrutinib can be increased when combined with Rifapentine. |
| Rilonacept | The metabolism of Ibrutinib can be increased when combined with Rilonacept. |
| Rilpivirine | The metabolism of Ibrutinib can be decreased when combined with Rilpivirine. |
| Risankizumab | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Risankizumab. |
| Risperidone | The metabolism of Ibrutinib can be decreased when combined with Risperidone. |
| Ritonavir | The serum concentration of Ibrutinib can be increased when it is combined with Ritonavir. |
| Rituximab | The risk or severity of adverse effects can be increased when Rituximab is combined with Ibrutinib. |
| Rivaroxaban | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Rivaroxaban. |
| Roflumilast | Roflumilast may increase the immunosuppressive activities of Ibrutinib. |
| Rolapitant | The metabolism of Ibrutinib can be decreased when combined with Rolapitant. |
| Romidepsin | The metabolism of Ibrutinib can be decreased when combined with Romidepsin. |
| Ropeginterferon | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Ropeginterferon alfa-2b. |
| Ropivacaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Ropivacaine. |
| Rosuvastatin | The metabolism of Ibrutinib can be decreased when combined with Rosuvastatin. |
| Rotavirus vaccine | The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Ibrutinib. |
| Rotigotine | The metabolism of Ibrutinib can be decreased when combined with Rotigotine. |
| Roxithromycin | The metabolism of Ibrutinib can be decreased when combined with Roxithromycin. |
| Rubella viru | The risk or severity of infection can be increased when Rubella virus vaccine is combined with Ibrutinib. |
| Rucaparib | The metabolism of Ibrutinib can be decreased when combined with Rucaparib. |
| Rupatadine | The metabolism of Rupatadine can be decreased when combined with Ibrutinib. |
| Rutin | The metabolism of Ibrutinib can be decreased when combined with Rutin. |
| Ruxolitinib | The risk or severity of adverse effects can be increased when Ruxolitinib is combined with Ibrutinib. |
| Salmeterol | The metabolism of Ibrutinib can be decreased when combined with Salmeterol. |
| Salmon calcitonin | The therapeutic efficacy of Salmon calcitonin can be decreased when used in combination with Ibrutinib. |
| Saquinavir | The metabolism of Ibrutinib can be decreased when combined with Saquinavir. |
| Sarilumab | The metabolism of Ibrutinib can be decreased when combined with Sarilumab. |
| Satralizumab | The serum concentration of Ibrutinib can be decreased when it is combined with Satralizumab. |
| Saxagliptin | The metabolism of Ibrutinib can be decreased when combined with Saxagliptin. |
| Secukinumab | The metabolism of Ibrutinib can be increased when combined with Secukinumab. |
| Selegiline | The metabolism of Ibrutinib can be decreased when combined with Selegiline. |
| Selumetinib | The metabolism of Selumetinib can be decreased when combined with Ibrutinib. |
| Sertindole | The metabolism of Ibrutinib can be decreased when combined with Sertindole. |
| Sertraline | The metabolism of Ibrutinib can be decreased when combined with Sertraline. |
| Sildenafil | The metabolism of Ibrutinib can be decreased when combined with Sildenafil. |
| Siltuximab | The metabolism of Ibrutinib can be decreased when combined with Siltuximab. |
| Simeprevir | The metabolism of Ibrutinib can be decreased when combined with Simeprevir. |
| Simvastatin | The metabolism of Ibrutinib can be decreased when combined with Simvastatin. |
| Siponimod | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Siponimod. |
| Sipuleucel-T | The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Ibrutinib. |
| Sirolimus | The metabolism of Sirolimus can be decreased when combined with Ibrutinib. |
| Sitaxentan | The metabolism of Ibrutinib can be decreased when combined with Sitaxentan. |
| Smallpox | The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Ibrutinib. |
| Sodium citrate | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Sodium citrate. |
| Solifenacin | The metabolism of Ibrutinib can be decreased when combined with Solifenacin. |
| Somatostatin | The metabolism of Ibrutinib can be decreased when combined with Somatostatin. |
| Somatrogon | The metabolism of Ibrutinib can be increased when combined with Somatrogon. |
| Sorafenib | The metabolism of Ibrutinib can be decreased when combined with Sorafenib. |
| Sotalol | The metabolism of Sotalol can be decreased when combined with Ibrutinib. |
| Sotorasib | The serum concentration of Ibrutinib can be decreased when it is combined with Sotorasib. |
| Spesolimab | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Spesolimab. |
| St. John’s Wort | The metabolism of Ibrutinib can be increased when combined with St. John’s Wort. |
| Stiripentol | The metabolism of Ibrutinib can be decreased when combined with Stiripentol. |
| Streptokinase | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Streptokinase. |
| Streptozocin | The risk or severity of adverse effects can be increased when Streptozocin is combined with Ibrutinib. |
| Sulfamethoxazole | The metabolism of Ibrutinib can be decreased when combined with Sulfamethoxazole. |
| Sulfaphenazole | The metabolism of Ibrutinib can be decreased when combined with Sulfaphenazole. |
| Sulfasalazine | The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Ibrutinib. |
| Sulfinpyrazone | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Sulfinpyrazone. |
| Sulodexide | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Sulodexide. |
| Sunitinib | The metabolism of Ibrutinib can be decreased when combined with Sunitinib. |
| Tacrolimus | The metabolism of Ibrutinib can be decreased when combined with Tacrolimus. |
| Tadalafil | The metabolism of Ibrutinib can be decreased when combined with Tadalafil. |
| Tafenoquine | The metabolism of Ibrutinib can be decreased when combined with Tafenoquine. |
| Tamoxifen | The metabolism of Ibrutinib can be decreased when combined with Tamoxifen. |
| Tamsulosin | The metabolism of Ibrutinib can be decreased when combined with Tamsulosin. |
| Tedizolid | The risk or severity of myelosuppression can be increased when Tedizolid phosphate is combined with Ibrutinib. |
| Tegafur | The metabolism of Tegafur can be decreased when combined with Ibrutinib. |
| Tegaserod | The metabolism of Ibrutinib can be decreased when combined with Tegaserod. |
| Telaprevir | The metabolism of Ibrutinib can be decreased when combined with Telaprevir. |
| Telithromycin | The metabolism of Ibrutinib can be decreased when combined with Telithromycin. |
| Telotristat ethyl | The serum concentration of Ibrutinib can be decreased when it is combined with Telotristat ethyl. |
| Temozolomide | The risk or severity of adverse effects can be increased when Temozolomide is combined with Ibrutinib. |
| Temsirolimus | The metabolism of Temsirolimus can be decreased when combined with Ibrutinib. |
| Tenecteplase | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Tenecteplase. |
| Teniposide | The metabolism of Ibrutinib can be decreased when combined with Teniposide. |
| Teprotumumab | The risk or severity of adverse effects can be increased when Teprotumumab is combined with Ibrutinib. |
| Terbinafine | The metabolism of Ibrutinib can be decreased when combined with Terbinafine. |
| Terfenadine | The metabolism of Ibrutinib can be decreased when combined with Terfenadine. |
| Teriflunomide | The risk or severity of adverse effects can be increased when Teriflunomide is combined with Ibrutinib. |
| Teriparatide | The therapeutic efficacy of Teriparatide can be decreased when used in combination with Ibrutinib. |
| Testosterone | The metabolism of Ibrutinib can be decreased when combined with Testosterone. |
| Testosterone | The metabolism of Ibrutinib can be decreased when combined with Testosterone cypionate. |
| Testosterone en | The metabolism of Ibrutinib can be decreased when combined with Testosterone enanthate. |
| Testosterone un | The metabolism of Ibrutinib can be decreased when combined with Testosterone undecanoate. |
| Tetrabenazine | The metabolism of Ibrutinib can be decreased when combined with Tetrabenazine. |
| Tetracaine | The risk or severity of methemoglobinemia can be increased when Ibrutinib is combined with Tetracaine. |
| Tetracycline | The metabolism of Ibrutinib can be decreased when combined with Tetracycline. |
| Tezacaftor | The metabolism of Tezacaftor can be decreased when combined with Ibrutinib. |
| Thalidomide | The risk or severity of adverse effects can be increased when Thalidomide is combined with Ibrutinib. |
| Theophylline | The metabolism of Theophylline can be decreased when combined with Ibrutinib. |
| Thiopental | The metabolism of Ibrutinib can be decreased when combined with Thiopental. |
| Thioridazine | The metabolism of Ibrutinib can be decreased when combined with Thioridazine. |
| Thiotepa | The risk or severity of adverse effects can be increased when Thiotepa is combined with Ibrutinib. |
| Thyroid, porcine | The therapeutic efficacy of Thyroid, porcine can be decreased when used in combination with Ibrutinib. |
| Thyrotropin alfa | The therapeutic efficacy of Thyrotropin alfa can be decreased when used in combination with Ibrutinib. |
| Ticagrelor | The metabolism of Ibrutinib can be decreased when combined with Ticagrelor. |
| Tick-borne | The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Ibrutinib. |
| Ticlopidine | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Ticlopidine. |
| Timolol | The metabolism of Ibrutinib can be decreased when combined with Timolol. |
| Tinzaparin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Tinzaparin. |
| Tioconazole | The metabolism of Ibrutinib can be decreased when combined with Tioconazole. |
| Tioguanine | The risk or severity of adverse effects can be increased when Tioguanine is combined with Ibrutinib. |
| Tiotropium | The metabolism of Ibrutinib can be decreased when combined with Tiotropium. |
| Tipranavir | The metabolism of Ibrutinib can be decreased when combined with Tipranavir. |
| Tirofiban | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Tirofiban. |
| Tixocortol | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Tixocortol. |
| Tocilizumab | The metabolism of Ibrutinib can be increased when combined with Tocilizumab. |
| Tofacitinib | Ibrutinib may increase the immunosuppressive activities of Tofacitinib. |
| Tolterodine | The metabolism of Ibrutinib can be decreased when combined with Tolterodine. |
| Topotecan | The metabolism of Ibrutinib can be decreased when combined with Topotecan. |
| Tositumomab | The risk or severity of adverse effects can be increased when Tositumomab is combined with Ibrutinib. |
| Trabectedin | The metabolism of Trabectedin can be decreased when combined with Ibrutinib. |
| Tramadol | The metabolism of Ibrutinib can be decreased when combined with Tramadol. |
| Tranylcypromine | The metabolism of Ibrutinib can be decreased when combined with Tranylcypromine. |
| Trastuzumab | Trastuzumab may increase the neutropenic activities of Ibrutinib. |
| Trastuzumab | The metabolism of Trastuzumab emtansine can be decreased when combined with Ibrutinib. |
| Trazodone | The metabolism of Ibrutinib can be decreased when combined with Trazodone. |
| Tretinoin | The risk or severity of adverse effects can be increased when Tretinoin is combined with Ibrutinib. |
| Triamcinolone | The risk or severity of adverse effects can be increased when Triamcinolone is combined with Ibrutinib. |
| Triazolam | The metabolism of Ibrutinib can be decreased when combined with Triazolam. |
| Trichlormethiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Ibrutinib. |
| Triclabendazole | The metabolism of Ibrutinib can be decreased when combined with Triclabendazole. |
| Trifluridine | The risk or severity of adverse effects can be increased when Trifluridine is combined with Ibrutinib. |
| Triflusal | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Triflusal. |
| Trilostane | The risk or severity of adverse effects can be increased when Trilostane is combined with Ibrutinib. |
| Trimipramine | The metabolism of Trimipramine can be decreased when combined with Ibrutinib. |
| Tripelennamine | The metabolism of Ibrutinib can be decreased when combined with Tripelennamine. |
| Troglitazone | The metabolism of Ibrutinib can be decreased when combined with Troglitazone. |
| Troleandomycin | The metabolism of Ibrutinib can be decreased when combined with Troleandomycin. |
| Trospium | The metabolism of Ibrutinib can be decreased when combined with Trospium. |
| Tucatinib | The metabolism of Tucatinib can be decreased when combined with Ibrutinib. |
| Typhoid vaccine | The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Ibrutinib. |
| Typhoid Vaccine | The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Ibrutinib. |
| Typhoid Vi | The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Ibrutinib. |
| Udenafil | The metabolism of Ibrutinib can be decreased when combined with Udenafil. |
| Umeclidinium | The metabolism of Umeclidinium can be decreased when combined with Ibrutinib. |
| Upadacitinib | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Upadacitinib. |
| Urokinase | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Urokinase. |
| Valentine | The metabolism of Valbenazine can be decreased when combined with Ibrutinib. |
| Valproic acid | The metabolism of Ibrutinib can be decreased when combined with Valproic acid. |
| Vardenafil | The metabolism of Ibrutinib can be decreased when combined with Vardenafil. |
| Varicella zoster | The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Ibrutinib. |
| Varicella zoster | The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Ibrutinib. |
| Vedolizumab | The risk or severity of adverse effects can be increased when Vedolizumab is combined with Ibrutinib. |
| Vemurafenib | The metabolism of Ibrutinib can be decreased when combined with Vemurafenib. |
| Venetoclax | The metabolism of Ibrutinib can be decreased when combined with Venetoclax. |
| Venlafaxine | The metabolism of Ibrutinib can be decreased when combined with Venlafaxine. |
| Verapamil | The metabolism of Ibrutinib can be decreased when combined with Verapamil. |
| Vernakalant | The metabolism of Ibrutinib can be decreased when combined with Vernakalant. |
| Vibrio cholerae | The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Ibrutinib. |
| Vilanterol | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Vilanterol. |
| Vilazodone | The metabolism of Ibrutinib can be decreased when combined with Vilazodone. |
| Viloxazine | The metabolism of Ibrutinib can be decreased when combined with Viloxazine. |
| Vinblastine | The metabolism of Ibrutinib can be decreased when combined with Vinblastine. |
| Vincristine | The metabolism of Vincristine can be decreased when combined with Ibrutinib. |
| Vindesine | The risk or severity of adverse effects can be increased when Vindesine is combined with Ibrutinib. |
| Vinorelbine | The risk or severity of adverse effects can be increased when Vinorelbine is combined with Ibrutinib. |
| Vitamin E | Vitamin E may increase the antiplatelet activities of Ibrutinib. |
| Voclosporin | The risk or severity of adverse effects can be increased when Ibrutinib is combined with Voclosporin. |
| Vonoprazan | The metabolism of Vonoprazan can be decreased when combined with Ibrutinib. |
| Vorapaxar | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Vorapaxar. |
| Voriconazole | The metabolism of Ibrutinib can be decreased when combined with Voriconazole. |
| Vorinostat | The risk or severity of adverse effects can be increased when Vorinostat is combined with Ibrutinib. |
| Vortioxetine | The metabolism of Vortioxetine can be decreased when combined with Ibrutinib. |
| Warfarin | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Warfarin. |
| Ximelagatran | The risk or severity of bleeding and hemorrhage can be increased when Ibrutinib is combined with Ximelagatran. |
| Yellow fever | The risk or severity of infection can be increased when Yellow fever vaccine is combined with Ibrutinib. |
| Yohimbine | The metabolism of Ibrutinib can be decreased when combined with Yohimbine. |
| Zafirlukast | The metabolism of Ibrutinib can be decreased when combined with Zafirlukast. |
| Zaleplon | The metabolism of Ibrutinib can be decreased when combined with Zaleplon. |
| Zidovudine | The risk or severity of adverse effects can be increased when Zidovudine is combined with Ibrutinib. |
| Zimelidine | The metabolism of Ibrutinib can be decreased when combined with Zimelidine. |
| Ziprasidone | The metabolism of Ibrutinib can be decreased when combined with Ziprasidone. |
| Zolpidem | The metabolism of Ibrutinib can be decreased when combined with Zolpidem. |
| Zonisamide | The metabolism of Ibrutinib can be decreased when combined with Zonisamide. |
| Zuclopenthixol | The metabolism of Ibrutinib can be decreased when combined with Zuclopenthixol |
Pregnancy and Lactation
AU TGA pregnancy category: D
US FDA pregnancy category: Not Assigned
Pregnancy
This drug is a kinase inhibitor and can cause fetal harm based on findings from animal studies. Administration to pregnant animals during organogenesis at exposures up to 2 to 20 times the recommended human dose caused embryofetal toxicity including structural abnormalities. This drug should not be used during pregnancy unless the benefit outweighs the risk to the fetus. Advise females of reproductive potential and male patients to use effective contraceptive measures during therapy and for 1 to 3 months after. Females taking hormonal contraception should add a barrier contraceptive method as it is currently unknown whether this drug reduces the effectiveness of hormonal contraceptives. Male patients should not donate sperm during therapy and for 1 to 3 months after. Verify the pregnancy status of females of reproductive potential prior to initiating therapy. The time following treatment with this drug when it is safe to become pregnant is unknown.
Lactation
No information is available on the clinical use of ibrutinib during breastfeeding. Because ibrutinib is more than 97% bound to plasma proteins, the amount in milk is likely to be low. The manufacturer recommends that breastfeeding be discontinued during ibrutinib therapy and for 1 week after the last dose.
How should this medicine be used?
Ibrutinib comes as a capsule and a tablet to take by mouth. It is usually taken once daily. Take ibrutinib at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ibrutinib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the capsules whole with a glass of water; do not open, break, or chew them. Swallow the tablets whole with a glass of water; do not cut, crush or chew them.
If you are receiving an obinutuzumab (Gazyva) injection or rituximab (Rituxan) injection, your doctor may tell you to take your dose of ibrutinib before you receive your injection.
Your doctor may decrease your dose, or interrupt or discontinue your treatment. This depends on how well the medication works for you and the side effects you experience. Talk to your doctor about how you are feeling during your treatment. Continue to take ibrutinib even if you feel well. Do not stop taking ibrutinib without talking to your doctor. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
How should I take ibrutinib tablets and capsules
- Swallow ibrutinib capsules or tablets whole with a glass of water.
- Do not open, break, or chew the capsules.
- Do not cut, crush, or chew the tablets.
How should I take ibrutinib oral suspension
- Follow the Instructions for Use that comes with your oral suspension for information about the correct way to give a dose to your child. If you have questions about how to give this medication, talk to your healthcare provider or call 1-877-877-3536.
- Each oral suspension carton contains:
- 1 bottle of the medication with pre-inserted bottle adapter. Do not remove the bottle adapter
- 2 reusable 3 mL oral dosing syringes (called ‘syringe’ in this Instructions for Use) measuring in 0.1 mL increments.
- Only use the syringes that come with your medication. Do not use the syringes for other patients or with other medicines.
- If you cannot read the markings on the syringes, throw them away and call 1-877-877-3536 to get new ones.
- Preparing and giving a dose of ibrutinib oral suspension
- Step 1: Gather and check supplies
- Check your child’s prescribed dose in milliliters (mLs). Find this mL marking on the syringe.
- If the dose is more than the marking on the syringe, split the dose between syringes as prescribed.
- Gather bottle and syringe(s).
- Check the bottle and make sure that it is the correct medication and the printed on it and the expiration date (“EXP”) has not passed.
- Do not use if the expiration date has passed or the carton seal has been tampered with
- Step 2: Record or check discard date
- When opening the bottle for the first time, record the date that is 60 days from the day the bottle is opened underneath the words “Discard Date. Use within 60 days of opening.
- Step 3: Shake bottle before each use
- Step 4: Remove cap from bottle
- Press down and twist the cap counterclockwise to remove it from the bottle.
- If there is fluid on top of the adapter you may wipe it with clean disposable tissue.
- Do not remove the bottle adapter.
- Step 5: Attach syringe to bottle
- Make sure the syringe is clean and dry before use.
- Push the plunger down all the way.
- Gently insert tip of the syringe into the adapter.
- Turn the assembled bottle and syringe upside down.
- Step 6: Fill syringe
- Slowly pull the syringe plunger down, past the number of mLs for your prescribed dose.
- Check for air bubbles and proceed to Step 7 for instructions on how to remove air bubbles.
- Step 7: Remove air bubbles and adjust to the prescribed dose (mL)
- Hold the syringe and tap the sides to send bubbles to the tip.
- With the syringe attached to the bottle, push the plunger up to remove the air bubbles from the top.
- After the bubbles are removed, push the plunger up until the top of the colored plunger is even with the markings on the syringe for the dose.
- Air bubbles must be removed to ensure the correct dose. Repeat steps 6 and 7 if any air bubbles remain.
- Step 8: Remove syringe from bottle
- Turn the assembled bottle upright.
- Hold the middle of the syringe and carefully remove it from the bottle.
- Place the bottle aside.
- Do not touch the plunger of the syringe to avoid accidentally spilling the medicine before you are ready.
- Note: If more than 1 syringe is needed to give the full dose, repeat steps 5 to 8 with the second syringe to complete the prescribed dose.
- Step 9: Give ibrutinib oral suspension
- Place the tip of the syringe along the inside of your child’s cheek.
- Slowly push the plunger all the way in to give the entire dose.
- Repeat with second syringe if needed to complete the prescribed dose.
- Note: this medication must be given as soon as possible after being drawn from the bottle.
- Note: Make sure your child drinks water after swallowing the dose of medicine.
- Step 10: Recap bottle
- Place the cap back on the bottle.
- Make sure the bottle is tightly closed between each use.
- Step 11: Rinse syringe
- Remove plunger from the syringe, rinse only with water and air dry.
- Store the syringe in a clean, dry place.
- Do not clean the syringe with soap or in the dishwasher.
- Step 1: Gather and check supplies
- Each oral suspension carton contains:
What special precautions should I follow?
Before taking ibrutinib,
- tell your doctor and pharmacist if you are allergic to ibrutinib, any other medications, or any of the ingredients in ibrutinib capsules or tablets. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven); antifungals such as fluconazole (Diflucan), itraconazole (Onmel, Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend); antiplatelet medications such as clopidogrel (Plavix), prasugrel (Effient), ticagrelor (Brilinta), and ticlopidine; aprepitant (Emend); carbamazepine (Carbatrol, Epitol, Tegretol, Teril); clarithromycin (Biaxin, Prevpac), digoxin (Lanoxin); diltiazem (Cardizem, Cartia, Tiazac, others); erythromycin (E.E.S., Erythrocin, others), certain medications to treat human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) such as efavirenz (Sustiva, in Atripla), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Invirase); methotrexate (Otrexup, Rasuvo, Trexall, Xatmep); nefazodone; phenytoin (Dilantin, Phenytek); rifampin (Rifadin, Rifamate, Rimactane, others); verapamil (Calan, Covera, in Tarka, others); and telithromycin (no longer available in the U.S.; Ketek). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor what herbal products you are taking, especially St. John’s Wort.
- tell your doctor if you have an infection or recently had surgery. Also tell your doctor if you smoke or if you have or have ever had diabetes, an irregular heartbeat, hypertension (high blood pressure), high cholesterol, bleeding problems, or heart, kidney, or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, are breast-feeding, or if you plan on fathering a child. You should not become pregnant while you are taking ibrutinib. If you are female, you will need to take a pregnancy test before you start treatment and should use birth control to prevent pregnancy during your treatment with ibrutinib and for 1 month after you stop taking the medication. If you are male, you and your female partner should use birth control during your treatment with ibrutinib and continue for 1 month after your final dose. If you or your partner become pregnant while taking ibrutinib, call your doctor immediately. Ibrutinib can cause fetal harm.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ibrutinib. Your doctor may tell you to stop taking ibrutinib 3 to 7 days before the surgery or procedure.
