Imbruvica (ibrutinib) can cause side effects that range from mild to serious. More common side effects include diarrhea and fatigue. If you have side effects from Imbruvica that are bothersome or don’t go away, talk with your doctor about tips for managing them.
Imbruvica is used in certain situations to treat the following conditions:
- chronic lymphocytic leukemia or small lymphocytic lymphoma in adults
- Waldenstrom macroglobulinemia in adults
- chronic (long-lasting) graft-versus-host disease in adults and in children ages 12 months and older
The active ingredient in Imbruvica is ibrutinib. The drug comes in three oral forms: capsules, tablets, and a liquid suspension (a type of liquid mixture).
Some people may experience mild or serious side effects during their Imbruvica treatment. The following lists include a few of the more common side effects reported by people who took Imbruvica in studies. These side effects can vary depending on the condition the drug is being used to treat.
More common side effects in people taking Imbruvica for cancer include:
- neutropenia (low levels of white blood cells called neutrophils)
- diarrhea
- thrombocytopenia (low levels of blood cells called platelets)
More common side effects in people taking Imbruvica for chronic (long-lasting) graft versus host disease include:
For more information about some of these side effects, see the “Tips for managing side effects” section.
Imbruvica can cause mild side effects. These side effects can vary depending on the condition the drug is being used to treat.
Examples of mild side effects that have been reported with Imbruvica when used to treat cancer include:
- bruising
- diarrhea
- fatigue
- muscle pain or joint pain
- skin rash
Examples of mild side effects that have been reported with Imbruvica when used to treat chronic (long-lasting) graft-versus-host disease include:
- bruising
- diarrhea
- fatigue
- mouth sores
- muscle spasms
- nausea
In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And do not stop using Imbruvica unless your doctor recommends it.
For more information about some of these side effects, see the “Tips for managing side effects” section. Imbruvica may cause mild side effects other than the ones listed above. See the Imbruvica prescribing information for details.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Imbruvica and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.
In rare cases, serious side effects can occur with Imbruvica. These side effects are expected to be the same regardless of the condition being treated.
Serious side effects that have been reported with Imbruvica include:
- anemia (low levels of red blood cells)
- bleeding
- heart problems, such as an abnormal heart rhythm
- high blood pressure
- neutropenia
- other forms of cancer, including skin cancer
- tumor lysis syndrome (when cancer cells release their contents into the blood after being broken down in the body)
- thrombocytopenia
- infections
If you develop serious side effects while taking Imbruvica, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Allergic reactionFor some people, Imbruvica can cause an allergic reaction. But this side effect wasn’t reported in the drug’s studies.
In general, symptoms of an allergic reaction can be mild or serious.
What might helpIf you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue Imbruvica treatment.
If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to Imbruvica, they may have you switch to a different treatment.
Get answers to some frequently asked questions about Imbruvica’s side effects.
Could Imbruvica cause any eye-related side effects?
Yes, Imbruvica can cause eye-related side effects (also called ocular side effects). In studies, eye side effects were more common in people taking Imbruvica for cancer.
Examples of eye side effects that have been reported with Imbruvica include:
- blurry vision
- conjunctivitis (pink eye)
- dry eye
- reduced clarity or sharpness of vision
- watery eyes
If you’re concerned about eye-related side effects from Imbruvica, talk with your doctor. They can discuss your risks for these side effects. They can also suggest ways to manage them if they happen.
Does Imbruvica have any long-term side effects?
Most of Imbruvica’s side effects are short term. Side effects usually go away either shortly after your body gets used to Imbruvica or after you stop taking the drug.
But some of Imbruvica’s side effects might last longer. For example, heart problems, such as an abnormal heart rhythm, could cause long-term heart damage. Or you may develop other forms of cancer, including skin cancer, that can require long-term treatment.
If you’re concerned about long-term side effects of Imbruvica, talk with your doctor.
Will stopping my Imbruvica treatment cause any side effects?
It’s possible. Side effects after stopping Imbruvica weren’t reported during studies of the drug.
But since Imbruvica was released onto the market, there have been reports of withdrawal side effects in people who stopped taking the drug. Withdrawal side effects can occur when you stop taking a drug that your body has become dependent on. With dependence, your body needs the drug to function like usual.
Possible symptoms of withdrawal from Imbruvica include:
- body aches
- chills
- fever
- headache
- joint pain
- night sweats
If you’re concerned about having side effects after stopping Imbruvica, talk with your doctor.
Are there specific side effects for the 420-mg strength of Imbruvica?
Imbruvica comes in several strengths that vary by form. The highest available strength is the 420-mg tablet.
With most drugs, higher doses increase the risk of side effects, but it’s not known if this is true for Imbruvica. Studies of Imbruvica didn’t compare differences in side effects based on the strength or form of the drug.
The following table shows the different forms of Imbruvica and the available strengths of each.
| Form | Strengths |
| tablets | 140 milligrams (mg), 280 mg, and 420 mg |
| capsules | 70 mg and 140 mg |
| liquid suspension | 70 mg per milliliter (mg/mL) |
If you have questions about your risk for side effects from Imbruvica based on the form or strength you use, talk with your doctor.
Learn more about some of the side effects Imbruvica may cause.
Thrombocytopenia
Thrombocytopenia is a common side effect of Imbruvica. Platelets are a type of blood cell that help your blood clot.
Low platelet levels can lead to bruising and bleeding problems, such as having a bloody nose, gums, or urine.
What might help
Your doctor will likely check your platelet level regularly during treatment to watch for this side effect. But if you notice any unusual bruising or bleeding while taking Imbruvica, tell your doctor right away.
If you have a severely low platelet count, you may need to have a blood transfusion. Your doctor will recommend the best treatment for you based on your platelet count.
Infections
Mild infections are a common side effect of Imbruvica. In rare cases, taking Imbruvica may also lead to serious infections.
Possible mild infections that have been reported with Imbruvica include:
- pneumonia
- skin infection
- upper respiratory infection, such as the common cold
- urinary tract infection (UTI), which can occur in your bladder, kidneys, ureters, or urethra (tube that helps move urine out of the bladder)
Examples of serious infections that may occur from using Imbruvica include:
- progressive multifocal leukoencephalopathy (a virus that attacks the protective layer around your nerve cells)
- pneumocystis jirovecii pneumonia (a lung infection caused by a fungus)
Symptoms of mild and serious infections can vary depending on the specific infection you have. But common symptoms of infection are:
- chills
- confusion
- fatigue
- fever
What might help
Tell your doctor right away if you have any symptoms of infection while taking Imbruvica. You’ll likely be prescribed medications to help treat the infection. And your doctor may monitor you closely to make sure the infection improves with treatment.
In addition, your doctor may prescribe certain medications to reduce the risk of infections associated with Imbruvica treatment.
Diarrhea
Diarrhea is a common side effect of Imbruvica. It can cause your body to lose too much water and electrolytes, which can lead to dehydration.
What might help
The following tips can help you manage diarrhea from Imbruvica:
- Avoid greasy or spicy foods. Instead, eat bland foods that won’t upset your stomach. An example is the BRAT diet, which consists of bananas, rice, applesauce, and toast.
- Stay hydrated by drinking water or sports drinks that have electrolytes, such as Gatorade.
- If your doctor or pharmacist says it’s safe, you can also take certain over-the-counter drugs to relieve diarrhea. These include bismuth subsalicylate (Pepto-Bismol) and loperamide (Imodium).
If you have diarrhea while taking Imbruvica, talk with your doctor. And tell them right away about any diarrhea you have that doesn’t go away after about a week.
Imbruvica may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Imbruvica. The following list includes factors to consider.
Heart problems or risk for heart disease: Taking Imbruvica can lead to heart problems, such as an abnormal heart rhythm. Before starting the drug, tell your doctor if you have heart problems or are at risk for heart disease. Conditions that may raise your risk for heart disease include diabetes, high cholesterol, and high blood pressure. If you have any of these conditions, your doctor will likely monitor you closely for other heart problems during your Imbruvica treatment.
Bleeding problems: Before starting your Imbruvica treatment, tell your doctor about any bleeding problems you may have. Imbruvica can cause bleeding. Using the drug if you already have bleeding problems can raise your risk for this side effect even more.
Liver problems: If you have liver problems, your body may not be able to break down Imbruvica properly. This can cause increased levels of the drug in your body, which can raise your risk for side effects. Before taking Imbruvica, talk with your doctor about any liver problems you have.
Allergic reaction: If you’ve had an allergic reaction to Imbruvica or any of its ingredients, you should not take Imbruvica. Ask your doctor what other medications are better options for you.
Recent or upcoming surgeries: Before starting Imbruvica treatment, tell your doctor if you’ve recently had or plan to have any type of surgery or dental procedure. Imbruvica can raise your risk for bleeding. So your doctor may need to temporarily stop your Imbruvica treatment to help prevent serious bleeding during surgery. But do not stop taking Imbruvica unless your doctor says it’s safe to do so.
Infection: Before starting Imbruvica treatment, tell your doctor if you have any current infections. Imbruvica can raise your risk for mild and serious infections, such as skin infection and pneumonia. If you have a current infection, your doctor will likely treat the infection before you start your Imbruvica treatment.
Alcohol and Imbruvica
It should be safe to drink alcohol during your Imbruvica treatment.
If you drink alcohol, talk with your doctor about the amount that’s safe for you to drink while taking Imbruvica.
Pregnancy and breastfeeding while taking Imbruvica
You should not use Imbruvica during pregnancy or while breastfeeding.
Imbruvica hasn’t been studied in pregnancy, but it’s thought to cause fetal harm based on animal studies. Because of this risk, your doctor will give you a pregnancy test before starting Imbruvica treatment to make sure you are not pregnant.
If you can become pregnant, you should use effective birth control while taking Imbruvica and for at least 1 month after your last dose.
If you are a male with a partner who can become pregnant, you should also use effective birth control while taking Imbruvica and for at least 1 month after your last dose. (Note: In this article, we use the term “male” to refer to someone’s sex assigned at birth. To learn more about this topic, see this article comparing sex and gender.)
It’s not known if Imbruvica can pass into breast milk. To be safe, you should not breastfeed while using Imbruvica and for at least 1 week after your last dose.
Before starting Imbruvica treatment, tell your doctor if you’re pregnant, breastfeeding, or planning to become pregnant or to breastfeed.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.