A BTK inhibitor tablet for some lymphomas
Zanubrutinib
A targeted cancer tablet for some lymphomas, with bleeding, heart-rhythm changes and infection as key risks.
What is Zanubrutinib?
Zanubrutinib is a specialist targeted cancer tablet used for some types of lymphoma and related blood cancers. It blocks a signal (BTK) that these cancer cells rely on to grow and survive. Its main risks are bleeding and bruising (so care is needed around surgery and with blood-thinning medicines), an irregular heartbeat called atrial fibrillation, a higher risk of serious infections, a fall in the infection-fighting white cells, and a slightly higher chance of other (second) cancers, particularly skin cancers. It is taken by mouth under the care of a specialist blood-cancer team, with contraception important because it can harm an unborn baby.
Education and reference only. This is a plain-language guide to Zanubrutinib — 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
Zanubrutinib is a targeted cancer medicine taken as tablets, used for some types of lymphoma and related blood cancers (such as certain non-Hodgkin lymphomas and Waldenström's macroglobulinaemia). It belongs to a group of medicines called BTK inhibitors. BTK is a signalling protein that some blood-cancer cells depend on to grow and survive; by blocking it, zanubrutinib stops these signals and helps control the cancer. It is taken by mouth, usually long-term, under the care of a specialist blood-cancer team.
How it works
Zanubrutinib blocks an enzyme called Bruton's tyrosine kinase (BTK), which passes on growth and survival signals inside certain cancerous white blood cells. By switching off these signals, zanubrutinib stops the cancer cells multiplying and helps them die, bringing the cancer under control. Because BTK also plays a part in how platelets help blood to clot, blocking it can increase the tendency to bleed and bruise. Its effects on immune cells also explain the higher risk of infections, while the way it changes signalling in the body underlies the risk of heart-rhythm problems such as atrial fibrillation.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist targeted cancer tablet used in the UK for some types of lymphoma and related blood cancers.
Practical use
How to take Zanubrutinib
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the tablets or capsules by mouth, at about the same time each day, exactly as your specialist team directs.
- Report any unusual bruising or bleeding, such as nosebleeds, bleeding gums or blood in your urine or stools, straight away.
- Tell your team well ahead of any surgery or dental work, as the medicine may need to be paused to reduce bleeding.
- Report palpitations, an irregular or fast heartbeat, breathlessness or dizziness, and treat any fever or infection as urgent.
- Protect your skin from the sun, check for new or changing skin spots, and use effective contraception, as it can harm an unborn baby.
Weighing it up
Advantages & disadvantages of Zanubrutinib
Advantages
- A targeted tablet that can effectively control some types of lymphoma and related blood cancers.
- Taken by mouth at home rather than needing infusions.
- Works in a focused way by blocking a signal that the cancer cells rely on.
Disadvantages
- Increases the risk of bleeding and bruising, needing care around surgery and with blood thinners.
- Can cause an irregular heartbeat (atrial fibrillation) and raises the risk of serious infections.
- Slightly increases the chance of other (second) cancers, particularly skin cancers, and can harm an unborn baby.
Practical use
Good to know
There are several safety points to keep in mind with zanubrutinib. It increases the risk of bleeding and bruising, so unusual bruising, nosebleeds, blood in the urine or stools, or any major bleeding should be reported, and it may need to be paused around surgery or dental procedures. It can cause an irregular heartbeat (atrial fibrillation), so any palpitations, breathlessness or dizziness should be reported. It raises the risk of serious infections and can lower the white cells that fight infection, so a fever or feeling unwell should be treated urgently. It also slightly increases the chance of other (second) cancers, especially skin cancers, so it is sensible to protect the skin from the sun and report any new or changing skin spots. Effective contraception is important because it can harm an unborn baby.
Who should not take it / use with caution
- People who have had a serious allergic reaction to zanubrutinib should not take it.
- It is used with great care in people with a high bleeding risk, an active serious infection or significant heart-rhythm problems.
- It is avoided in pregnancy because it can harm an unborn baby; it is given only under specialist blood-cancer care.
Monitoring
- Regular blood counts to check the white cells and watch for low counts.
- Watching for bleeding, signs of infection and heart-rhythm changes such as palpitations.
- Skin checks for new or changing spots, and reviewing how the cancer is responding.
Side effects
- Bleeding and bruising, ranging from minor bruises to, less commonly, more serious bleeding.
- A fall in the white cells that fight infection, with a higher risk of serious infections.
- An irregular heartbeat (atrial fibrillation), tiredness, diarrhoea and rash.
- Less commonly but seriously, major bleeding, serious infections, or other (second) cancers such as skin cancers.
Key interactions
- Blood-thinning and antiplatelet medicines, and some supplements such as fish oil, add to the bleeding risk.
- Some medicines and grapefruit can change how zanubrutinib is broken down, so tell your team about everything you take.
- Other medicines that lower the blood counts add to the infection risk; always give your team a full medicines list.
Available as: Capsules or tablets taken by mouth.
Answers
Zanubrutinib: frequently asked questions
What is zanubrutinib used for?
It is a targeted cancer tablet used for some types of lymphoma and related blood cancers, blocking a signal (BTK) that the cancer cells rely on.
Why does it cause bleeding and bruising?
The BTK signal it blocks also helps platelets clot blood, so blocking it can increase bleeding and bruising; report unusual bleeding and tell your team before any surgery.
Can it affect my heart?
Yes, it can cause an irregular heartbeat called atrial fibrillation, so report any palpitations, breathlessness or dizziness to your team.
Does it increase the risk of other cancers?
It slightly increases the chance of other (second) cancers, especially skin cancers, so protect your skin from the sun and report any new or changing skin spots.
Do I need contraception?
Yes. It can harm an unborn baby, so effective contraception is important during treatment and for the period your team advises.
Authoritative sources
- BNF
- NICE CKS
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