What is Venetoclax
Venetoclax is a B-cell lymphoma-2 (BCL-2) protein inhibitor that has demonstrated cytotoxic activity in tumor cells that overexpress BCL-2. It is indicated as a single agent or in combination with obinutuzumab or rituximab for the treatment of chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).
Venetoclax has demonstrated efficacy in CLL or SLL with or without 17p deletion.
Venetoclax is also indicated in combination with azacitidine, decitabine, or low-dose cytarabine for the treatment of newly-diagnosed acute myelogenous leukemia in adults who are age 75 years or older or who have comorbidities that make them ineligible for intensive induction chemotherapy.
Due to a risk of tumor lysis syndrome, the venetoclax dose is increased using a ramp-up dosing schedule; prophylactic hydration and antihyperuricemic agents are recommended starting prior to the first dose.
Brand Name
Venclexta
Indications
- acute myelogenous leukemia (AML)
- chronic lymphocytic leukemia (CLL)
- small lymphocytic lymphoma (SLL)
Side Effects
- abdominal pain
- anemia
- anorexia
- arthralgia
- back pain
- bleeding
- constipation
- cough
- diarrhea
- dizziness
- dyspnea
- edema
- elevated hepatic enzymes
- fatigue
- fever
- headache
- hemolytic anemia
- hyperbilirubinemia
- hypercalcemia
- hyperglycemia
- hyperkalemia
- hyperphosphatemia
- hypertension
- hyperuricemia
- hypoalbuminemia
- hypocalcemia
- hypoglycemia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hypophosphatemia
- hypotension
- hypoxia
- infection
- leukopenia
- lymphopenia
- metabolic acidosis
- musculoskeletal pain
- myalgia
- nausea
- nephrotoxicity
- neutropenia
- oral ulceration
- peripheral edema
- rash
- renal failure (unspecified)
- thrombocytopenia
- tumor lysis syndrome (TLS)
- vomiting
Monitoring Parameters
- CBC with differential
- pregnancy testing
- serum creatinine/BUN
- serum electrolytes
- serum uric acid
Contraindications
- anemia
- breast-feeding
- contraception requirements
- electrolyte imbalance
- hepatic disease
- infection
- infertility
- multiple myeloma
- neutropenia
- pregnancy
- pregnancy testing
- renal disease
- renal failure
- renal impairment
- reproductive risk
- thrombocytopenia
- treatment outside of a clinical trial
- tumor lysis syndrome (TLS)
- vaccination
Interactions
- Afatinib
- Amiodarone
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Apalutamide
- Aprepitant, Fosaprepitant
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Betrixaban
- Bexarotene
- Boceprevir
- Bosentan
- Brigatinib
- Cabozantinib
- Capmatinib
- Carbamazepine
- Carvedilol
- Cenobamate
- Ceritinib
- Chloramphenicol
- Ciprofloxacin
- Clarithromycin
- Cobicistat
- Colchicine
- Colchicine; Probenecid
- Conivaptan
- Crizotinib
- Cyclosporine
- Dabrafenib
- Daclatasvir
- Danazol
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Dexamethasone
- Dextromethorphan; Quinidine
- Digoxin
- Diltiazem
- Dronedarone
- Duvelisib
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Encorafenib
- Enzalutamide
- Erythromycin
- Erythromycin; Sulfisoxazole
- Eslicarbazepine
- Etravirine
- Everolimus
- Fedratinib
- Flibanserin
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluvoxamine
- Fosamprenavir
- Fosphenytoin
- Fostamatinib
- Glecaprevir; Pibrentasvir
- grapefruit juice
- Idelalisib
- Imatinib
- Indinavir
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Istradefylline
- Itraconazole
- Ivacaftor
- Ketoconazole
- Lapatinib
- Ledipasvir; Sofosbuvir
- Lefamulin
- Letermovir
- Live Vaccines
- Lomitapide
- Lopinavir; Ritonavir
- Lorlatinib
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Mefloquine
- Mifepristone
- Mitotane
- Modafinil
- Nafcillin
- Nefazodone
- Nelfinavir
- Neratinib
- Netupitant, Fosnetupitant; Palonosetron
- Nevirapine
- Nilotinib
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Osimertinib
- Palifermin
- Penicillamine
- Phenobarbital
- Phenytoin
- Ponatinib
- Posaconazole
- Primidone
- Propafenone
- Quinidine
- Quinine
- Ranolazine
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Rimegepant
- Ritonavir
- Rolapitant
- Sapropterin
- Saquinavir
- Sarecycline
- Simeprevir
- Sirolimus
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Sorafenib
- St. John’s Wort, Hypericum perforatum
- Talazoparib
- Telaprevir
- Telithromycin
- Temsirolimus
- Tezacaftor; Ivacaftor
- Ticagrelor
- Tipranavir
- Tolvaptan
- Topotecan
- Trandolapril; Verapamil
- Tuberculin Purified Protein Derivative, PPD
- Tucatinib
- Ubrogepant
- Vemurafenib
- Verapamil
- Voriconazole
- Warfarin
- Zonisamide
