Ibrutinib

Say it: eye-BROO-ti-nib · Brand names: Imbruvica

Ibrutinib is a targeted pill that blocks a protein some blood cancer cells need to grow and survive.

What it is

B cells are a type of white blood cell. In some blood cancers, B cells grow out of control. Ibrutinib blocks a protein called BTK (Bruton tyrosine kinase) that these cancer cells need to grow and survive. This slows or stops the cancer.

Often used for

• chronic lymphocytic leukemia (CLL)
• small lymphocytic lymphoma (SLL)
• Waldenstrom macroglobulinemia
• chronic graft versus host disease after a stem cell transplant

How you get it

Ibrutinib is a tablet, capsule or liquid you take by mouth once a day. Many people take it every day for as long as it keeps working. Your schedule may be different.

Common side effects and what helps

• Diarrhea. Drink plenty of fluids and tell your team if it does not get better.
• Bruising easily. Use a soft toothbrush and an electric razor.
• Muscle, bone or joint aches. Gentle stretching and warm baths may help.
• Rash. Use gentle soap and moisturizer, and tell your team about any new rash.
• Feeling tired. Rest and short walks can help.
• Low blood counts. Your team will check your blood.
• Higher blood pressure. Your team will check it at each visit.

Call your care team right away if you have

• Bleeding that will not stop, black or bloody stools, vomiting blood, or coughing up blood
• A severe headache, confusion, or trouble speaking, which can be signs of bleeding in the brain
• A fast, pounding or uneven heartbeat, dizziness, fainting, or chest discomfort
• Shortness of breath or swelling in the legs
• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills

Before you start, tell your team

• If you take blood thinners, aspirin or other medicines that raise bleeding risk
• If you are having surgery, dental work or another procedure, since you may need to pause this medicine for a few days. Your team will tell you when
• If you have heart rhythm problems, heart failure or high blood pressure
• If you have liver problems or an infection
• If you are pregnant, may become pregnant, or are breastfeeding
• All the medicines you take, including vitamins, herbs and supplements

Good to know

• Ibrutinib raises the risk of bleeding. Your team will tell you when to stop it before and after surgery.
• It can cause heart rhythm problems, including a rhythm called atrial fibrillation, and rarely heart failure or sudden death. Your team may check your heart.
• Serious infections can happen. Your team may give medicines to prevent some infections.
• You will have regular blood tests to check your blood counts.
• Skin cancers are more common. Use sunscreen, cover up in the sun, and have your skin checked.

At home

• Take it once a day with a glass of water at about the same time each day.
• Swallow tablets or capsules whole. Do not open, break or chew them.
• Avoid grapefruit, grapefruit juice and Seville oranges (often in marmalade), since they can raise the amount of medicine in your body.
• If you miss a dose, ask your care team what to do. Do not take two doses to make up for it.
• Store at room temperature, away from children and pets.

Questions to ask

• How long will I take this medicine?
• Should I stop it before surgery or dental work?
• Do I need heart tests?
• Which of my other medicines could interact with it?

Part of these treatment plans

• IBR

Side effect guides

• Fatigue (tiredness)
• Diarrhea
• Low platelets and bleeding
• Skin rash (including EGFR-inhibitor rash)

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.