NO PPI RESTRICTIONS WITH
TABLET FORMULATION2
For patients requiring acid-reducing agents such as PPIs, antacids, or H2-receptor antagonists, CALQUENCE tablets can be taken concomitantly without any dosage modifications.2
Same strength, same straightforward dosing regimen for patients with CLL/SLL or R/R MCL1,2
If a dose of CALQUENCE is missed by more than 3 hours, it should be skipped and the next dose should be taken at its regularly scheduled time. Extra tablets of CALQUENCE should not be taken to make up for a missed dose.2
Continuous BTK
inhibition with one
tablet taken orally
twice daily†2
CALQUENCE maintained a median steady-state BTK occupancy of ≥95% in peripheral blood over 12 hours, inactivating BTK throughout the recommended dosing interval.2
Flexibility of dosing as monotherapy or in combination with obinutuzumab in patients with previously untreated CLL2
Dosing as monotherapy2
Dosing in combination with obinutuzumab2
In the ELEVATE-TN clinical trial, CALQUENCE 100 mg was given approximately every 12 hours until disease progression or unacceptable toxicity and obinutuzumab was given 28 days after first CALQUENCE dose (Day 1 of Cycle 2) and was given for up to 6 cycles.2
Dosage Modification
Dosage modifications for patients taking concomitant medication
Recommended dosage modification for use with CYP3A inhibitors or inducers2
CYP3A | COADMINISTERED DRUG | RECOMMENDED CALQUENCE USE |
---|---|---|
Inhibition | Strong CYP3A inhibitor |
Avoid coadministration If these inhibitors will be used short-term (such as anti-infectives for up to 7 days), interrupt CALQUENCE After discontinuation of strong CYP3A inhibitor for at least 24 hours, resume previous dosage of CALQUENCE |
Moderate CYP3A inhibitor |
Reduce the CALQUENCE 100 mg every |
|
Induction | Strong CYP3A inducer |
Avoid coadministration If coadministration is unavoidable, increase CALQUENCE dosage to 200 mg approximately every 12 hours |
Coadministration of CALQUENCE with a strong CYP3A inducer decreased acalabrutinib plasma concentrations. Decreased acalabrutinib concentrations may reduce CALQUENCE activity. Coadministration of CALQUENCE with a strong CYP3A inhibitor increased acalabrutinib plasma concentrations. Increased acalabrutinib concentrations may result in increased toxicity. Please see above and full Prescribing Information, for recommended adjustments.2
Dosage modifications for adverse reactions
Recommended dosage modifications for Grade ≥3 adverse reactions2
EVENT |
ADVERSE REACTION OCCURRENCE | DOSAGE MODIFICATION (Starting dose=100 mg approximately every 12 hours) |
---|---|---|
Grade 3 or greater non-hematologic toxicities, Grade 3 thrombocytopenia with bleeding, Grade 4 thrombocytopenia, or Grade 4 neutropenia lasting longer than 7 days |
First and second |
Interrupt CALQUENCE Once toxicity has resolved to Grade 1 or baseline level, CALQUENCE may be resumed at 100 mg approximately every 12 hours |
Third |
Interrupt CALQUENCE Once toxicity has resolved to Grade 1 or baseline level, CALQUENCE may be resumed at a reduced frequency of 100 mg once daily |
|
Fourth |
Discontinue CALQUENCE |
Adverse reactions graded by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE).
†Twice-daily dosing=approximately every 12 hours.2
BTK= Bruton tyrosine kinase; CLL=chronic lymphocytic leukemia; MCL=mantle cell lymphoma; R/R=relapsed/refractory; SLL=small lymphocytic lymphoma.
- Sharma S, Pepin X, Burri H, et al. Bioequivalence and Relative Bioavailability Studies to Assess a New Acalabrutinib Formulation That Enables Coadministration With Proton-Pump Inhibitors. Clin Pharmacol Drug Dev. 2022;11(11):1294-1307.
- CALQUENCE® (acalabrutinib) tablets [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2024.
- CALQUENCE® (acalabrutinib) capsules [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2024.
- Sun C, Nierman P, Kendall EK, et al. Clinical and biological implications of target occupancy in CLL treated with the BTK inhibitor acalabrutinib. Blood. 2020;136(1):93-105.
- Barf T, Covey T, Izumi R, et al. Acalabrutinib (ACP-196): a covalent Bruton tyrosine kinase inhibitor with a differentiated selectivity and in vivo potency profile. J Pharmacol Exp Ther. 2017;363(2):240-252.
- Podoll T, Pearson PG, Kaptein A, et al. Identification and characterization of ACP-5862, the major circulating active metabolite of acalabrutinib: both are potent and selective covalent Bruton tyrosine kinase inhibitors. J Pharmacol Exp Ther. 2023;384(1):173-186.