Acalabrutinib

Generic Name: acalabrutinib

Kinase Inhibitor [EPC]Over-the-Counter (OTC)

Brand Names:

Calquence

11 DESCRIPTION CALQUENCE (acalabrutinib) is a kinase inhibitor. The molecular formula for acalabrutinib maleate is C 26 H 23 N 7 O 2 •C 4 H 4 O 4 .H 2 O, and the molecular weight is 599.59. The chemical name is 4-{8-Amino-3-[(2 S )-1-(but-2-ynoyl) pyrrolidin-2-yl] imidazo[1,5- a ]pyrazin-1-yl}- N -(pyridin-2-yl)benzamide (2 Z )-2-butenedioic acid hydrate. The chemical structure of acalabrutinib is shown below: Acalabrutinib maleate is a white to pale brown powder with pH-dependent solubility.

Overview

11 DESCRIPTION CALQUENCE (acalabrutinib) is a kinase inhibitor. The molecular formula for acalabrutinib maleate is C 26 H 23 N 7 O 2 •C 4 H 4 O 4 .H 2 O, and the molecular weight is 599.59. The chemical name is 4-{8-Amino-3-[(2 S )-1-(but-2-ynoyl) pyrrolidin-2-yl] imidazo[1,5- a ]pyrazin-1-yl}- N -(pyridin-2-yl)benzamide (2 Z )-2-butenedioic acid hydrate. The chemical structure of acalabrutinib is shown below: Acalabrutinib maleate is a white to pale brown powder with pH-dependent solubility.

Uses

1 INDICATIONS AND USAGE CALQUENCE is a kinase inhibitor indicated: • In combination with bendamustine and rituximab for the treatment of adult patients with previously untreated mantle cell lymphoma (MCL) who are ineligible for autologous hematopoietic stem cell transplantation (HSCT). (1.1 ) • For the treatment of adult patients with MCL who have received at least one prior therapy. ( 1.2 ) • For the treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).

Dosage

2 DOSAGE AND ADMINISTRATION • Recommended dose is 100 mg orally approximately every 12 hours; swallow whole with water and with or without food. ( 2.1 ) • Advise patients not to chew, crush, dissolve, or cut tablets. ( 2.1 ) • Manage toxicities using treatment interruption, dose reduction, or discontinuation. ( 2.3 ) • Avoid CALQUENCE in patients with severe hepatic impairment. ( 8.6 ) 2.1 Recommended Dosage CALQUENCE Administration Instructions Advise patients to swallow tablet whole with water. Advise patients not to chew, crush, dissolve, or cut the tablets. CALQUENCE may be taken with or without food. 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.

Side Effects

6 ADVERSE REACTIONS The following clinically significant adverse reactions are discussed in greater detail in other sections of the labeling: • Serious and Opportunistic Infections [see Warnings and Precautions (5.1) ] • Hemorrhage [see Warnings and Precautions (5.2) ] • Cytopenias [see Warnings and Precautions (5.3) ] • Second Primary Malignancies [see Warnings and Precautions (5.4) ] • Cardiac Arrhythmias [see Warnings and Precautions (5.5) ] • Hepatotoxicity, including DILI [see Warnings and Precautions (5.6) ] The most common adverse reactions (≥ 30%), excluding laboratory abnormalities, are upper respiratory tract infection, diarrhea, headache, and musculoskeletal pain.

Interactions

7 DRUG INTERACTIONS • Strong CYP3A Inhibitors : Avoid co-administration with CALQUENCE. ( 2.2 , 7 ) • Moderate CYP3A Inhibitors : Reduce the dosage of CALQUENCE. ( 2.2 , 7 ) • Strong CYP3A Inducers : Avoid co-administration with CALQUENCE. If co-administration is unavoidable, increase the dosage of CALQUENCE. ( 2.2 , 7 ) 7.1 Effect of Other Drugs on CALQUENCE Strong CYP3A Inhibitors Clinical Effect Co-administration of CALQUENCE with a strong CYP3A inhibitor increased acalabrutinib plasma concentrations [see Clinical Pharmacology (12.3) ] . Increased acalabrutinib concentrations may result in increased toxicity. Prevention or Management Avoid co-administration of CALQUENCE with strong CYP3A inhibitors.

Warnings

5 WARNINGS AND PRECAUTIONS • Serious and Opportunistic Infections: Monitor for signs and symptoms of infection and treat promptly. ( 5.1 ) • Hemorrhage: Monitor for bleeding and manage appropriately. ( 5.2 ) • Cytopenias: Monitor complete blood counts regularly. ( 5.3 ) • Second Primary Malignancies: Other malignancies have occurred, including skin cancers and other solid tumors. Advise patients to use sun protection. ( 5.4 ) • Cardiac Arrhythmias: Monitor for symptoms of arrhythmias and manage. ( 5.5 ) • Hepatotoxicity, Including Drug Induced Liver Injury: Monitor hepatic function throughout treatment. 4 CONTRAINDICATIONS None. None. ( 4 )

Pregnancy

8.1 Pregnancy Risk Summary Based on findings in animals, CALQUENCE may cause fetal harm and dystocia when administered to a pregnant woman. There are no available data in pregnant women to inform the drug-associated risk. In animal reproduction studies, administration of acalabrutinib to animals during organogenesis resulted in dystocia in rats and reduced fetal growth in rabbits at maternal exposures (AUC) 2 times exposures in patients at the recommended dose of 100 mg approximately every 12 hours ( see Data ) . Advise pregnant women of the potential risk to a fetus.

Storage

16 HOW SUPPLIED/STORAGE AND HANDLING How Supplied Pack Size Contents NDC Number 60-count bottle Bottle containing 60 tablets with a child-resistant closure 100 mg, orange, oval, biconvex tablet, with debossment ‘ACA100’ on one side and plain on the reverse 0310-3512-60 Storage Store at 20°C-25°C (68°F-77°F); excursions permitted to 15°C-30°C (59°F-86°F) [see USP Controlled Room Temperature].

Frequently Asked Questions

What is Acalabrutinib used for?

1 INDICATIONS AND USAGE CALQUENCE is a kinase inhibitor indicated: • In combination with bendamustine and rituximab for the treatment of adult patients with previously untreated mantle cell lymphoma (MCL) who are ineligible for autologous hematopoietic stem cell transplantation (HSCT). (1.1 ) • For the treatment of adult patients with MCL who have received at least one prior therapy. ( 1.2 ) • For the treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).

What are the side effects of Acalabrutinib?

6 ADVERSE REACTIONS The following clinically significant adverse reactions are discussed in greater detail in other sections of the labeling: • Serious and Opportunistic Infections [see Warnings and Precautions (5.1) ] • Hemorrhage [see Warnings and Precautions (5.2) ] • Cytopenias [see Warnings and Precautions (5.3) ] • Second Primary Malignancies [see Warnings and Precautions (5.4) ] • Cardiac Arrhythmias [see Warnings and Precautions (5.5) ] • Hepatotoxicity, including DILI [see Warnings and Precautions (5.6) ] The most common adverse reactions (≥ 30%), excluding laboratory abnormalities, are upper respiratory tract infection, diarrhea, headache, and musculoskeletal pain.

Can I take Acalabrutinib during pregnancy?

8.1 Pregnancy Risk Summary Based on findings in animals, CALQUENCE may cause fetal harm and dystocia when administered to a pregnant woman. There are no available data in pregnant women to inform the drug-associated risk. In animal reproduction studies, administration of acalabrutinib to animals during organogenesis resulted in dystocia in rats and reduced fetal growth in rabbits at maternal exposures (AUC) 2 times exposures in patients at the recommended dose of 100 mg approximately every 12 hours ( see Data ) . Advise pregnant women of the potential risk to a fetus.

What are the important warnings for Acalabrutinib?

5 WARNINGS AND PRECAUTIONS • Serious and Opportunistic Infections: Monitor for signs and symptoms of infection and treat promptly. ( 5.1 ) • Hemorrhage: Monitor for bleeding and manage appropriately. ( 5.2 ) • Cytopenias: Monitor complete blood counts regularly. ( 5.3 ) • Second Primary Malignancies: Other malignancies have occurred, including skin cancers and other solid tumors. Advise patients to use sun protection. ( 5.4 ) • Cardiac Arrhythmias: Monitor for symptoms of arrhythmias and manage. ( 5.5 ) • Hepatotoxicity, Including Drug Induced Liver Injury: Monitor hepatic function throughout treatment. 4 CONTRAINDICATIONS None. None. ( 4 )

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Medical Disclaimer

This drug information is for educational purposes only and should not replace professional medical advice. Drug information is sourced from the FDA National Drug Code Directory and Structured Product Labeling. Always consult with a healthcare provider before starting, stopping, or changing any medication.