Idelalisib Brand Name– ZYDELIG
What is Idelalisib
Idelalisib is a phosphatidylinositol 3-kinase inhibitor.
It is indicated in combination with rituximab for the treatment of relapsed chronic lymphocytic leukemia (CLL) and as a single-agent for the treatment of relapsed B-cell follicular lymphoma (FL) or relapsed small lymphocytic lymphoma in patients who have received at least 2 prior systemic therapies.
It should not be used as first-line treatment of CLL or FL; additionally, idelalisib is not recommended for use in combination with bendamustine and/or rituximab for the treatment of FL.
Increased rates of adverse events, including death, were reported in patients who received idelalisib in combination with other cancer therapy in 6 clinical trials; these trials were stopped early.
Fatal and/or serious toxicities including hepatotoxicity, diarrhea or colitis, pneumonitis, infection, and intestinal perforation have been reported with idelalisib therapy.
Routine liver monitoring, for example, is required as part of the Zydelig REMs program. Information is available at www.ZydeligREMs.com
Indications
- chronic lymphocytic leukemia (CLL)
- non-Hodgkin’s lymphoma (NHL)
For the treatment of chronic lymphocytic leukemia (CLL)
NOTE: The FDA has designated idelalisib as an orphan drug for the treatment of CLL.
Side Effects
- abdominal pain
- abdominal pain
- anaphylactoid reactions
- anemia
- anemia
- anorexia
- anorexia
- arthralgia
- arthralgia
- asthenia
- asthenia
- chills
- chills
- colitis
- colitis
- cough
- cough
- dehydration
- dehydration
- diarrhea
- diarrhea
- dyspnea
- dyspnea
- elevated hepatic enzymes
- elevated hepatic enzymes
- enterocolitis
- exfoliative dermatitis
- fatigue
- fatigue
- fever
- fever
- gastroesophageal reflux
- gastroesophageal reflux
- GI perforation
- headache
- headache
- hepatotoxicity
- hypoxia
- infection
- infection
- insomnia
- lethargy
- leukopenia
- leukopenia
- lymphocytosis
- lymphopenia
- lymphopenia
- maculopapular rash
- maculopapular rash
- nausea
- nausea
- neutropenia
- neutropenia
- night sweats
- peripheral edema
- peripheral edema
- pneumonitis
- rash
- rash
- sinusitis
- Stevens-Johnson syndrome
- stomatitis
- stomatitis
- thrombocytopenia
- thrombocytopenia
- toxic epidermal necrolysis
- vomiting
- vomiting
Monitoring Parameters
- CBC with differential
- LFTs
- pregnancy testing
Contraindications
- abdominal pain
- breast-feeding
- colitis
- contraception requirements
- diarrhea
- geriatric
- GI perforation
- hepatic disease
- hepatotoxicity
- infection
- infertility
- male-mediated teratogenicity
- nausea/vomiting
- neutropenia
- pneumonitis
- pregnancy
- pregnancy testing
- reproductive risk
- serious rash
Interactions
- Abacavir; Dolutegravir; Lamivudine
- Abemaciclib
- Acalabrutinib
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Tramadol
- Ado-Trastuzumab emtansine
- Alfentanil
- Alfuzosin
- Aliskiren
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Aliskiren; Valsartan
- Almotriptan
- Alosetron
- Alprazolam
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Apalutamide
- Apixaban
- Aprepitant, Fosaprepitant
- Aripiprazole
- Artemether; Lumefantrine
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atazanavir
- Atazanavir; Cobicistat
- Atorvastatin
- Atorvastatin; Ezetimibe
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Avanafil
- Avapritinib
- Axitinib
- Azelastine; Fluticasone
- Bedaquiline
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Benzhydrocodone; Acetaminophen
- Betamethasone
- Boceprevir
- Bortezomib
- Bosentan
- Bosutinib
- Brentuximab vedotin
- Brexpiprazole
- Brigatinib
- Bromocriptine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Budesonide
- Budesonide; Formoterol
- Bupivacaine
- Bupivacaine Liposomal
- Bupivacaine; Lidocaine
- Buprenorphine
- Buprenorphine; Naloxone
- Buspirone
- Cabazitaxel
- Cabozantinib
- Caffeine; Ergotamine
- Cannabidiol
- Capmatinib
- Carbamazepine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cariprazine
- Ceritinib
- Cevimeline
- Chloramphenicol
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Cilostazol
- Cinacalcet
- Cisapride
- Citalopram
- Clarithromycin
- Clindamycin
- Clobazam
- Clomipramine
- Clonazepam
- Clorazepate
- Clozapine
- Cobicistat
- Cobimetinib
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colchicine
- Colchicine; Probenecid
- Conivaptan
- Conjugated Estrogens; Medroxyprogesterone
- Copanlisib
- Crizotinib
- Cyclosporine
- Dabrafenib
- Daclatasvir
- Dapsone
- Darifenacin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasatinib
- Deflazacort
- Delavirdine
- Dexamethasone
- Dextromethorphan; Quinidine
- Diazepam
- Diclofenac
- Diclofenac; Misoprostol
- Dienogest; Estradiol valerate
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Dihydroergotamine
- Diltiazem
- Diphenhydramine; Hydrocodone; Phenylephrine
- Disopyramide
- Disulfiram
- Docetaxel
- Dolasetron
- Dolutegravir
- Dolutegravir; Lamivudine
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doravirine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxazosin
- Doxorubicin
- Doxorubicin Liposomal
- Dronabinol
- Dronedarone
- Droperidol
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Dutasteride
- Dutasteride; Tamsulosin
- Duvelisib
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Eletriptan
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Enalapril; Felodipine
- Encorafenib
- Enfortumab vedotin
- Entrectinib
- Enzalutamide
- Eplerenone
- Erdafitinib
- Ergotamine
- Erlotinib
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Esomeprazole
- Esomeprazole; Naproxen
- Estazolam
- Estradiol Cypionate; Medroxyprogesterone
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Eszopiclone
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Ethosuximide
- Etonogestrel
- Etravirine
- Everolimus
- Ezetimibe; Simvastatin
- Fedratinib
- Felodipine
- Fentanyl
- Flibanserin
- Flurazepam
- Flutamide
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Fosamprenavir
- Fosphenytoin
- Fostamatinib
- Gefitinib
- Gilteritinib
- Glasdegib
- Granisetron
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guanfacine
- Halofantrine
- Haloperidol
- Homatropine; Hydrocodone
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydroxyprogesterone
- Ibrutinib
- Ibuprofen; Oxycodone
- Ifosfamide
- Iloperidone
- Imatinib
- Imipramine
- Indinavir
- Irinotecan
- Irinotecan Liposomal
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isradipine
- Istradefylline
- Itraconazole
- Ivabradine
- Ivacaftor
- Ivermectin
- Ivosidenib
- Ixabepilone
- Ketoconazole
- Lansoprazole
- Lansoprazole; Naproxen
- Lapatinib
- Larotrectinib
- Lefamulin
- Lemborexant
- Lesinurad
- Lesinurad; Allopurinol
- Letermovir
- Leuprolide; Norethindrone
- Levonorgestrel
- Lidocaine
- Lidocaine; Prilocaine
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lorlatinib
- Losartan
- Lovastatin
- Lovastatin; Niacin
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lumateperone
- Lurasidone
- Lurbinectedin
- Maprotiline
- Maraviroc
- Medroxyprogesterone
- Mefloquine
- Meloxicam
- Mestranol; Norethindrone
- Metformin; Repaglinide
- Methadone
- Methylprednisolone
- Midazolam
- Midostaurin
- Mifepristone
- Mirtazapine
- Mitotane
- Modafinil
- Mometasone
- Naldemedine
- Naloxegol
- Nanoparticle Albumin-Bound Paclitaxel
- Nefazodone
- Nelfinavir
- Neratinib
- Netupitant, Fosnetupitant; Palonosetron
- Nevirapine
- Niacin; Simvastatin
- Nifedipine
- Nilotinib
- Nimodipine
- Nisoldipine
- Norethindrone
- Norgestrel
- Nortriptyline
- Olaparib
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole
- Omeprazole; Amoxicillin; Rifabutin
- Omeprazole; Sodium Bicarbonate
- Ondansetron
- Oral Contraceptives
- Osilodrostat
- Oxybutynin
- Oxycodone
- Paclitaxel
- Palbociclib
- Paricalcitol
- Pemigatinib
- Perampanel
- Perindopril; Amlodipine
- Perphenazine; Amitriptyline
- Pexidartinib
- Phenobarbital
- Phenytoin
- Pimavanserin
- Pimozide
- Polatuzumab Vedotin
- Prasugrel
- Pravastatin
- Prednisolone
- Prednisone
- Primidone
- Propafenone
- Quazepam
- Quetiapine
- Quinidine
- Quinine
- Rabeprazole
- Ramelteon
- Ranolazine
- Regorafenib
- Repaglinide
- Retapamulin
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rilpivirine
- Rimegepant
- Ripretinib
- Ritonavir
- Rivaroxaban
- Ropivacaine
- Ruxolitinib
- Saquinavir
- Segesterone Acetate; Ethinyl Estradiol
- Selegiline
- Selpercatinib
- Selumetinib
- Sertraline
- Sibutramine
- Sildenafil
- Silodosin
- Simeprevir
- Simvastatin
- Simvastatin; Sitagliptin
- Siponimod
- Sirolimus
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Solifenacin
- Sonidegib
- St. John’s Wort, Hypericum perforatum
- Sufentanil
- Sunitinib
- Suvorexant
- Tacrolimus
- Tadalafil
- Tamsulosin
- Tazemetostat
- Telaprevir
- Telithromycin
- Telotristat Ethyl
- Temsirolimus
- Teniposide
- Terbinafine
- Testosterone
- Tezacaftor; Ivacaftor
- Theophylline, Aminophylline
- Thiotepa
- Tiagabine
- Ticagrelor
- Tinidazole
- Tipranavir
- Tofacitinib
- Tolterodine
- Tolvaptan
- Toremifene
- Trabectedin
- Tramadol
- Trandolapril; Verapamil
- Trazodone
- Triamcinolone
- Triazolam
- Tucatinib
- Ubrogepant
- Ulipristal
- Umeclidinium; Vilanterol
- Upadacitinib
- Valbenazine
- Vardenafil
- Vemurafenib
- Venetoclax
- Venlafaxine
- Verapamil
- Vilazodone
- Vinblastine
- Vincristine
- Vincristine Liposomal
- Vinorelbine
- Voriconazole
- Voxelotor
- Warfarin
- Yohimbine
- Zaleplon
- Zanubrutinib
- Zileuton
- Ziprasidone
- Zolmitriptan
- Zolpidem
- Zonisamide
