Zanubrutinib

Say it: ZAN-ue-BROO-ti-nib · Brand names: Brukinsa

Zanubrutinib 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. Zanubrutinib blocks a protein called BTK (Bruton tyrosine kinase) that these cancer cells need to grow and survive. It is designed to hit BTK more precisely than some older medicines like it.

Often used for

• chronic lymphocytic leukemia (CLL)
• small lymphocytic lymphoma (SLL)
• mantle cell lymphoma
• Waldenstrom macroglobulinemia
• marginal zone lymphoma
• follicular lymphoma (with another medicine)

How you get it

Zanubrutinib is a capsule or tablet you take by mouth, either once a day or twice 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

• Low blood counts. Your team will check your blood.
• Cold symptoms or infections. Wash your hands often and avoid people who are sick.
• Bruising easily. Use a soft toothbrush and an electric razor.
• Rash. Use gentle soap and moisturizer, and tell your team about any new rash.
• Muscle or joint aches. Gentle stretching and warm baths may help.
• Diarrhea. Drink plenty of fluids and tell your team if it does not get better.
• Cough. Tell your team if it is new or getting worse.

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
• A fast, pounding or uneven heartbeat, dizziness, fainting, or chest discomfort
• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Yellow skin or eyes, dark urine, or pain on the right side of your belly

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 or high blood pressure
• If you have liver problems or hepatitis B
• If you are pregnant, may become pregnant, or are breastfeeding
• All the medicines you take, including vitamins, herbs and supplements

Good to know

• Zanubrutinib raises the risk of bleeding. Your team will tell you when to stop it around surgery.
• Serious infections can happen. Your team may give medicines to prevent some infections.
• Heart rhythm problems, such as atrial fibrillation, can happen.
• It can rarely cause liver injury. You will have blood tests to check your liver and blood counts.
• Skin cancers are more common. Use sunscreen, cover up in the sun, and have your skin checked.

At home

• Take it with water at the same time or times each day, with or without food.
• Swallow the capsules or tablets whole. Do not open, break or chew them.
• 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

• Should I take it once or twice a day?
• How long will I take this medicine?
• Should I stop it before surgery or dental work?
• Which of my other medicines could interact with it?

Side effect guides

• Diarrhea
• Low white blood cells and infection risk
• Low platelets and bleeding
• Skin rash (including EGFR-inhibitor rash)
• Cough

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.