A targeted oral treatment for some blood cancers
Acalabrutinib
A targeted oral cancer medicine used to treat chronic lymphocytic leukaemia and mantle cell lymphoma.
What is Acalabrutinib?
Acalabrutinib is a specialist targeted cancer medicine used to treat chronic lymphocytic leukaemia (CLL) and mantle cell lymphoma, which are cancers of certain white blood cells. It works by blocking a protein called BTK that these cancer cells need to grow and survive. It is taken as a capsule by mouth, usually long term, under the care of a cancer specialist. The most important risks are bleeding, an irregular heartbeat called atrial fibrillation, serious infections and, over time, other cancers; headache is a common early side effect. It can harm an unborn baby, so reliable contraception is important.
Education and reference only. This is a plain-language guide to Acalabrutinib — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Acalabrutinib is a targeted cancer medicine known as a BTK inhibitor. It is used to treat chronic lymphocytic leukaemia (CLL) and mantle cell lymphoma, cancers in which a type of white blood cell grows out of control. Unlike older chemotherapy that affects many fast-growing cells, acalabrutinib is aimed at a specific signal the cancer cells rely on. It is taken by mouth as a capsule, usually over a long period, and is prescribed and supervised by a haematology or cancer specialist team.
How it works
Acalabrutinib blocks a protein called Bruton's tyrosine kinase (BTK), which the cancerous white blood cells use to receive signals telling them to grow, multiply and stay alive. By switching off this signal, the medicine slows the cancer's growth and encourages the abnormal cells to die. Because the signal it blocks also plays a part in how some normal blood cells work, this helps explain side effects such as bleeding and a tendency to infection. It is taken regularly to keep the signal blocked over time.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist cancer medicine used in the UK to treat certain types of leukaemia and lymphoma, taken as a capsule by mouth.
Practical use
How to take Acalabrutinib
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the capsules by mouth as prescribed, swallowing them whole with water and not crushing or chewing them.
- Take it at evenly spaced times each day to keep the effect steady, and try not to miss doses.
- Avoid grapefruit and grapefruit juice, which can change how much medicine is in your body.
- Tell your team about any unusual bleeding or bruising, and before any surgery or dental procedure.
- Use reliable contraception as advised, and report fever, palpitations or signs of infection promptly.
Weighing it up
Advantages & disadvantages of Acalabrutinib
Advantages
- A targeted oral treatment for CLL and mantle cell lymphoma that can be taken at home.
- Aims at a specific signal the cancer relies on rather than affecting the whole body like older chemotherapy.
- Often controls the disease over a long period under specialist supervision.
Disadvantages
- Can increase the risk of bleeding and of an irregular heartbeat (atrial fibrillation).
- Can lower resistance to infection and, over time, slightly raise the risk of other cancers.
- Interacts with several medicines and with grapefruit, and can harm an unborn baby.
Practical use
Good to know
The most important things to understand about acalabrutinib are its main risks. It can increase the chance of bleeding and bruising, so you should tell your team about any unusual or heavy bleeding, and let them know before any surgery or dental work. It can cause an irregular, often fast, heartbeat called atrial fibrillation, so report palpitations, breathlessness or dizziness. Because it affects the immune system, serious infections can occur, and any fever or signs of infection should be reported promptly. Over the long term there is a slightly higher chance of other cancers, including skin cancers, so sun protection and skin checks are sensible. Headache is common, especially early on, and usually eases. It can harm an unborn baby, so effective contraception is important during treatment. It interacts with several other medicines and with grapefruit, so always share a full medicines list.
Who should not take it / use with caution
- People who have had a serious allergic reaction to acalabrutinib should not take it.
- It is not suitable in pregnancy because it can harm an unborn baby; effective contraception is needed.
- It is used with caution in people with bleeding problems, heart-rhythm problems or active infections, under specialist guidance.
Monitoring
- Regular blood counts to check blood cells and watch for low counts.
- Checking for signs of bleeding, infection and heart-rhythm problems such as atrial fibrillation.
- Skin checks over time because of the slightly higher chance of skin cancers.
Side effects
- Headache, especially when treatment is first started, which usually eases.
- Bleeding or easy bruising, and an irregular heartbeat (atrial fibrillation).
- Infections, tiredness, diarrhoea and changes in blood counts.
- Less commonly, serious bleeding, serious infections or, over time, other cancers including skin cancers.
Key interactions
- Medicines and foods that affect the liver's drug-handling enzymes, including grapefruit, can raise or lower its levels.
- Blood-thinning and antiplatelet medicines can add to the risk of bleeding, so they need careful review.
- Stomach-acid medicines such as some antacids and acid blockers can change how well it is absorbed, so timing matters.
Available as: Capsules taken by mouth.
Answers
Acalabrutinib: frequently asked questions
What is acalabrutinib used for?
It is a targeted cancer medicine used to treat chronic lymphocytic leukaemia (CLL) and mantle cell lymphoma by blocking a protein called BTK that the cancer cells rely on.
Why does it cause bleeding or bruising?
The signal it blocks also plays a part in how some blood cells work, so it can increase bleeding and bruising; tell your team about unusual bleeding and before any surgery.
What is atrial fibrillation and why does it matter?
It is an irregular, often fast, heartbeat that acalabrutinib can cause; report palpitations, breathlessness or dizziness so it can be checked.
Why must I avoid grapefruit?
Grapefruit can change how your body handles the medicine and raise its levels, so it is best avoided during treatment.
Can I take it in pregnancy?
No. It can harm an unborn baby, so reliable contraception is important during treatment; discuss any pregnancy plans with your specialist.
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.