Key takeaways
- Brukinsa (zanubrutinib) is approved by the Food and Drug Administration (FDA) to treat certain types of blood cancer. Examples include chronic lymphocytic leukemia and mantle cell lymphoma.
- This drug comes as an oral capsule that you take twice per day.
- Brukinsa is a type of targeted therapy. It works by blocking the action of an enzyme called Bruton’s tyrosine kinase (BTK) to stop cancer cells from multiplying.
The Food and Drug Administration (FDA) has approved Brukinsa to treat the following types of blood cancer in certain adults:
Drug details
You’ll find key information about Brukinsa here:
- Drug class: Bruton’s tyrosine kinase (BTK) inhibitors
- Drug forms: oral capsule (oral tablet available October 2025)
- Generic available? no
- Prescription required? yes
- Controlled substance? no
- Accelerated approval?
yes , for mantle cell lymphoma, marginal zone lymphoma, and follicular lymphoma
Brukinsa is available only as a brand-name medication. It’s not currently available in generic form. (A generic drug is an exact copy of the active ingredient in a brand-name medication.)
Brukinsa contains the active ingredient zanubrutinib.
The Food and Drug Administration (FDA) approves prescription drugs such as Brukinsa to treat certain conditions. Brukinsa is FDA approved to treat chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) in adults.
For information on other approved uses of Brukinsa, see the “Brukinsa other uses” section.
More about CLL and SLL
CLL is a blood cancer that typically starts in your bone marrow. With CLL, your body makes abnormal lymphocytes (a type of white blood cell).
Usually, lymphocytes help your body fight off infections. But with CLL, your body might not be able to fight off infections as easily as usual. This is because the abnormal lymphocytes do not work with your immune system like regular lymphocytes do.
SLL is basically the same as CLL, except the abnormal lymphocytes are produced in your lymph nodes instead of your bone marrow.
Effectiveness for CLL or SLL
In clinical trials of Brukinsa, the drug was found safe and effective for treating CLL or SLL. For more information, see Brukinsa’s prescribing information.
The Food and Drug Administration (FDA) approves prescription drugs such as Brukinsa to treat certain conditions. In addition to chronic lymphocytic leukemia and small lymphocytic lymphoma, Brukinsa is approved to treat the following blood cancers in certain adults:
To learn how Brukinsa works to treat these conditions, see the “How Brukinsa works” section.
Brukinsa may also be used off-label for other conditions. With off-label use, a drug that’s approved to treat one condition is used to treat a different condition. For information on off-label uses of Brukinsa, talk with your doctor.
Brukinsa for mantle cell lymphoma
Brukinsa is FDA approved to treat mantle cell lymphoma (MCL). It’s approved for this use in adults who have tried at least one other past treatment for the condition.
MCL is a form of cancer that affects certain white blood cells called B cells. With MCL, your B cells grow abnormally. The condition can also cause enlarged lymph nodes in certain areas of your body.
The abnormal B cells caused by MCL can crowd out healthy blood cells, which normally help the body fight off infections. This means that with MCL, you may have a higher risk of infections than people who do not have MCL.
Effectiveness for MCL
In early clinical trials of Brukinsa, the drug was found safe and effective for treating MCL. For more information, see Brukinsa’s prescribing information.
It’s important to note that Brukinsa received
Brukinsa for Waldenstrom macroglobulinemia
Brukinsa is FDA approved to treat Waldenstrom macroglobulinemia (WM). This is a slow-growing type of non-Hodgkin’s lymphoma that starts in B cells.
WM causes your body to produce a large amount of abnormal proteins called macroglobulins. These proteins are mainly found in the bone marrow, where they crowd out other cells responsible for producing different types of blood cells.
Effectiveness for WM
In clinical trials of Brukinsa, the drug was found safe and effective for treating WM. For more information, see Brukinsa’s prescribing information.
Brukinsa for marginal zone lymphoma
Brukinsa is FDA approved to treat marginal zone lymphoma (MZL) that is relapsed (has returned) or refractory (does not respond or stops responding to treatment). For this use, a person must have tried at least one anti–CD20-based treatment. Examples of this type of treatment include rituximab (Rituxan) and ocrelizumab (Ocrevus).
MZL is another slow-growing type of non-Hodgkin’s lymphoma that starts in B cells. MZL begins forming in areas of lymph tissue called marginal zones. This type of lymphoma can develop in lymph nodes, the spleen, or lymphoid tissue that has a lot of B cells. (Lymphoid tissue refers to tissue that makes up the lymphatic system, which is part of the body’s immune system.)
Effectiveness for MZL
In clinical trials of Brukinsa, the drug was found safe and effective for treating MZL. For more information, see Brukinsa’s prescribing information.
It’s important to note that Brukinsa received accelerated approval from the FDA to treat MZL. For an explanation of accelerated approval, see the “Effectiveness for MCL” section.
Brukinsa for follicular lymphoma
Brukinsa is FDA approved to treat follicular lymphoma (FL) that is relapsed (has returned) or refractory (does not respond or stops responding to treatment). In addition, a person must have already tried two or more systemic treatments. (These are treatments that work throughout the body.) For this use, Brukinsa is taken in combination with obinutuzumab (Gazyva).
FL is another slow-growing type of non-Hodgkin’s lymphoma that starts in B cells. With follicular lymphoma, abnormal B cells build up in the lymph nodes. These abnormal cells form clumps, which are referred to as follicles.
Effectiveness for FL
In clinical trials of Brukinsa, the drug was found safe and effective for treating FL. For more information, see the Brukinsa prescribing information.
It’s important to note that Brukinsa received accelerated approval from the FDA to treat FL. For an explanation of accelerated approval, see the “Effectiveness for MCL” section.
Brukinsa and children
Brukinsa has not been studied in children. So it’s not known whether the drug is safe or effective for use in people younger than 18 years of age.
The Brukinsa dosage your doctor prescribes will depend on several factors. These include:
- the severity of the condition you’re taking Brukinsa to treat
- your age
- other medical conditions you may have
- other medications you may be taking
Typically, your doctor will start you on a standard dosage of Brukinsa. Then they’ll adjust your dosage over time to reach the amount of drug that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect and the least number of side effects.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Drug forms and strengths
Brukinsa contains the active ingredient zanubrutinib. It’s available as 80-milligram (mg) capsules.
In October 2025, Brukinsa tablets will become available. These will come in a strength of 160 mg.
Typical dosage
The dosage of Brukinsa is the same for all of the cancers the drug is approved to treat. The usual dosage of Brukinsa is either of the following options:
- 160 mg taken twice per day
- 320 mg taken once per day
If you’re taking Brukinsa in combination with obinutuzumab (Gazyva) for follicular lymphoma, your doctor will let you know the dosage of obinutuzumab you should take.
Your doctor may adjust your dosage of Brukinsa if needed. For example, they may do this depending on other medications you’re taking and how well your body tolerates Brukinsa.
What if I miss a dose?
If you miss a dose of Brukinsa, take the missed dose as soon as possible that day. Then, on the following day, you can go back to your usual schedule for taking Brukinsa.
To help make sure that you do not miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.
Will I need to use this drug long term?
Brukinsa is meant to be a long-term treatment. If you and your doctor determine that Brukinsa is safe and effective for you, you might take the drug long term.
Typically, Brukinsa treatment is continued until either your disease worsens or you have bothersome or severe side effects from the drug. Your doctor will recommend how long you should keep taking this drug based on your individual situation.
Brukinsa can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Brukinsa. These lists do not include all possible side effects.
For more information on the possible side effects of Brukinsa, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Brukinsa and want to tell the FDA about it, visit MedWatch or call 800-332-1088.
Mild side effects
Mild side effects of Brukinsa may include the following. Note that side effects can vary depending on the condition you’re taking Brukinsa to treat.
- bruising
- diarrhea
- cough
- muscle pain
- back pain
- tiredness
- constipation
- blood in your urine
- increased liver enzymes
- increased uric acid level
- rash, which is discussed in more detail in “Side effect details”
This is a partial list of mild side effects from Brukinsa. To learn about other mild side effects, talk with your doctor or pharmacist, or see Brukinsa’s prescribing information.
Most of these side effects may go away within a few days to a couple of weeks. But if they become more severe or do not go away, talk with your doctor or pharmacist.
Serious side effects
Serious side effects from Brukinsa are not common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.
Serious side effects and their symptoms can include:
- Atypical heart rhythm. Symptoms can include:
- palpitations (feeling your heartbeat flutter or skip a beat)
- dizziness
- chest pain
- shortness of breath
- Low platelet count. Symptoms can include:
- bruising more easily than usual
- bleeding from your gums or nose
- blood in your stool or urine
- petechiae (tiny reddish, purple, or brown spots on your skin)
- Anemia (low red blood cell count). Symptoms can include:
- weakness
- tiredness
- shortness of breath
- pale skin and fingertips
- dizziness
- Hemorrhage (bleeding). Symptoms can include:
- abdominal pain
- blood in your stool or urine
- vomiting blood
- chest pain
- headache
- Developing other forms of cancer, particularly skin cancer. Symptoms of skin cancer include:
- spots on your skin that are painful and itch or burn
- moles that change in size or color
- new brown spots on your skin that have darker circles in them
Other serious side effects, explained in more detail in “Side effect details,” include:
- allergic reaction
- infections
- low level of neutrophils (a type of white blood cell)
Side effect details
You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.
Allergic reaction
As with most drugs, some people can have an allergic reaction after taking Brukinsa. Symptoms of a mild allergic reaction can include:
- skin rash
- itchiness
- flushing
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your tongue, mouth, or throat
- difficulty breathing
Call your doctor right away if you have a severe allergic reaction to Brukinsa. But call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.
Infections
People taking Brukinsa have had serious, sometimes fatal, infections. For example, pneumonia was the most common serious infection reported in clinical trials of Brukinsa.
Other serious infections were also reported in clinical trials of Brukinsa. These infections include:
With reactivation of HBV, the virus is already inside your body, but it flares up and can cause symptoms.
Symptoms of infection will vary, depending on the type of infection you have. But they can include:
- fever
- weakness
- tiredness
- confusion
- cough
- shortness of breath
It’s important to remember that both cancer and Brukinsa can lower your body’s ability to fight off infections. Because of this, make sure to tell your doctor right away if you think you have an infection. They’ll check whether you have an infection and prescribe medication for it if needed. In some cases, your doctor may also recommend that you stop taking Brukinsa.
Low neutrophil count
Brukinsa works to treat certain blood cancers by decreasing the amount of abnormal blood cells in your body. However, the drug can also affect your level of healthy blood cells. For example, Brukinsa may lower your level of certain white blood cells called neutrophils. These blood cells are white blood cells that help fight infections.
Keep in mind that certain types of blood cancers can also lower your level of healthy blood cells. (This happens because the cancer cells crowd out your healthy blood cells.)
Having a decreased neutrophil count can lower your body’s ability to fight off infections. Because of this, it’s important to let your doctor know if you think you have an infection during treatment. For more information about infections during Brukinsa treatment, see the “Infections” section.
While you’re taking Brukinsa, your doctor will routinely check your blood cell counts. Based on the results of these blood tests, your doctor may change your dosage of Brukinsa. In some cases, they may recommend that you use a medication other than Brukinsa for your condition.
Rash
It’s possible to have a rash while you’re taking Brukinsa. This was a commonly reported side effect in clinical trials of the drug.
Keep in mind that in some cases, a rash can be a sign of allergic reaction. But in other cases, a rash might not be related to an allergic reaction. And it may go away on its own, without any treatment. For more information on allergic reactions related to Brukinsa, see the “Allergic reaction” section.
If you get a rash while you’re taking Brukinsa, call your doctor. They may prescribe a medication for you to treat the rash. Or they may recommend other ways to help reduce this side effect.
It’s not known whether Brukinsa interacts with alcohol. However, drinking alcohol can cause some of the same side effects as Brukinsa does, such as diarrhea. And it’s possible that drinking alcohol while taking Brukinsa could worsen these side effects.
If you drink alcohol, it’s important to talk with your doctor about whether it’s safe to drink it while you’re taking Brukinsa.
Brukinsa can interact with several other medications. It can also interact with certain supplements as well as certain foods.
Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.
Brukinsa and other medications
Here you’ll find examples of medications that can interact with Brukinsa. These are not all of the drugs that may interact with Brukinsa.
Before taking Brukinsa, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Brukinsa and certain antifungals
Taking Brukinsa with certain drugs used to treat fungal infections can increase the level of Brukinsa in your body. This interaction could increase your risk of side effects from Brukinsa. (For more information about side effects caused by Brukinsa, see the “Brukinsa side effects” section.)
Examples of antifungals that can increase Brukinsa levels include:
- fluconazole (Diflucan)
- itraconazole (Sporanox)
- voriconazole (Vfend)
- ketoconazole
If you need to take an antifungal medication while you’re taking Brukinsa, make sure to talk with your doctor. They may recommend an antifungal that does not interact with Brukinsa. Or in some cases, your doctor may lower your dosage of Brukinsa while you’re taking the antifungal.
Brukinsa and certain antibiotics
Taking Brukinsa with certain antibiotics can change the level of Brukinsa in your body.
In some cases, the level of Brukinsa may be increased. This interaction could increase your risk of side effects from Brukinsa. (For more information about side effects caused by Brukinsa, see the “Brukinsa side effects” section.)
Examples of antibiotics that can increase Brukinsa levels include:
- erythromycin (EryPed)
- clarithromycin
- ciprofloxacin (Cipro)
In other cases, the level of Brukinsa may be decreased. This interaction could affect how well Brukinsa is able to treat your condition. An example of an antibiotic that can decrease Brukinsa levels is rifampin (Rifadin).
If you need to take an antibiotic during your treatment with Brukinsa, make sure to talk with your doctor. They will likely recommend taking an antibiotic that does not interact with Brukinsa. However, if you need to take one of the antibiotics listed, your doctor may adjust your Brukinsa dosage during this period.
Brukinsa and efavirenz
Efavirenz is an antiretroviral medication that’s used for HIV treatment. Taking Brukinsa with efavirenz can decrease the level of Brukinsa in your body. This interaction could affect how well Brukinsa is able to treat your condition.
If your doctor prescribes efavirenz or combination drugs containing efavirenz for you, make sure that they know you’re also taking Brukinsa. Your doctor may adjust your dosage of Brukinsa while you’re taking the drugs together. Or they may recommend that you take a different antiretroviral medication.
Brukinsa and omeprazole
Omeprazole (Prilosec) is a proton pump inhibitor that’s used to treat certain gastrointestinal conditions. These conditions include heartburn and peptic ulcer disease. Taking Brukinsa with omeprazole may lower the level of omeprazole in your body. This interaction could affect how well omeprazole is able to treat your condition.
Omeprazole is available both as a prescription drug and an over-the-counter (OTC) drug. This means you can purchase OTC omeprazole without a prescription. But it’s still important to talk with your doctor before you take omeprazole with Brukinsa.
Your doctor can recommend whether it’s safe for you to take omeprazole with Brukinsa. In some cases, they may recommend a medication other than omeprazole for you.
Brukinsa and herbs and supplements
There aren’t any herbs or supplements that have been specifically reported to interact with Brukinsa. However, you should still check with your doctor or pharmacist before using any of these products while taking Brukinsa.
Brukinsa and foods
There aren’t any foods that have been specifically reported to interact with Brukinsa. If you have any questions about eating certain foods with Brukinsa, talk with your doctor.
Brukinsa and lab tests
It’s not known whether Brukinsa interacts with any lab tests. However, Brukinsa can affect your levels of certain blood cells that may be checked on lab tests. For more information about how Brukinsa can affect your blood cell levels, see the “Brukinsa side effects” section.
As with all medications, the cost of Brukinsa can vary.
The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.
It’s important to note that you’ll have to get Brukinsa at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or require help from healthcare professionals to be used safely and effectively.
Your insurance plan may require you to get prior authorization before approving coverage for Brukinsa. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide whether the drug will be covered.
If you’re not sure whether you’ll need to get prior authorization for Brukinsa, contact your insurance company.
Drug coupons
You can visit Optum Perks for price estimates of Brukinsa. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with insurance copays or benefits.
Financial and insurance assistance
If you need financial support to pay for Brukinsa or if you need help understanding your insurance coverage, help is available.
BeOne, the manufacturer of Brukinsa, offers a program called myBeOne. Through this program, you may be eligible for cost savings for this drug. For more information and to find out if you’re eligible for support, call 833-234-4363 or visit the program website.
Generic version
Brukinsa is not available in a generic form. A generic drug contains the same active ingredient as the brand-name version. Generics tend to cost less than brand-name drugs.
Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission. Learn more.
Other drugs are available that can treat the conditions Brukinsa is approved by the Food and Drug Administration (FDA) to treat. Some may be a better fit for you than others. If you’re interested in finding an alternative to Brukinsa, talk with your doctor. They can tell you about other medications that may work well for you.
Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.
Alternatives for chronic lymphocytic leukemia and small lymphocytic lymphoma
Examples of other drugs that may be used to treat chronic lymphocytic leukemia and small lymphocytic lymphoma include the following:
Alternatives for mantle cell lymphoma
Examples of other drugs that may be used to treat mantle cell lymphoma include the following:
- ibrutinib (Imbruvica)
- acalabrutinib (Calquence)
- ixazomib (Ninlaro)
- bortezomib (Velcade)
- R-CHOP, which contains rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone
- VR-CAP, which contains rituximab, cyclophosphamide, doxorubicin, bortezomib, and prednisone
- lenalidomide (Revlimid)
- bendamustine (Treanda)
Alternatives for Waldenstrom macroglobulinemia
Examples of other drugs that may be used to treat Waldenstrom macroglobulinemia include the following:
Alternatives for marginal zone lymphoma
Examples of other drugs that may be used to treat marginal zone lymphoma include the following:
- rituximab (Rituxan)
- bendamustine (Treanda)
- ibritumomab (Zevalin)
- duvelisib (Copiktra)
- idelalisib (Zydelig)
Alternatives for follicular lymphoma
Examples of other drugs that may be used to treat follicular lymphoma include the following:
- obinutuzumab (Gazyva)
- idelalisib (Zydelig)
- bendamustine (Treanda)
- rituximab (Rituxan)
- ibritumomab (Zevalin)
- duvelisib (Copiktra)
You may wonder how Brukinsa compares with other medications that are prescribed for similar uses. Here we look at how Brukinsa and Velcade are alike and different.
Ingredients
Brukinsa contains the active ingredient zanubrutinib. It belongs to a class of drugs called Bruton’s tyrosine kinase (BTK) inhibitors.
Velcade, on the other hand, contains the active ingredient bortezomib. It belongs to a class of drugs called proteasome inhibitors.
Uses
The Food and Drug Administration (FDA) has approved Brukinsa and Velcade to treat a type of blood cancer called mantle cell lymphoma (MCL) in adults. In the case of Brukinsa, it’s typically prescribed to adults who have used at least one other past treatment for their MCL. (Velcade does not have this restriction.)
For MCL, Brukinsa received
Both drugs also have approved uses that differ. Brukinsa is FDA approved to treat chronic lymphocytic leukemia and small lymphocytic lymphoma, Waldenstrom macroglobulinemia, marginal zone lymphoma, and follicular lymphoma in certain adults. (The latter two conditions received accelerated approval from the FDA.)
Velcade is also approved to treat multiple myeloma, which is another type of blood cancer, in adults. Your doctor can tell you more about this use of Velcade.
Drug forms and administration
Brukinsa comes as oral capsules, which you take by mouth. It’s typically taken either once or twice daily, with or without food. (Note that Brukinsa will be available as oral tablets in October 2025.)
Velcade, on the other hand, is given as an injection by a healthcare professional. Velcade can be given either subcutaneously or intravenously. Velcade is typically given twice weekly for 2 weeks, followed by a week of rest (that is, the drug is not administered during the third week).
Side effects and risks
Brukinsa and Velcade both work in similar ways in your body. Therefore, these medications can cause very similar side effects, but some different ones as well. Here are examples of these side effects.
Mild side effects
The following table lists some of the more common mild side effects that can occur with Brukinsa, with Velcade, or with both drugs (when taken individually).
| Mild side effect | Brukinsa | Velcade |
|---|---|---|
| bruising | ✓ | |
| coughing | ✓ | |
| muscle pain | ✓ | |
| back pain | ✓ | |
| blood in your urine | ✓ | |
| increased uric acid level | ✓ | |
| difficulty sleeping | ✓ | |
| hair loss | ✓ | |
| weight loss | ✓ | |
| vomiting | ✓ | ✓ |
| rash | ✓ | ✓ |
| diarrhea | ✓ | ✓ |
| constipation | ✓ | ✓ |
| fatigue | ✓ | ✓ |
| increased liver enzymes | ✓ | ✓ |
Serious side effects
The following table lists some of the serious side effects that can occur with Brukinsa, with Velcade, or with both drugs (when taken individually).
| Serious side effect | Brukinsa | Velcade |
|---|---|---|
| hemorrhage (bleeding) | ✓ | |
| developing other forms of cancer | ✓ | |
| atypical heart rhythm | ✓ | |
| neurological issues, such as nerve damage and posterior reversible encephalopathy syndrome | ✓ | |
| decreased blood pressure | ✓ | |
| new or worsened heart failure | ✓ | |
| problems with breathing | ✓ | |
| gastrointestinal issues, such as painful blockages in the digestive tract | ✓ | |
| thrombotic microangiopathy (a rare blood disorder that affects small blood vessels) | ✓ | |
| tumor lysis syndrome (a condition that’s caused by the death of cancer cells in the body) | ✓ | |
| anemia (low level of red blood cells) | ✓ | ✓ |
| liver damage | ✓ | ✓ |
| allergic reaction | ✓ | ✓ |
| infections, such as pneumonia | ✓ | ✓ |
| low level of platelets | ✓ | ✓ |
| low level of neutrophils (a type of white blood cell) | ✓ | ✓ |
Effectiveness
These drugs have not been directly compared in clinical trials. However, separate trials have found both Brukinsa and Velcade to be effective in treating MCL.
Costs
Brukinsa and Velcade are both brand-name drugs. There is currently no generic form of Brukinsa available, but a generic version of Velcade called bortezomib is available. Brand-name medications usually cost more than generics.
Keep in mind that the actual price you’ll pay for either drug depends on your insurance plan, your location, and your prescribed dosage. Your cost will also vary depending on whether you get the drug from a pharmacy or receive it from your doctor.
Like Velcade (discussed previously), other medications are also prescribed for uses similar to those of Brukinsa. Here we look at how Brukinsa and Imbruvica are alike and different.
Ingredients
Brukinsa contains the active ingredient zanubrutinib. It belongs to a class of drugs called Bruton’s tyrosine kinase (BTK) inhibitors.
Imbruvica contains the active ingredient ibrutinib. It’s also a BTK inhibitor.
Uses
Brukinsa and Imbruvica are both approved to treat the following in adults:
Brukinsa is also approved to treat mantle cell lymphoma (MCL), marginal zone lymphoma (MZL), and follicular lymphoma (FL) in certain adults.
For MCL, MZL, and FL, Brukinsa received
Imbruvica is also approved to treat:
- CLL and SLL in adults with a certain gene mutation (atypical change)
- chronic (long-lasting) graft-versus-host disease in adults and children ages 12 months and older
Drug forms and administration
Brukinsa comes as oral capsules, which you take by mouth. It’s typically taken either once or twice daily, with or without food. (Note that Brukinsa will be available as oral tablets in October 2025.)
Imbruvica comes as oral capsules and oral tablets, which are taken by mouth with a glass of water. It also comes as an oral liquid suspension, which is taken by mouth. (This form is typically given to some children.) Imbruvica is typically taken once daily.
Side effects and risks
Brukinsa and Imbruvica both belong to a class of drugs called BTK inhibitors. Therefore, these medications can cause very similar side effects, but some different ones as well. Here are examples of these side effects.
Mild side effects
The following table gives examples of some of the more common mild side effects that can occur with Brukinsa, with Imbruvica, or with both drugs (when taken individually).
| Mild side effect | Brukinsa | Imbruvica |
|---|---|---|
| back pain | ✓ | |
| increased liver enzymes | ✓ | |
| sores in your mouth | ✓ | |
| rash | ✓ | ✓ |
| diarrhea | ✓ | ✓ |
| bruising | ✓ | ✓ |
| tiredness | ✓ | ✓ |
| muscle pain | ✓ | ✓ |
| cough | ✓ | ✓ |
| constipation | ✓ | ✓ |
| blood in your urine | ✓ | ✓ |
| increased uric acid level | ✓ | ✓ |
| bone pain | ✓ | ✓ |
Serious side effects
The following table gives examples of serious side effects that can occur with Brukinsa, with Imbruvica, or with both drugs (when taken individually). Side effects also vary based on what condition you have.
| Serious side effect | Brukinsa | Imbruvica |
|---|---|---|
| increased blood pressure | ✓ | |
| tumor lysis syndrome (a condition that’s caused by the death of cancer cells in the body) | ✓ | |
| allergic reaction | ✓ | ✓ |
| hemorrhage (bleeding) | ✓ | ✓ |
| infections, such as pneumonia | ✓ | ✓ |
| low level of neutrophils (a type of white blood cell) | ✓ | ✓ |
| low level of platelets | ✓ | ✓ |
| low level of red blood cells | ✓ | ✓ |
| developing other forms of cancer | ✓ | ✓ |
| atypical heart rhythm | ✓ | ✓ |
Effectiveness
These drugs have not been directly compared in clinical trials. But separate clinical trials have found both Brukinsa and Imbruvica to be effective in treating CLL, SLL, and WM.
Costs
Brukinsa and Imbruvica are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.
Keep in mind that the actual price you’ll pay for either drug depends on your insurance plan, your location, and your prescribed dosage.
You should take Brukinsa according to your doctor’s or healthcare professional’s instructions. You’ll take Brukinsa by mouth, typically once or twice daily. You should take it with a glass of water.
When to take
There’s no recommendation for an exact time of day that you should take Brukinsa.
However, if you’re taking Brukinsa once daily, try to be consistent in taking the drug at about the same time each day. If you’re taking Brukinsa twice daily, try to keep your doses about 12 hours apart.
To help make sure that you do not miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.
Taking Brukinsa with food
Brukinsa can be taken with or without food. Sometimes taking the medication with food can help decrease certain side effects, such as nausea.
Can Brukinsa be split, opened, or chewed?
It’s important that you swallow Brukinsa capsules whole. You should not break, crush, open, or chew the capsules. Doing so can affect how your body absorbs the drug and may cause harmful effects.
The manufacturer of Brukinsa recommends against crushing or chewing Brukinsa tablets. However, Brukinsa tablets may be split in half if your doctor recommends this.
Brukinsa is approved to treat certain blood cancers. With these cancers, your B cells (a type of white blood cell) grow abnormally. (For details about the cancers Brukinsa treats, see the “Brukinsa for chronic lymphocytic leukemia and small lymphocytic lymphoma” and “Brukinsa other uses” sections.)
Brukinsa contains the active ingredient zanubrutinib. It belongs to a class of drugs called Bruton’s tyrosine kinase (BTK) inhibitors.
Brukinsa works by inhibiting (blocking) the action of the Bruton’s tyrosine kinase (BTK) enzyme. (Enzymes are proteins that aid chemical changes in the body.) By targeting BTK, Brukinsa can stop abnormal B cells in your body from multiplying. In some people, this mechanism of action (how a drug works) may lead to reduced tumor growth as well.
How long does it take to work?
How soon a person notices Brukinsa working for them can vary. Your doctor will monitor you during treatment to see when Brukinsa starts working and how well it works. To do this, your doctor may order certain blood tests for you.
There have not been any studies to look at the safety or effectiveness of Brukinsa in pregnant females.
However, in animal studies, zanubrutinib (the active ingredient in Brukinsa) did cause harm to fetuses exposed to the drug. For example, pregnancies exposed to the drug had increased rates of:
- pregnancy loss
- fetal heart malformations
- problems with fetal eye development and vision
Keep in mind that animal studies do not always predict what will happen in people. However, because of possible risks, it’s recommended that females of reproductive age have a negative pregnancy test before starting Brukinsa.
In addition, both males and females taking Brukinsa should use birth control to prevent pregnancy. For more information about this, see the “Brukinsa and birth control” section.
If you’re pregnant or planning to become pregnant, talk with your doctor before taking Brukinsa.
Note: The use of binary terms such as “male” and “female” or “men” and “women” in this article reflects the language of the sources we’ve used. Unless otherwise noted, it’s unclear whether the research we reference included participants with expansive gender identities.
It’s not known whether Brukinsa is safe to take during pregnancy. However, the drug has been shown to cause harm when given to pregnant animals. It’s important to remember that animal studies do not always predict what will happen in humans. But because of possible risks with Brukinsa, it’s recommended that pregnancy be avoided while you’re taking this drug.
For more information about the risks of taking Brukinsa during pregnancy, see the “Brukinsa and pregnancy” section.
If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control options while you’re taking Brukinsa. Here we describe recommendations for both females and males taking Brukinsa.
Birth control in females taking Brukinsa
If you’re a female of reproductive age, it’s recommended that you use effective birth control while you’re taking Brukinsa. You should continue to use birth control for at least 1 week after stopping Brukinsa.
Birth control in males taking Brukinsa
If you’re a male who is sexually active with someone who can become pregnant, you should use effective birth control while you’re taking Brukinsa. And you should continue to use birth control for at least 1 week after stopping Brukinsa.
It’s not known whether Brukinsa is safe to use while breastfeeding. However, Brukinsa may be harmful to children who are breastfed.
Because of this, it’s recommended that you do not breastfeed while you’re taking Brukinsa. And you should continue to avoid breastfeeding for at least 2 weeks after stopping the drug.
If you have questions about the safety of breastfeeding while you’re taking Brukinsa, talk with your doctor.
Here are answers to some frequently asked questions about Brukinsa.
Is Brukinsa a chemotherapy drug?
No, Brukinsa is not a chemotherapy drug. Chemotherapy refers to traditional medications used to treat cancer. These medications work by killing rapidly multiplying cells in your body.
Because cancer cells typically multiply quickly, chemotherapy affects cancer cells. However, chemotherapy can also kill some of the body’s healthy cells that also multiply quickly.
Unlike chemotherapy, Brukinsa is a targeted therapy that belongs to a class of drugs called BTK inhibitors.
Brukinsa works by inhibiting (blocking) the action of Bruton’s tyrosine kinase (BTK). By targeting BTK, Brukinsa can stop certain cancer cells in your body from multiplying. In some people, this may lead to reduced tumor growth as well.
If you’d like to know more about using chemotherapy versus targeted therapy for your condition, talk with your doctor.
Do I need to avoid sun exposure while I’m taking Brukinsa?
Yes, it’s recommended that you protect yourself from sunlight while you’re taking Brukinsa. This is because Brukinsa may increase your risk of certain types of skin cancer. Sun exposure can also increase this risk.
If you’re going to be out in the sun, it’s important that you use sunscreen with an SPF of at least 30. (SPF, or sun protection factor, describes how much protection from sunlight a certain product provides.) Doing this will help to protect you from harmful effects of the sun. You can also wear protective clothing to cover your skin from sunlight.
If you have questions about sun exposure while you’re taking Brukinsa, talk with your doctor.
How will my doctor monitor my health during Brukinsa treatment?
During Brukinsa treatment, your doctor will order certain lab tests to check how your condition is responding. For example, your doctor may order the following blood tests:
- complete blood count (CBC), which checks your blood cell levels
- basic metabolic panel (BMP), which checks your electrolyte levels and kidney function
- liver function tests (LFTs), which check your liver function
A CBC can help show how well your body is responding to Brukinsa treatment. For example, a CBC shows the levels of certain blood cells in your body, including both healthy and cancerous blood cells. If Brukinsa is working to treat your cancer, your blood cell levels may have improved with treatment.
In addition, a CBC can also show your doctor if you’re having certain side effects from Brukinsa. These side effects include low neutrophil count, low platelet count, and low red blood cell count. If your blood cell levels are too low with Brukinsa, your doctor may adjust your dosage of the drug.
If you have questions about the tests you’ll need during Brukinsa treatment, talk with your doctor.
Before taking Brukinsa, discuss your health history with your doctor. Brukinsa may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:
- allergic reaction
- bleeding problems or planned surgeries
- fever or a current infection
- high blood pressure
- heart rhythm problems
- liver problems, including whether you’ve ever had hepatitis B
- pregnancy
- breastfeeding
Note: For more information about the potential negative effects of Brukinsa, see the “Brukinsa side effects” section.
You should not take more Brukinsa than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.
What to do in case you take too much Brukinsa
If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.