What is Acalabrutinib: Uses, Dosage, Side Effects and More

Acalabrutinib is a targeted cancer medication that helps treat certain types of blood cancers by blocking specific proteins that cancer cells need to grow and survive. This oral medication belongs to a class of drugs called BTK inhibitors, which work like a key that fits into a specific lock on cancer cells, stopping them from multiplying.

If you or someone you care about has been prescribed acalabrutinib, you're likely feeling a mix of hope and concern. That's completely natural. Understanding how this medication works and what to expect can help you feel more confident about your treatment journey.

What is Acalabrutinib?

Acalabrutinib is a precision cancer drug that targets a specific protein called Bruton's tyrosine kinase (BTK). Think of BTK as a switch that tells certain cancer cells to grow and spread. Acalabrutinib works by turning off this switch, which helps slow down or stop the cancer from getting worse.

This medication is what doctors call a "targeted therapy" because it focuses on specific parts of cancer cells rather than affecting all rapidly dividing cells in your body. This targeted approach often means fewer side effects compared to traditional chemotherapy, though every person's experience is unique.

The drug comes as capsules that you take by mouth, making it convenient for at-home treatment. Your healthcare team will monitor you closely while you're taking acalabrutinib to ensure it's working effectively and to manage any side effects that might occur.

What is Acalabrutinib Used For?

Acalabrutinib is primarily used to treat specific types of blood cancers, particularly chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). These conditions involve white blood cells that don't function properly and can crowd out healthy blood cells.

Your doctor might prescribe acalabrutinib if you have CLL or SLL that has returned after other treatments or if you're newly diagnosed and other treatments aren't suitable for you. It's also used for mantle cell lymphoma, another type of blood cancer that affects lymph nodes and other organs.

The medication works best for cancers that have certain genetic characteristics. Your healthcare team will run specific tests on your cancer cells to determine if acalabrutinib is likely to be effective for your particular situation.

How Does Acalabrutinib Work?

Acalabrutinib works by blocking the BTK protein, which is like a communication hub that cancer cells use to receive growth signals. When this protein is blocked, the cancer cells can't get the messages they need to survive and multiply.

This medication is considered a moderately strong targeted therapy. While it's powerful enough to effectively treat blood cancers, it's generally gentler on your body than traditional chemotherapy because it specifically targets cancer cells rather than all fast-growing cells.

The drug builds up in your system over time, so you'll need to take it consistently every day for it to work effectively. Most people start seeing results within a few weeks to months, though your doctor will monitor your progress through regular blood tests and check-ups.

How Should I Take Acalabrutinib?

Take acalabrutinib exactly as your doctor prescribes, typically twice daily about 12 hours apart. You can take it with or without food, but try to take it at the same times each day to help maintain steady levels in your body.

Swallow the capsules whole with water. Don't open, break, or chew them, as this can affect how the medication is absorbed. If you have trouble swallowing capsules, talk to your healthcare team about alternatives rather than trying to modify the capsules yourself.

It's important to avoid grapefruit and grapefruit juice while taking acalabrutinib, as they can increase the amount of medication in your blood to potentially dangerous levels. Your doctor will provide a complete list of foods and medications to avoid.

How Long Should I Take Acalabrutinib For?

You'll likely take acalabrutinib for as long as it continues to work effectively and you're tolerating it well. For most people with blood cancers, this means taking it indefinitely, as stopping the medication could allow the cancer to start growing again.

Your healthcare team will regularly monitor your response to treatment through blood tests, imaging scans, and physical exams. These check-ups help determine if the medication is still working and if any adjustments need to be made to your treatment plan.

Some people may need to take breaks from acalabrutinib if they experience significant side effects. Your doctor will work with you to find the right balance between controlling your cancer and maintaining your quality of life.

What Are the Side Effects of Acalabrutinib?

Like all medications, acalabrutinib can cause side effects, though not everyone experiences them. Most side effects are manageable with proper care and monitoring from your healthcare team.

The most common side effects you might experience include headaches, diarrhea, muscle and joint pain, and fatigue. These effects often improve as your body adjusts to the medication, usually within the first few weeks of treatment.

Here are the more common side effects that patients report:

• Headaches that may feel like tension headaches
• Diarrhea that can usually be managed with dietary changes
• Muscle aches and joint pain, similar to flu-like symptoms
• Fatigue that may come and go throughout the day
• Bruising more easily than usual
• Minor bleeding, such as nosebleeds or bleeding gums
• Upper respiratory infections like cold symptoms

Most of these side effects are mild to moderate and can be managed with supportive care. Your healthcare team will provide specific strategies for dealing with each one.

Some less common but more serious side effects require immediate medical attention. While these occur in a smaller percentage of patients, it's important to know what to watch for.

Contact your healthcare provider right away if you experience:

• Unusual bleeding that doesn't stop easily
• Signs of infection like fever, chills, or persistent cough
• Severe diarrhea that leads to dehydration
• Irregular heartbeat or chest pain
• Severe skin reactions or rash
• Yellowing of skin or eyes

These symptoms are manageable when caught early, so don't hesitate to reach out to your care team if you're concerned about any changes in how you feel.

Rarely, acalabrutinib can cause more serious complications that affect a very small percentage of patients. Your doctor will monitor you closely for these possibilities through regular testing and check-ups.

Who Should Not Take Acalabrutinib?

Acalabrutinib isn't suitable for everyone, and your doctor will carefully evaluate whether it's right for you based on your overall health and medical history. People with certain conditions may need alternative treatments or special monitoring.

You should not take acalabrutinib if you're allergic to it or any of its ingredients. Your healthcare team will review all your known allergies before prescribing this medication to ensure it's safe for you.

Your doctor will be extra cautious about prescribing acalabrutinib if you have:

• A history of bleeding disorders or are taking blood-thinning medications
• Active infections or a weakened immune system
• Heart rhythm problems or other heart conditions
• Liver problems or elevated liver enzymes
• A history of skin cancer or other secondary cancers

These conditions don't automatically disqualify you from taking acalabrutinib, but they may require additional monitoring or dosage adjustments to ensure your safety.

If you're pregnant, planning to become pregnant, or breastfeeding, acalabrutinib is not recommended as it could harm your baby. Your healthcare team will discuss effective birth control methods if you're of childbearing age.

Acalabrutinib Brand Names

Acalabrutinib is sold under the brand name Calquence. This is the only brand name currently available for this medication, as it's a relatively new targeted therapy that was developed by AstraZeneca.

You might see both names used interchangeably in your medical records or prescription bottles. Whether your doctor refers to it as acalabrutinib or Calquence, they're talking about the same medication.

Generic versions of acalabrutinib are not yet available, so Calquence is currently the only option for obtaining this medication. Your insurance coverage and pharmacy benefits will determine your out-of-pocket costs for this brand-name medication.

Acalabrutinib Alternatives

If acalabrutinib isn't right for you or stops working effectively, several other treatment options are available for blood cancers. Your healthcare team will help you explore these alternatives based on your specific situation and medical history.

Other BTK inhibitors like ibrutinib (Imbruvica) and zanubrutinib (Brukinsa) work similarly to acalabrutinib but may have different side effect profiles. Some people tolerate one BTK inhibitor better than another, so switching between them is sometimes helpful.

Additional treatment options might include:

• Other targeted therapies like venetoclax (Venclexta)
• Monoclonal antibodies such as rituximab or obinutuzumab
• Traditional chemotherapy combinations
• Immunotherapy treatments
• Clinical trials testing new medications

Your doctor will consider factors like your cancer's specific characteristics, your overall health, previous treatments, and personal preferences when recommending alternatives. The goal is always to find the most effective treatment with the fewest side effects for your unique situation.

Is Acalabrutinib Better Than Ibrutinib?

Acalabrutinib and ibrutinib are both BTK inhibitors that work in similar ways, but they have some important differences that might make one more suitable for you than the other. Neither is universally "better" – the best choice depends on your individual circumstances.

Acalabrutinib is often considered to have fewer heart-related side effects compared to ibrutinib. Studies suggest that people taking acalabrutinib may experience less irregular heartbeat and high blood pressure, which can be important if you have existing heart conditions.

Both medications are similarly effective at treating blood cancers, but acalabrutinib may cause less diarrhea and joint pain in some people. However, individual responses vary, and what works best for one person may not be ideal for another.

Your doctor will help you weigh the potential benefits and risks of each option based on your medical history, current health status, and the specific characteristics of your cancer. The decision often comes down to which medication is most likely to give you the best quality of life while effectively treating your condition.