Chronic lymphoid leukemia

Active Ingredient: Idelalisib

Indication for Idelalisib

Population group: only adults (18 years old or older)

Idelalisib is indicated in combination with rituximab for the treatment of adult patients with chronic lymphocytic leukaemia (CLL):

  • who have received at least one prior therapy, or
  • as first line treatment in the presence of 17p deletion or TP53 mutation in patients who are not eligible for any other therapies.

For this indication, competent medicine agencies globally authorize below treatments:

300 mg in 2 divided doses daily

Route of admnistration

Oral

Defined daily dose

300 - 300 mg

Dosage regimen

From 150 To 150 mg 2 time(s) per day every day

Detailed description

The recommended dose is 150 mg idelalisib twice daily. Treatment should be continued until disease progression or unacceptable toxicity.

If the patient misses a dose of idelalisib within 6 hours of the time it is usually taken, the patient should take the missed dose as soon as possible and resume the normal dosing schedule. If a patient misses a dose by more than 6 hours, the patient should not take the missed dose and simply resume the usual dosing schedule.

Dose modification

Elevated liver transaminases

Treatment with idelalisib must be withheld in the event of a Grade 3 or 4 aminotransferase elevation (alanine aminotransferase [ALT]/aspartate aminotransferase [AST] >5 x upper limit of normal [ULN]). Once values have returned to Grade 1 or below (ALT/AST ≤3 x ULN), treatment can be resumed at 100 mg twice daily.

If the event does not recur, the dose can be re-escalated to 150 mg twice daily at the discretion of the treating physician.

If the event recurs, treatment with idelalisib must be withheld until the values return to Grade 1 or less, after which re-initiation at 100 mg twice daily may be considered at the discretion of the physician.

Diarrhoea/colitis

Treatment with idelalisib must be withheld in the event of Grade 3 or 4 diarrhoea/colitis. Once diarrhoea/colitis has returned to Grade 1 or below, treatment can be resumed at 100 mg twice daily. If diarrhoea/colitis does not recur, the dose can be re-escalated to 150 mg twice daily at the discretion of the treating physician.

Pneumonitis

Treatment with idelalisib must be withheld in the event of suspected pneumonitis. Once pneumonitis has resolved and if re-treatment is appropriate, resumption of treatment at 100 mg twice daily can be considered. Treatment with idelalisib must be permanently discontinued in the event of moderate or severe symptomatic pneumonitis or organising pneumonia.

Rash

Treatment with idelalisib must be withheld in the event of Grade 3 or 4 rash. Once rash has returned to Grade 1 or below, treatment can be resumed at 100 mg twice daily. If rash does not recur, the dose can be re-escalated to 150 mg twice daily at the discretion of the treating physician.

Neutropenia

Treatment with idelalisib should be withheld in patients while absolute neutrophil count (ANC) is below 500 per mm³. ANC should be monitored at least weekly until ANC is ≥500 per mm³ when treatment can be resumed at 100 mg twice daily.

ANC 1,000 to <1,500/mm³ ANC 500 to <1,000/mm³ ANC <500/mm³
Maintain idelalisib dosing. Maintain idelalisib dosing. Monitor ANC at least weekly.
Interrupt idelalisib dosing. Monitor ANC at least weekly until ANC ≥500/mm³, then may resume idelalisib dosing at 100 mg twice daily.

Dosage considerations

It can be taken with or without food.

Active ingredient

Idelalisib

Idelalisib inhibits phosphatidylinositol 3-kinase p110δ (PI3Kδ), which is hyperactive in B-cell malignancies and is central to multiple signalling pathways that drive proliferation, survival, homing, and retention of malignant cells in lymphoid tissues and bone marrow. Idelalisib induces apoptosis and inhibits proliferation in cell lines derived from malignant B-cells and in primary tumour cells.

Read more about Idelalisib

Related medicines

Develop a tailored medication plan for your case, considering factors such as age, gender, and health history

Ask the Reasoner

Liability Disclaimer : RxReasoner has utilized reasonable care in providing content and services that are accurate, complete and up to date. However, RxReasoner does not accept any responsibility or liability about it. The content and services of RxReasoner are for informational purposes only and they are not intended to be a substitute for the knowledge, expertise, skill, and judgment of physicians, pharmacists, nurses, or other healthcare professionals involved in patient care. RxReasoner offers no medical advice. Users are responsible for the use of the provided content. A shown indication or treatment should not be construed to indicate that the medication is safe, appropriate, or effective in any given patient or under any particular circumstances. The absence of an indication or treatment should not roule out the existence of other appropriate medications. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition or medicament. RxReasoner is not liable for any damages allegedly sustained arising out of the use of its content and services.