Zanubrutinib is an inhibitor of Bruton’s tyrosine kinase (BTK) with potential antineoplastic activity. Upon administration, zanubrutinib inhibits the activity of BTK and prevents the activation of the B-cell antigen receptor (BCR) signaling pathway. This prevents both B-cell activation and BTK-mediated activation of downstream survival pathways, which leads to the 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 overexpressed in B-cell malignancies; it plays an important role in B-lymphocyte development, activation, signaling, proliferation, and survival.
Zanubrutinib is an oral inhibitor of Bruton’s tyrosine kinase that is used in the therapy of refractory mantle cell lymphoma. Zanubrutinib has been associated with a low rate of serum enzyme elevations during therapy but has not been linked to cases of clinically apparent acute liver injury although it may pose a risk for reactivation of hepatitis B in susceptible patients.
Zanubrutinib is a novel Bruton’s tyrosine kinase (BTK) inhibitor used for the treatment of adult patients with mantle cell lymphoma (MCL) who have received at least one prior therapy. Mantle cell lymphoma is an aggressive mature B-cell non-Hodgkin lymphoma that is associated with early relapse, poor clinical outcomes, and long-term survival. BTK is an enzyme that plays a role in oncogenic signaling pathways, where it promotes the survival and proliferation of malignant B cells. Compared to the first-generation BTK inhibitor [ibrutinib], zanubrutinib displays higher potency and selectivity for BTK with fewer off-target effects. Due to this enhanced selectivity towards BTK, zanubrutinib belongs to the second-generation BTK inhibitor drug group that also includes [acalabrutinib], which was approved by the FDA in 2017. Zanubrutinib was granted accelerated approval by the FDA in November 2019 based on clinical trial results that demonstrated an 84% overall response rate from zanubrutinib therapy in patients with MCL, which measures the proportion of patients in a trial whose tumor is entirely or partially destroyed by a drug. It is currently marketed under the trade name BRUKINSA™ and is available as oral capsules. In August 2021, the FDA granted accelerated approval to zanubrutinib for the treatment of adults with Waldenström’s macroglobulinemia. This indication is valid in the US, Europe, and Canada. In September 2021, zanubrutinib was granted another accelerated approval for the treatment of relapsed or refractory marginal zone lymphoma who have received at least one anti-CD20-based regimen. Zanubrutinib is an immunomodulating agent that decreases the survival of malignant B cells. It inhibits BTK by binding to its active site. It works to inhibit the proliferation and survival of malignant B cells to reduce the tumor size in mantle cell lymphoma.
Mechanism of Action
Bruton’s tyrosine kinase (BTK) is a non-receptor kinase and a signaling molecule for the B cell receptors expressed on the peripheral B cell surface. The BCR signaling pathway plays a crucial role in normal B-cell development but also in the proliferation and survival of malignant B cells in many B-cell malignancies, including mantle-cell lymphoma (MCL). Once activated by upstream Src-family kinases, BTK phosphorylates phospholipase-Cγ (PLCγ), leading to Ca2+ mobilization and activation of NF-κB and MAP kinase pathways. These downstream cascades promote the expression of genes involved in B cell proliferation and survival. The BCR signaling pathway also induces the anti-apoptotic protein Bcl-xL and regulates the integrin α4β1 (VLA-4)-mediated adhesion of B cells to vascular cell adhesion molecule-1 (VCAM-1) and fibronectin via BTK. Apart from the direct downstream signal transduction pathway of B cells, BTK is also involved in chemokine receptor, Toll-like receptor (TLR), and Fc receptor signaling pathways. Zanubrutinib inhibits BTK by forming a covalent bond with cysteine 481 residue in the adenosine triphosphate (ATP)–a binding pocket of BTK, which is the enzyme’s active site. This binding specificity is commonly seen with other BTK inhibitors. Due to this binding profile, zanubrutinib may also bind with varying affinities to related and unrelated ATP-binding kinases that possess a cysteine residue at this position. By blocking the BCR signaling pathway, zanubrutinib inhibits the proliferation, trafficking, chemotaxis, and adhesion of malignant B cells, ultimately leading to reduced tumor size. Zanubrutinib was also shown to downregulate programmed death-ligand 1 (PD-1) expression and cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) on CD4+ T cells.
Indications
- Zanubrutinib is indicated for the treatment of adult patients with mantle cell lymphoma (MCL) who have received at least one prior therapy. It is used to treat Waldenström’s macroglobulinemia in adults. Zanubrutinib is also indicated for the treatment of relapsed or refractory marginal zone lymphoma (MZL) in adults who have received at least one anti-CD20-based regimen.
- Burkina as monotherapy 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 chemo-immunotherapy.
- Zanubrutinib is an oral inhibitor of Bruton’s tyrosine kinase that is used in the therapy of refractory mantle cell lymphoma. Zanubrutinib has been associated with a low rate of serum enzyme elevations during therapy but has not been linked to cases of clinically apparent acute liver injury although it may pose a risk for reactivation of hepatitis B in susceptible patients.
- Zanubrutinib is indicated for the treatment of adults with mantle cell lymphoma (MCL) who have received at least one prior therapy and for the treatment of Waldenström’s macroglobulinemia.[rx]
- Mantle Cell Lymphoma (MCL)
- Refractory Marginal Zone Lymphoma
- Relapsed Marginal Zone Lymphoma
- Waldenström’s Macroglobulinemia (WM)
Use in Cancer
Zanubrutinib is approved to treat adults with:
- Mantle cell lymphoma who have received at least one other type of treatment.¹
- Marginal zone lymphoma who have received at least one anti-CD20-based therapy but it did not work or is no longer working.¹
- Waldenström macroglobulinemia.
This use is approved under FDA’s Accelerated Approval Program. As a condition of approval, a confirmatory trial(s) must show that zanubrutinib provides a clinical benefit in these patients. Zanubrutinib is also being studied in the treatment of other types of cancer.
Contraindications
- 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
- atrial fibrillation
- pregnancy
- a patient who is producing milk and breastfeeding
- Child-Pugh class C liver impairment
Dosage
Strengths: 80 mg
Lymphoma
- 160 mg orally 2 times a day until disease progression or unacceptable toxicity
- 320 mg orally once a day until disease progression 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 Waldenström’s macroglobulinemia (WM)
- For the treatment of adult patients with relapsed or refractory marginal zone lymphoma (MZL) who have received at least one anti-CD20-based regimen
Dose Adjustments
DOSE MODIFICATIONS FOR ADVERSE REACTIONS (starting dose of 160 mg 2 times a day OR 320 mg once a day):
FOR:
- 1) GRADE 3 OR HIGHER NONHEMATOLOGICAL TOXICITIES
- 2) GRADE 3 FEBRILE NEUTROPENIA; GRADE 3 THROMBOCYTOPENIA WITH SIGNIFICANT BLEEDING OR
- 3) GRADE 4 NEUTROPENIA (LASTING MORE THAN 10 CONSECUTIVE DAYS) OR
4) GRADE 4 THROMBOCYTOPENIA (LASTING MORE THAN 10 CONSECUTIVE DAYS)
Below are dose modifications for the reactions 1 through 4 listed above:
- First Occurrence: Interrupt therapy; when toxicity has resolved to Grade 1 or less or baseline resume at 160 mg 2 times a day or 320 mg once a day
- Second Occurrence: Interrupt therapy; when toxicity has resolved to Grade 1 or less or baseline resume at 80 mg 2 times a day or 160 mg once a day
- Third Occurrence: Interrupt therapy; when toxicity has resolved to Grade 1 or less or baseline resume at 80 mg once a day
- Fourth Occurrence: Discontinue therapy
- Asymptomatic lymphocytosis should not be regarded as an adverse reaction, and these patients should continue taking this drug.
Dose Modifications for Concomitant use with CYP450 3A Inhibitors or Inducers:
- Strong CYP450 3A inhibitor: 80 mg orally once a day; interrupt dose as recommended for adverse reactions
- Moderate CYP450 3A inhibitor: 80 mg orally 2 times a day; interrupt dose as recommended for adverse reactions
- Moderate or strong CYP450 3A inducer: Avoid concomitant use.
- After discontinuation of a CYP450 3A inhibitor, resume the previous dose of this drug.
Side Effects
The Most Common
- diarrhea
- constipation
- cough
- muscle, joint, or back pain
- rash
- fever, sore throat, cough, chills, or other signs of infection
- painful, frequent, or urgent urination
- unusual bruising or bleeding
- blood in your stools or black, tarry stools; pink or brown urine; vomiting blood or coffee-ground vomit; coughing up blood
- feeling dizzy, weak, or confused; changes in speech; a headache that lasts a long time
- fast or irregular heartbeat, palpitations, feeling lightheaded or dizzy, fainting, shortness of breath, chest pain
More Common
- blood in your stools or black stools (looks like tar)
- pink or brown urine
- unexpected bleeding, or bleeding that is severe or you cannot control
- vomit blood or vomit that looks like coffee grounds
- cough up blood or blood clots
- increased bruising
- dizziness
- weakness
- confusion
- change in speech
- headache that lasts a long time
Rare
- Infections that can be serious and may lead to death. Tell your healthcare provider right away if you have fever, chills, or flu-like symptoms.
- Decrease in blood cell counts. Decreased blood counts (white blood cells, platelets, and red blood cells) are common with zanubrutinib, but can also be severe. Your healthcare provider should do blood tests during treatment with zanubrutinib to check your blood counts.
- Second primary cancers. New cancers have happened in people during treatment with zanubrutinib, including cancers of the skin or other organs. Your healthcare provider will check you for other cancers during treatment with zanubrutinib. Use sun protection when you are outside in sunlight.
- Heart rhythm problems (atrial fibrillation and atrial flutter). Tell your healthcare provider if you have any of the following signs or symptoms: your heartbeat is fast or irregular, feel lightheaded or dizzy, pass out (faint), shortness of breath, chest discomfort
- decreased white blood cells
- upper respiratory tract infection
- decreased platelet count
- bleeding
- rash
- muscle or joint pain
Drug Interaction
| DRUG | INTERACTION |
|---|---|
| Abametapir | The serum concentration of Zanubrutinib can be increased when it is combined with Abametapir. |
| Abatacept | The metabolism of Zanubrutinib can be increased when combined with Abatacept. |
| Acalabrutinib | The metabolism of Zanubrutinib can be decreased when combined with Acalabrutinib. |
| Acetaminophen | The metabolism of Zanubrutinib can be increased when combined with Acetaminophen. |
| Acetazolamide | The metabolism of Zanubrutinib can be decreased when combined with Acetazolamide. |
| Adalimumab | The metabolism of Zanubrutinib can be increased when combined with Adalimumab. |
| Albendazole | The metabolism of Zanubrutinib can be decreased when combined with Albendazole. |
| Aldesleukin | The metabolism of Zanubrutinib can be decreased when combined with Aldesleukin. |
| Alpelisib | The metabolism of Zanubrutinib can be increased when combined with Alpelisib. |
| Aminoglutethimide | The metabolism of Zanubrutinib can be increased when combined with Aminoglutethimide. |
| Amiodarone | The metabolism of Zanubrutinib can be decreased when combined with Amiodarone. |
| Amitriptyline | The metabolism of Zanubrutinib can be decreased when combined with Amitriptyline. |
| Amobarbital | The metabolism of Zanubrutinib can be increased when combined with Amobarbital. |
| Amprenavir | The metabolism of Zanubrutinib can be decreased when combined with Amprenavir. |
| Anakinra | The metabolism of Zanubrutinib can be increased when combined with Anakinra. |
| Antipyrine | The metabolism of Zanubrutinib can be decreased when combined with Antipyrine. |
| Apalutamide | The metabolism of Zanubrutinib can be increased when combined with Apalutamide. |
| Apomorphine | The metabolism of Zanubrutinib can be decreased when combined with Apomorphine. |
| Apremilast | The metabolism of Zanubrutinib can be increased when combined with Apremilast. |
| Aprepitant | The metabolism of Zanubrutinib can be decreased when combined with Aprepitant. |
| Armodafinil | The metabolism of Zanubrutinib can be increased when combined with Armodafinil. |
| Artemether | The metabolism of Zanubrutinib can be decreased when combined with Artemether. |
| Articaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Articaine. |
| Asciminib | The serum concentration of Zanubrutinib can be increased when it is combined with Asciminib. |
| Astemizole | The metabolism of Zanubrutinib can be decreased when combined with Astemizole. |
| Asunaprevir | The metabolism of Zanubrutinib can be increased when combined with Asunaprevir. |
| Atazanavir | The metabolism of Zanubrutinib can be decreased when combined with Atazanavir. |
| Avacopan | The metabolism of Zanubrutinib can be decreased when combined with Avacopan. |
| Avanafil | The serum concentration of Avanafil can be increased when it is combined with Zanubrutinib. |
| Azithromycin | The metabolism of Zanubrutinib can be decreased when combined with Azithromycin. |
| Beclomethasone | The metabolism of Zanubrutinib can be increased when combined with Beclomethasone dipropionate. |
| Belzutifan | The serum concentration of Zanubrutinib can be decreased when it is combined with Belzutifan. |
| Benzocaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Benzocaine. |
| Benzphetamine | The metabolism of Zanubrutinib can be decreased when combined with Benzphetamine. |
| Benzyl alcohol | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Benzyl alcohol. |
| Berotralstat | The metabolism of Zanubrutinib can be decreased when combined with Berotralstat. |
| Betamethasone | The metabolism of Zanubrutinib can be increased when combined with Betamethasone. |
| Betamethasone phosphate | The metabolism of Zanubrutinib can be increased when combined with Betamethasone phosphate. |
| Bexarotene | The metabolism of Zanubrutinib can be increased when combined with Bexarotene. |
| Bicalutamide | The metabolism of Zanubrutinib can be decreased when combined with Bicalutamide. |
| Bifonazole | The metabolism of Zanubrutinib can be decreased when combined with Bifonazole. |
| Bimekizumab | The metabolism of Zanubrutinib can be increased when combined with Bimekizumab. |
| Boceprevir | The metabolism of Zanubrutinib can be decreased when combined with Boceprevir. |
| Bosentan | The metabolism of Zanubrutinib can be increased when combined with Bosentan. |
| Bosutinib | The metabolism of Zanubrutinib can be decreased when combined with Bosutinib. |
| Brentuximab vedotin | The metabolism of Zanubrutinib can be decreased when combined with Brentuximab vedotin. |
| Brivaracetam | The metabolism of Zanubrutinib can be decreased when combined with Brivaracetam. |
| Brompheniramine | The metabolism of Zanubrutinib can be decreased when combined with Brompheniramine. |
| Budesonide | The metabolism of Zanubrutinib can be increased when combined with Budesonide. |
| Bupivacaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Bupivacaine. |
| Buprenorphine | The metabolism of Zanubrutinib can be decreased when combined with Buprenorphine. |
| Bupropion | The metabolism of Zanubrutinib can be decreased when combined with Bupropion. |
| Butacaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Butacaine. |
| Butalbital | The metabolism of Zanubrutinib can be increased when combined with Butalbital. |
| Butamben | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Butamben. |
| Calcitriol | The metabolism of Zanubrutinib can be increased when combined with Calcitriol. |
| Canakinumab | The metabolism of Zanubrutinib can be increased when combined with Canakinumab. |
| Candicidin | The metabolism of Zanubrutinib can be decreased when combined with Candicidin. |
| Cannabidiol | The metabolism of Zanubrutinib can be decreased when combined with Cannabidiol. |
| Capsaicin | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Capsaicin. |
| Carbamazepine | The metabolism of Zanubrutinib can be increased when combined with Carbamazepine. |
| Cefradine | The metabolism of Zanubrutinib can be increased when combined with Cefradine. |
| Cenobamate | The serum concentration of Zanubrutinib can be decreased when it is combined with Cenobamate. |
| Cephalexin | The metabolism of Zanubrutinib can be decreased when combined with Cephalexin. |
| Ceritinib | The metabolism of Zanubrutinib can be decreased when combined with Ceritinib. |
| Cerivastatin | The metabolism of Zanubrutinib can be increased when combined with Cerivastatin. |
| Certolizumab pegol | The metabolism of Zanubrutinib can be increased when combined with Certolizumab pegol. |
| Chloramphenicol | The metabolism of Zanubrutinib can be decreased when combined with Chloramphenicol. |
| Chloroprocaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Chloroprocaine. |
| Chlorpromazine | The metabolism of Zanubrutinib can be increased when combined with Chlorpromazine. |
| Cimetidine | The metabolism of Zanubrutinib can be decreased when combined with Cimetidine. |
| Cinchocaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Cinchocaine. |
| Cinnarizine | The metabolism of Zanubrutinib can be decreased when combined with Cinnarizine. |
| Ciprofloxacin | The metabolism of Zanubrutinib can be decreased when combined with Ciprofloxacin. |
| Cisapride | The metabolism of Zanubrutinib can be decreased when combined with Cisapride. |
| Cisplatin | The metabolism of Zanubrutinib can be decreased when combined with Cisplatin. |
| Citalopram | The metabolism of Zanubrutinib can be decreased when combined with Citalopram. |
| Clarithromycin | The metabolism of Zanubrutinib can be decreased when combined with Clarithromycin. |
| Clevidipine | The metabolism of Zanubrutinib can be increased when combined with Clevidipine. |
| Clobazam | The metabolism of Zanubrutinib can be increased when combined with Clobazam. |
| Clobetasol propionate | The metabolism of Zanubrutinib can be increased when combined with Clobetasol propionate. |
| Clofazimine | The metabolism of Zanubrutinib can be decreased when combined with Clofazimine. |
| Clofibrate | The metabolism of Zanubrutinib can be increased when combined with Clofibrate. |
| Clopidogrel | The metabolism of Zanubrutinib can be decreased when combined with Clopidogrel. |
| Clotiazepam | The metabolism of Zanubrutinib can be decreased when combined with Clotiazepam. |
| Clozapine | The metabolism of Zanubrutinib can be decreased when combined with Clozapine. |
| Cobicistat | The metabolism of Zanubrutinib can be decreased when combined with Cobicistat. |
| Cobimetinib | The metabolism of Zanubrutinib can be decreased when combined with Cobimetinib. |
| Cocaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Cocaine. |
| Conivaptan | The metabolism of Zanubrutinib can be decreased when combined with Conivaptan. |
| Corticotropin | The metabolism of Zanubrutinib can be increased when combined with Corticotropin. |
| Cortisone acetate | The metabolism of Zanubrutinib can be increased when combined with Cortisone acetate. |
| Crizotinib | The metabolism of Zanubrutinib can be decreased when combined with Crizotinib. |
| Curcumin | The metabolism of Zanubrutinib can be decreased when combined with Curcumin. |
| Cyclophosphamide | The metabolism of Zanubrutinib can be increased when combined with Cyclophosphamide. |
| Cyclosporine | The metabolism of Zanubrutinib can be decreased when combined with Cyclosporine. |
| Cyproterone acetate | The metabolism of Zanubrutinib can be decreased when combined with Cyproterone acetate. |
| Dabrafenib | The serum concentration of Zanubrutinib can be decreased when it is combined with Dabrafenib. |
| Dacomitinib | The metabolism of Zanubrutinib can be decreased when combined with Dacomitinib. |
| Dalfopristin | The metabolism of Zanubrutinib can be decreased when combined with Dalfopristin. |
| Darunavir | The serum concentration of Zanubrutinib can be increased when it is combined with Darunavir. |
| Dasatinib | The metabolism of Zanubrutinib can be decreased when combined with Dasatinib. |
| Daunorubicin | The metabolism of Zanubrutinib can be decreased when combined with Daunorubicin. |
| Deferasirox | The metabolism of Zanubrutinib can be increased when combined with Deferasirox. |
| Deflazacort | The metabolism of Zanubrutinib can be increased when combined with Deflazacort. |
| Delavirdine | The metabolism of Zanubrutinib can be decreased when combined with Delavirdine. |
| Desipramine | The metabolism of Zanubrutinib can be decreased when combined with Desipramine. |
| Desvenlafaxine | The metabolism of Zanubrutinib can be decreased when combined with Desvenlafaxine. |
| Dexamethasone | The metabolism of Zanubrutinib can be increased when combined with Dexamethasone. |
| Dexamethasone acetate | The metabolism of Zanubrutinib can be increased when combined with Dexamethasone acetate. |
| Dextropropoxyphene | The metabolism of Zanubrutinib can be decreased when combined with Dextropropoxyphene. |
| Diclofenac | The metabolism of Zanubrutinib can be decreased when combined with Diclofenac. |
| Dicloxacillin | The metabolism of Zanubrutinib can be increased when combined with Dicloxacillin. |
| Diethylstilbestrol | The metabolism of Zanubrutinib can be decreased when combined with Diethylstilbestrol. |
| Difluocortolone | The metabolism of Zanubrutinib can be increased when combined with Difluocortolone. |
| Dihydroergocornine | The metabolism of Zanubrutinib can be decreased when combined with Dihydroergocornine. |
| Dihydroergocristine | The metabolism of Zanubrutinib can be decreased when combined with Dihydroergocristine. |
| Dihydroergotamine | The metabolism of Zanubrutinib can be decreased when combined with Dihydroergotamine. |
| Diltiazem | The metabolism of Zanubrutinib can be decreased when combined with Diltiazem. |
| Dimethyl sulfoxide | The metabolism of Zanubrutinib can be decreased when combined with Dimethyl sulfoxide. |
| Diosmin | The metabolism of Zanubrutinib can be decreased when combined with Diosmin. |
| Diphenhydramine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Diphenhydramine. |
| Docetaxel | The metabolism of Zanubrutinib can be decreased when combined with Docetaxel. |
| Domperidone | The metabolism of Zanubrutinib can be decreased when combined with Domperidone. |
| Dosulepin | The metabolism of Zanubrutinib can be decreased when combined with Dosulepin. |
| Doxazosin | The metabolism of Zanubrutinib can be decreased when combined with Doxazosin. |
| Doxorubicin | The metabolism of Zanubrutinib can be decreased when combined with Doxorubicin. |
| Dronabinol | The metabolism of Zanubrutinib can be decreased when combined with Dronabinol. |
| Dronedarone | The serum concentration of Zanubrutinib can be increased when it is combined with Dronedarone. |
| Drospirenone | The metabolism of Zanubrutinib can be decreased when combined with Drospirenone. |
| Duvelisib | The metabolism of Zanubrutinib can be decreased when combined with Duvelisib. |
| Dyclonine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Dyclonine. |
| Ebastine | The metabolism of Zanubrutinib can be decreased when combined with Ebastine. |
| Echinacea | The metabolism of Zanubrutinib can be increased when combined with Echinacea. |
| Econazole | The metabolism of Zanubrutinib can be decreased when combined with Econazole. |
| Efavirenz | The metabolism of Zanubrutinib can be increased when combined with Efavirenz. |
| Elexacaftor | The metabolism of Zanubrutinib can be decreased when combined with Elexacaftor. |
| Elvitegravir | The metabolism of Zanubrutinib can be decreased when combined with Elvitegravir. |
| Emapalumab | The metabolism of Zanubrutinib can be increased when combined with Emapalumab. |
| Enasidenib | The metabolism of Zanubrutinib can be increased when combined with Enasidenib. |
| Enzalutamide | The metabolism of Zanubrutinib can be increased when combined with Enzalutamide. |
| Epinastine | The metabolism of Zanubrutinib can be decreased when combined with Epinastine. |
| Epinephrine | The metabolism of Zanubrutinib can be decreased when combined with Epinephrine. |
| Ergotamine | The metabolism of Zanubrutinib can be decreased when combined with Ergotamine. |
| Erlotinib | The metabolism of Zanubrutinib can be decreased when combined with Erlotinib. |
| Erythromycin | The metabolism of Zanubrutinib can be decreased when combined with Erythromycin. |
| Erythropoietin | The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Zanubrutinib. |
| Esketamine | The metabolism of Zanubrutinib can be increased when combined with Esketamine. |
| Eslicarbazepine | The metabolism of Zanubrutinib can be increased when combined with Eslicarbazepine. |
| Eslicarbazepine acetate | The metabolism of Zanubrutinib can be increased when combined with Eslicarbazepine acetate. |
| Estetrol | The metabolism of Zanubrutinib can be decreased when combined with Estetrol. |
| Estradiol acetate | The metabolism of Zanubrutinib can be increased when combined with Estradiol acetate. |
| Estradiol benzoate | The metabolism of Zanubrutinib can be increased when combined with Estradiol benzoate. |
| Estradiol cypionate | The metabolism of Zanubrutinib can be increased when combined with Estradiol cypionate. |
| Estradiol dienanthate | The metabolism of Zanubrutinib can be increased when combined with Estradiol dienanthate. |
| Estradiol valerate | The metabolism of Zanubrutinib can be increased when combined with Estradiol valerate. |
| Etanercept | The metabolism of Zanubrutinib can be increased when combined with Etanercept. |
| Ethambutol | The metabolism of Zanubrutinib can be decreased when combined with Ethambutol. |
| Ethanol | The metabolism of Zanubrutinib can be increased when combined with Ethanol. |
| Ethyl chloride | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Ethyl chloride. |
| Etidocaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Etidocaine. |
| Etoricoxib | The metabolism of Zanubrutinib can be decreased when combined with Etoricoxib. |
| Etravirine | The metabolism of Zanubrutinib can be increased when combined with Etravirine. |
| Felbamate | The metabolism of Zanubrutinib can be increased when combined with Felbamate. |
| Fenfluramine | The metabolism of Zanubrutinib can be decreased when combined with Fenfluramine. |
| Fenofibrate | The metabolism of Zanubrutinib can be decreased when combined with Fenofibrate. |
| Fexinidazole | The metabolism of Zanubrutinib can be decreased when combined with Fexinidazole. |
| Flucloxacillin | The metabolism of Zanubrutinib can be increased when combined with Flucloxacillin. |
| Fluconazole | The metabolism of Zanubrutinib can be decreased when combined with Fluconazole. |
| Flunisolide | The metabolism of Zanubrutinib can be increased when combined with Flunisolide. |
| Flunitrazepam | The metabolism of Zanubrutinib can be decreased when combined with Flunitrazepam. |
| Fluocinolone acetonide | The metabolism of Zanubrutinib can be increased when combined with Fluocinolone acetonide. |
| Fluocinonide | The metabolism of Zanubrutinib can be increased when combined with Fluocinonide. |
| Fluocortolone | The metabolism of Zanubrutinib can be increased when combined with Fluocortolone. |
| Fluoxetine | The metabolism of Zanubrutinib can be decreased when combined with Fluoxetine. |
| Fluticasone | The metabolism of Zanubrutinib can be increased when combined with Fluticasone. |
| Fluticasone furoate | The metabolism of Zanubrutinib can be increased when combined with Fluticasone furoate. |
| Fluticasone propionate | The metabolism of Zanubrutinib can be decreased when combined with Fluticasone propionate. |
| Fluvastatin | The metabolism of Zanubrutinib can be increased when combined with Fluvastatin. |
| Fluvoxamine | The metabolism of Zanubrutinib can be decreased when combined with Fluvoxamine. |
| Formestane | The metabolism of Zanubrutinib can be increased when combined with Formestane. |
| Fosamprenavir | The metabolism of Zanubrutinib can be decreased when combined with Fosamprenavir. |
| Fosaprepitant | The metabolism of Zanubrutinib can be increased when combined with Fosaprepitant. |
| Fosnetupitant | The metabolism of Zanubrutinib can be decreased when combined with Fosnetupitant. |
| Fosphenytoin | The metabolism of Zanubrutinib can be increased when combined with Fosphenytoin. |
| Fostamatinib | The metabolism of Zanubrutinib can be decreased when combined with Fostamatinib. |
| Fusidic acid | The metabolism of Zanubrutinib can be decreased when combined with Fusidic acid. |
| Gilteritinib | The metabolism of Zanubrutinib can be decreased when combined with Gilteritinib. |
| Ginkgo biloba | The metabolism of Zanubrutinib can be decreased when combined with Ginkgo biloba. |
| Glecaprevir | The metabolism of Zanubrutinib can be decreased when combined with Glecaprevir. |
| Glyburide | The metabolism of Zanubrutinib can be decreased when combined with Glyburide. |
| Glycerol phenylbutyrate | The metabolism of Zanubrutinib can be increased when combined with Glycerol phenylbutyrate. |
| Golimumab | The metabolism of Zanubrutinib can be increased when combined with Golimumab. |
| Griseofulvin | The metabolism of Zanubrutinib can be increased when combined with Griseofulvin. |
| Haloperidol | The metabolism of Zanubrutinib can be decreased when combined with Haloperidol. |
| Halothane | The metabolism of Zanubrutinib can be decreased when combined with Halothane. |
| Hydralazine | The metabolism of Zanubrutinib can be decreased when combined with Hydralazine. |
| Hydrocodone | The metabolism of Zanubrutinib can be decreased when combined with Hydrocodone. |
| Idelalisib | The metabolism of Zanubrutinib can be decreased when combined with Idelalisib. |
| Ifosfamide | The metabolism of Zanubrutinib can be increased when combined with Ifosfamide. |
| Imatinib | The serum concentration of Zanubrutinib can be increased when it is combined with Imatinib. |
| Imipramine | The metabolism of Zanubrutinib can be decreased when combined with Imipramine. |
| Indinavir | The metabolism of Zanubrutinib can be decreased when combined with Indinavir. |
| Infigratinib | The metabolism of Zanubrutinib can be decreased when combined with Infigratinib. |
| Infliximab | The metabolism of Zanubrutinib can be increased when combined with Infliximab. |
| Irbesartan | The metabolism of Zanubrutinib can be decreased when combined with Irbesartan. |
| Irinotecan | The metabolism of Zanubrutinib can be decreased when combined with Irinotecan. |
| Isavuconazole | The metabolism of Zanubrutinib can be decreased when combined with Isavuconazole. |
| Isavuconazonium | The metabolism of Zanubrutinib can be decreased when combined with Isavuconazonium. |
| Isoflurane | The metabolism of Zanubrutinib can be decreased when combined with Isoflurane. |
| Isoniazid | The metabolism of Zanubrutinib can be decreased when combined with Isoniazid. |
| Isradipine | The metabolism of Zanubrutinib can be decreased when combined with Isradipine. |
| Istradefylline | The metabolism of Zanubrutinib can be decreased when combined with Istradefylline. |
| Itraconazole | The metabolism of Zanubrutinib can be decreased when combined with Itraconazole. |
| Ivacaftor | The metabolism of Zanubrutinib can be decreased when combined with Ivacaftor. |
| Ivosidenib | The metabolism of Zanubrutinib can be increased when combined with Ivosidenib. |
| Ketamine | The metabolism of Zanubrutinib can be decreased when combined with Ketamine. |
| Ketazolam | The metabolism of Zanubrutinib can be decreased when combined with Ketazolam. |
| Ketoconazole | The metabolism of Zanubrutinib can be decreased when combined with Ketoconazole. |
| Lacosamide | The metabolism of Zanubrutinib can be decreased when combined with Lacosamide. |
| Lanreotide | The metabolism of Zanubrutinib can be decreased when combined with Lanreotide. |
| Lapatinib | The metabolism of Zanubrutinib can be decreased when combined with Lapatinib. |
| Lefamulin | The serum concentration of Zanubrutinib can be increased when it is combined with Lefamulin. |
| Lemborexant | The metabolism of Zanubrutinib can be increased when combined with Lemborexant. |
| Lesinurad | The metabolism of Zanubrutinib can be increased when combined with Lesinurad. |
| Letermovir | The metabolism of Zanubrutinib can be decreased when combined with Letermovir. |
| Levobupivacaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Levobupivacaine. |
| Levoketoconazole | The metabolism of Zanubrutinib can be decreased when combined with Levoketoconazole. |
| Lidocaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Lidocaine. |
| Linagliptin | The metabolism of Zanubrutinib can be decreased when combined with Linagliptin. |
| Lomitapide | The metabolism of Zanubrutinib can be decreased when combined with Lomitapide. |
| Lonafarnib | The metabolism of Zanubrutinib can be decreased when combined with Lonafarnib. |
| Lopinavir | The metabolism of Zanubrutinib can be decreased when combined with Lopinavir. |
| Lorcaserin | The metabolism of Zanubrutinib can be decreased when combined with Lorcaserin. |
| Lorlatinib | The metabolism of Zanubrutinib can be increased when combined with Lorlatinib. |
| Losartan | The metabolism of Zanubrutinib can be decreased when combined with Losartan. |
| Lovastatin | The metabolism of Zanubrutinib can be decreased when combined with Lovastatin. |
| Lumacaftor | The metabolism of Zanubrutinib can be increased when combined with Lumacaftor. |
| Manidipine | The metabolism of Zanubrutinib can be decreased when combined with Manidipine. |
| Mavacamten | The serum concentration of Zanubrutinib can be decreased when it is combined with Mavacamten. |
| Medroxyprogesterone | The metabolism of Zanubrutinib can be increased when combined with Medroxyprogesterone acetate. |
| Meloxicam | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Meloxicam. |
| Memantine | The metabolism of Zanubrutinib can be decreased when combined with Memantine. |
| Meperidine | The metabolism of Zanubrutinib can be decreased when combined with Meperidine. |
| Mephenytoin | The metabolism of Zanubrutinib can be decreased when combined with Mephenytoin. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Mepivacaine. |
| Meprednisone | The metabolism of Zanubrutinib can be increased when combined with Meprednisone. |
| Methadone | The metabolism of Zanubrutinib can be decreased when combined with Methadone. |
| Methimazole | The metabolism of Zanubrutinib can be decreased when combined with Methimazole. |
| Methoxy | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Zanubrutinib. |
| Methoxyflurane | The metabolism of Zanubrutinib can be decreased when combined with Methoxyflurane. |
| Methylene blue | The metabolism of Zanubrutinib can be decreased when combined with Methylene blue. |
| Methylergometrine | The metabolism of Zanubrutinib can be decreased when combined with Methylergometrine. |
| Methylphenobarbital | The metabolism of Zanubrutinib can be increased when combined with Methylphenobarbital. |
| Methylprednisolone | The metabolism of Zanubrutinib can be increased when combined with Methylprednisolone. |
| Methylprednisone | The metabolism of Zanubrutinib can be decreased when combined with Methylprednisone. |
| Methyltestosterone | The metabolism of Zanubrutinib can be decreased when combined with Methyltestosterone. |
| Methysergide | The metabolism of Zanubrutinib can be decreased when combined with Methysergide. |
| Metreleptin | The metabolism of Zanubrutinib can be increased when combined with Metreleptin. |
| Metronidazole | The metabolism of Zanubrutinib can be decreased when combined with Metronidazole. |
| Metyrapone | The metabolism of Zanubrutinib can be increased when combined with Metyrapone. |
| Mexiletine | The metabolism of Zanubrutinib can be decreased when combined with Mexiletine. |
| Mianserin | The metabolism of Zanubrutinib can be decreased when combined with Mianserin. |
| Miconazole | The metabolism of Zanubrutinib can be decreased when combined with Miconazole. |
| Midazolam | The metabolism of Zanubrutinib can be decreased when combined with Midazolam. |
| Midostaurin | The metabolism of Zanubrutinib can be increased when combined with Midostaurin. |
| Mifepristone | The metabolism of Zanubrutinib can be increased when combined with Mifepristone. |
| Milnacipran | The metabolism of Zanubrutinib can be decreased when combined with Milnacipran. |
| Miocamycin | The metabolism of Zanubrutinib can be decreased when combined with Miocamycin. |
| Mirtazapine | The metabolism of Zanubrutinib can be decreased when combined with Mirtazapine. |
| Mitapivat | The metabolism of Zanubrutinib can be increased when combined with Mitapivat. |
| Mitotane | The metabolism of Zanubrutinib can be increased when combined with Mitotane. |
| Mobocertinib | The serum concentration of Zanubrutinib can be decreased when it is combined with Mobocertinib. |
| Modafinil | The metabolism of Zanubrutinib can be increased when combined with Modafinil. |
| Mometasone furoate | The metabolism of Zanubrutinib can be increased when combined with Mometasone furoate. |
| Mosunetuzumab | The metabolism of Zanubrutinib can be decreased when combined with Mosunetuzumab. |
| Nafcillin | The metabolism of Zanubrutinib can be increased when combined with Nafcillin. |
| Naloxone | The metabolism of Zanubrutinib can be decreased when combined with Naloxone. |
| Nefazodone | The metabolism of Zanubrutinib can be decreased when combined with Nefazodone. |
| Nelfinavir | The metabolism of Zanubrutinib can be decreased when combined with Nelfinavir. |
| Netupitant | The metabolism of Zanubrutinib can be decreased when combined with Netupitant. |
| Nevirapine | The metabolism of Zanubrutinib can be decreased when combined with Nevirapine. |
| Niacin | The metabolism of Zanubrutinib can be decreased when combined with Niacin. |
| Nicardipine | The metabolism of Zanubrutinib can be decreased when combined with Nicardipine. |
| Nicotine | The metabolism of Zanubrutinib can be decreased when combined with Nicotine. |
| Nilotinib | The metabolism of Zanubrutinib can be decreased when combined with Nilotinib. |
| Nilvadipine | The metabolism of Zanubrutinib can be decreased when combined with Nilvadipine. |
| Nintedanib | The metabolism of Zanubrutinib can be decreased when combined with Nintedanib. |
| Norethisterone | The metabolism of Zanubrutinib can be decreased when combined with Norethisterone. |
| Norgestimate | The metabolism of Zanubrutinib can be increased when combined with Norgestimate. |
| Noscapine | The metabolism of Zanubrutinib can be decreased when combined with Noscapine. |
| Octreotide | The serum concentration of Zanubrutinib can be increased when it is combined with Octreotide. |
| Olaparib | The metabolism of Zanubrutinib can be decreased when combined with Olaparib. |
| Omeprazole | The metabolism of Zanubrutinib can be increased when combined with Omeprazole. |
| Oritavancin | The metabolism of Zanubrutinib can be increased when combined with Oritavancin. |
| Orphenadrine | The metabolism of Zanubrutinib can be decreased when combined with Orphenadrine. |
| Osilodrostat | The metabolism of Zanubrutinib can be decreased when combined with Osilodrostat. |
| Osimertinib | The metabolism of Zanubrutinib can be decreased when combined with Osimertinib. |
| Ospemifene | The metabolism of Zanubrutinib can be decreased when combined with Ospemifene. |
| Oxcarbazepine | The metabolism of Zanubrutinib can be increased when combined with Oxcarbazepine. |
| Oxetacaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Oxetacaine. |
| Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Oxybuprocaine. |
| Oxybutynin | The metabolism of Zanubrutinib can be decreased when combined with Oxybutynin. |
| Paclitaxel | The metabolism of Zanubrutinib can be increased when combined with Paclitaxel. |
| Pacritinib | The serum concentration of Zanubrutinib can be increased when it is combined with Pacritinib. |
| Palbociclib | The metabolism of Zanubrutinib can be decreased when combined with Palbociclib. |
| Paroxetine | The metabolism of Zanubrutinib can be decreased when combined with Paroxetine. |
| Pasireotide | The metabolism of Zanubrutinib can be decreased when combined with Pasireotide. |
| Pazopanib | The metabolism of Zanubrutinib can be decreased when combined with Pazopanib. |
| Peginesatide | The risk or severity of Thrombosis can be increased when Peginesatide is combined with Zanubrutinib. |
| Pentobarbital | The metabolism of Zanubrutinib can be increased when combined with Pentobarbital. |
| Perampanel | The metabolism of Zanubrutinib can be increased when combined with Perampanel. |
| Perhexiline | The metabolism of Zanubrutinib can be decreased when combined with Perhexiline. |
| Phenobarbital | The metabolism of Zanubrutinib can be increased when combined with Phenobarbital. |
| Phenol | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Phenol. |
| Phenylbutazone | The metabolism of Zanubrutinib can be increased when combined with Phenylbutazone. |
| Phenytoin | The metabolism of Zanubrutinib can be increased when combined with Phenytoin. |
| Pimavanserin | The metabolism of Zanubrutinib can be decreased when combined with Pimavanserin. |
| Pimozide | The metabolism of Zanubrutinib can be decreased when combined with Pimozide. |
| Piperaquine | The metabolism of Zanubrutinib can be decreased when combined with Piperaquine. |
| Pitolisant | The serum concentration of Zanubrutinib can be decreased when it is combined with Pitolisant. |
| Posaconazole | The metabolism of Zanubrutinib can be decreased when combined with Posaconazole. |
| Pralsetinib | The metabolism of Zanubrutinib can be increased when combined with Pralsetinib. |
| Pramocaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Pramocaine. |
| Prasugrel | The metabolism of Zanubrutinib can be decreased when combined with Prasugrel. |
| Prednisolone | The metabolism of Zanubrutinib can be increased when combined with Prednisolone. |
| Prednisolone acetate | The metabolism of Zanubrutinib can be increased when combined with Prednisolone acetate. |
| Prednisolone phosphate | The metabolism of Zanubrutinib can be increased when combined with Prednisolone phosphate. |
| Prednisone acetate | The metabolism of Zanubrutinib can be increased when combined with Prednisone acetate. |
| Pretomanid | The metabolism of Zanubrutinib can be decreased when combined with Pretomanid. |
| Prilocaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Prilocaine. |
| Primaquine | The metabolism of Zanubrutinib can be decreased when combined with Primaquine. |
| Primidone | The metabolism of Zanubrutinib can be increased when combined with Primidone. |
| Probenecid | The metabolism of Zanubrutinib can be increased when combined with Probenecid. |
| Procaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Procaine. |
| Promethazine | The metabolism of Zanubrutinib can be decreased when combined with Promethazine. |
| Proparacaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Proparacaine. |
| Propofol | The metabolism of Zanubrutinib can be decreased when combined with Propofol. |
| Propoxycaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Propoxycaine. |
| Quazepam | The metabolism of Zanubrutinib can be decreased when combined with Quazepam. |
| Quinidine | The metabolism of Zanubrutinib can be decreased when combined with Quinidine. |
| Quinine | The metabolism of Zanubrutinib can be increased when combined with Quinine. |
| Quinupristin | The metabolism of Zanubrutinib can be decreased when combined with Quinupristin. |
| Raloxifene | The metabolism of Zanubrutinib can be decreased when combined with Raloxifene. |
| Ranolazine | The metabolism of Zanubrutinib can be decreased when combined with Ranolazine. |
| Remdesivir | The metabolism of Zanubrutinib can be decreased when combined with Remdesivir. |
| Ribociclib | The metabolism of Zanubrutinib can be decreased when combined with Ribociclib. |
| Rifabutin | The metabolism of Zanubrutinib can be increased when combined with Rifabutin. |
| Rifampicin | The metabolism of Zanubrutinib can be increased when combined with Rifampicin. |
| Rifamycin | The metabolism of Zanubrutinib can be increased when combined with Rifamycin. |
| Rifapentine | The metabolism of Zanubrutinib can be increased when combined with Rifapentine. |
| Rilonacept | The metabolism of Zanubrutinib can be increased when combined with Rilonacept. |
| Rilpivirine | The metabolism of Zanubrutinib can be decreased when combined with Rilpivirine. |
| Ritonavir | The metabolism of Zanubrutinib can be decreased when combined with Ritonavir. |
| Rofecoxib | The metabolism of Zanubrutinib can be increased when combined with Rofecoxib. |
| Roflumilast | The metabolism of Zanubrutinib can be decreased when combined with Roflumilast. |
| Romidepsin | The metabolism of Zanubrutinib can be decreased when combined with Romidepsin. |
| Ropivacaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Ropivacaine. |
| Rosuvastatin | The metabolism of Zanubrutinib can be decreased when combined with Rosuvastatin. |
| Roxithromycin | The metabolism of Zanubrutinib can be decreased when combined with Roxithromycin. |
| Rucaparib | The metabolism of Zanubrutinib can be decreased when combined with Rucaparib. |
| Rufinamide | The metabolism of Zanubrutinib can be increased when combined with Rufinamide. |
| Saquinavir | The metabolism of Zanubrutinib can be decreased when combined with Saquinavir. |
| Sarilumab | The metabolism of Zanubrutinib can be increased when combined with Sarilumab. |
| Satralizumab | The serum concentration of Zanubrutinib can be decreased when it is combined with Satralizumab. |
| Secobarbital | The metabolism of Zanubrutinib can be increased when combined with Secobarbital. |
| Secukinumab | The metabolism of Zanubrutinib can be increased when combined with Secukinumab. |
| Selegiline | The metabolism of Zanubrutinib can be decreased when combined with Selegiline. |
| Sertraline | The metabolism of Zanubrutinib can be decreased when combined with Sertraline. |
| Sevoflurane | The metabolism of Zanubrutinib can be decreased when combined with Sevoflurane. |
| Siltuximab | The metabolism of Zanubrutinib can be increased when combined with Siltuximab. |
| Simeprevir | The metabolism of Zanubrutinib can be decreased when combined with Simeprevir. |
| Simvastatin | The metabolism of Zanubrutinib can be decreased when combined with Simvastatin. |
| Siponimod | The metabolism of Zanubrutinib can be decreased when combined with Siponimod. |
| Sitaxentan | The metabolism of Zanubrutinib can be decreased when combined with Sitaxentan. |
| Somatostatin | The metabolism of Zanubrutinib can be decreased when combined with Somatostatin. |
| Somatrogon | The metabolism of Zanubrutinib can be increased when combined with Somatrogon. |
| Sorafenib | The metabolism of Zanubrutinib can be decreased when combined with Sorafenib. |
| Sotorasib | The serum concentration of Zanubrutinib can be decreased when it is combined with Sotorasib. |
| St. John’s Wort | The metabolism of Zanubrutinib can be increased when combined with St. John’s Wort. |
| Stiripentol | The metabolism of Zanubrutinib can be decreased when combined with Stiripentol. |
| Sulfamethoxazole | The metabolism of Zanubrutinib can be decreased when combined with Sulfamethoxazole. |
| Sulfaphenazole | The metabolism of Zanubrutinib can be decreased when combined with Sulfaphenazole. |
| Sulfinpyrazone | The metabolism of Zanubrutinib can be increased when combined with Sulfinpyrazone. |
| Suvorexant | The metabolism of Zanubrutinib can be decreased when combined with Suvorexant. |
| Tacrolimus | The metabolism of Zanubrutinib can be decreased when combined with Tacrolimus. |
| Tamoxifen | The metabolism of Zanubrutinib can be increased when combined with Tamoxifen. |
| Tasimelteon | The metabolism of Zanubrutinib can be decreased when combined with Tasimelteon. |
| Tazemetostat | The metabolism of Zanubrutinib can be decreased when combined with Tazemetostat. |
| Tecovirimat | The metabolism of Zanubrutinib can be increased when combined with Tecovirimat. |
| Telaprevir | The metabolism of Zanubrutinib can be decreased when combined with Telaprevir. |
| Telithromycin | The metabolism of Zanubrutinib can be decreased when combined with Telithromycin. |
| Telotristat ethyl | The serum concentration of Zanubrutinib can be decreased when it is combined with Telotristat ethyl. |
| Terbinafine | The metabolism of Zanubrutinib can be increased when combined with Terbinafine. |
| Terfenadine | The metabolism of Zanubrutinib can be decreased when combined with Terfenadine. |
| Testosterone | The metabolism of Zanubrutinib can be increased when combined with Testosterone. |
| Testosterone cypionate | The metabolism of Zanubrutinib can be decreased when combined with Testosterone cypionate. |
| Testosterone enanthate | The metabolism of Zanubrutinib can be decreased when combined with Testosterone enanthate. |
| Tetracaine | The risk or severity of methemoglobinemia can be increased when Zanubrutinib is combined with Tetracaine. |
| Tetracycline | The metabolism of Zanubrutinib can be decreased when combined with Tetracycline. |
| Thiamylal | The metabolism of Zanubrutinib can be increased when combined with Thiamylal. |
| Thiosulfuric acid | The metabolism of Zanubrutinib can be increased when combined with Thiosulfuric acid. |
| Thiotepa | The metabolism of Zanubrutinib can be decreased when combined with Thiotepa. |
| Ticagrelor | The metabolism of Zanubrutinib can be decreased when combined with Ticagrelor. |
| Ticlopidine | The metabolism of Zanubrutinib can be decreased when combined with Ticlopidine. |
| Tioconazole | The metabolism of Zanubrutinib can be decreased when combined with Tioconazole. |
| Tipranavir | The metabolism of Zanubrutinib can be decreased when combined with Tipranavir. |
| Tocilizumab | The metabolism of Zanubrutinib can be increased when combined with Tocilizumab. |
| Topiramate | The metabolism of Zanubrutinib can be increased when combined with Topiramate. |
| Tramadol | The metabolism of Zanubrutinib can be decreased when combined with Tramadol. |
| Tretinoin | The metabolism of Zanubrutinib can be decreased when combined with Tretinoin. |
| Triamcinolone | The metabolism of Zanubrutinib can be increased when combined with Triamcinolone. |
| Triclabendazole | The metabolism of Zanubrutinib can be decreased when combined with Triclabendazole. |
| Troglitazone | The metabolism of Zanubrutinib can be increased when combined with Troglitazone. |
| Troleandomycin | The metabolism of Zanubrutinib can be decreased when combined with Troleandomycin. |
| Tucatinib | The metabolism of Tucatinib can be decreased when combined with Zanubrutinib. |
| Valproic acid | The metabolism of Zanubrutinib can be decreased when combined with Valproic acid. |
| Velpatasvir | The metabolism of Zanubrutinib can be decreased when combined with Velpatasvir. |
| Vemurafenib | The metabolism of Zanubrutinib can be increased when combined with Vemurafenib. |
| Venetoclax | The metabolism of Zanubrutinib can be decreased when combined with Venetoclax. |
| Verapamil | The metabolism of Zanubrutinib can be decreased when combined with Verapamil. |
| Viloxazine | The metabolism of Zanubrutinib can be decreased when combined with Viloxazine. |
| Vinblastine | The metabolism of Zanubrutinib can be increased when combined with Vinblastine. |
| Vitamin E | The metabolism of Zanubrutinib can be increased when combined with Vitamin E. |
| Vorapaxar | The metabolism of Zanubrutinib can be decreased when combined with Vorapaxar. |
| Voriconazole | The metabolism of Zanubrutinib can be decreased when combined with Voriconazole. |
| Vortioxetine | The metabolism of Zanubrutinib can be decreased when combined with Vortioxetine. |
| Voxelotor | The serum concentration of Zanubrutinib can be increased when it is combined with Voxelotor. |
| Warfarin | The metabolism of Zanubrutinib can be increased when combined with Warfarin. |
| Zafirlukast | The metabolism of Zanubrutinib can be decreased when combined with Zafirlukast. |
| Zimelidine | The metabolism of Zanubrutinib can be decreased when combined with Zimelidine. |
| Ziprasidone | The metabolism of Zanubrutinib can be decreased when combined with Ziprasidone. |
Pregnancy and Lactation
Pregnancy
Tell your doctor if you are pregnant or plan to become pregnant. Zanubrutinib can harm your unborn baby. If you are able to become pregnant, your healthcare provider may do a pregnancy test before starting treatment with zanubrutinib.
Females should avoid getting pregnant during treatment and for 1 week after the last dose of zanubrutinib. You should use effective birth control (contraception) during treatment and for 1 week after the last dose of zanubrutinib.
Males should avoid getting female partners pregnant during treatment and for 1 week after the last dose of zanubrutinib. You should use effective birth control (contraception) during treatment and for 1 week after the last dose of zanubrutinib.
Lactation
Tell your doctor if your are breastfeeding or plan to breastfeed. It is not known if zanubrutinib passes into your breast milk. Do not breastfeed during treatment with zanubrutinib and for 2 weeks after the last dose of zanubrutinib.
How should this medicine be used?
Zanubrutinib comes as a capsule to take by mouth. It is usually taken once or twice daily with or without food. Take zanubrutinib at around the same time(s) 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 zanubrutinib 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, chew, or crush them.
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 zanubrutinib even if you feel well. Do not stop taking zanubrutinib without talking to your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
What special precautions should I follow?
Before taking zanubrutinib,
- tell your doctor and pharmacist if you are allergic to zanubrutinib, any other medications, or any of the ingredients in zanubrutinib capsules. 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: anticoagulant medications (‘blood thinners’) such as warfarin (Coumadin, Jantoven); antifungals such as fluconazole (Diflucan), itraconazole (Onmel, Sporanox), or ketoconazole; aprepitant (Cinvanti, Emend); clarithromycin (Biaxin, in 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), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Invirase); nefazodone; omeprazole (Prilosec); phenobarbital; phenytoin (Dilantin, Phenytek); pioglitazone (Actos); rifampin (Rifadin, Rifamate, Rimactane, others); midazolam; and oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos). 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 have or have ever had hepatitis B (HBV, a virus that infects the liver and may cause severe liver damage), an irregular heartbeat, high blood pressure, bleeding problems, or heart or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or if you plan on fathering a child. You should not become pregnant while you are taking zanubrutinib. 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 and for 1 week after your final dose. If you are male, you and your female partner should use birth control during your treatment with zanubrutinib and continue for 1 week after your final dose. If you or your partner become pregnant while taking zanubrutinib, call your doctor immediately. Zanubrutinib can cause fetal harm.
- tell your doctor if you are breast-feeding. Do not breastfeed while you are taking zanubrutinib and for 2 weeks after your final dose.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking zanubrutinib. Your doctor may tell you to stop taking zanubrutinib for a period of time before and after the surgery or procedure.
- plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Zanubrutinib may make your skin sensitive to the dangerous effects of sunlight and may increase your risk of developing skin cancer.
References
