Classes
DEA Class; Rx
Common Brand Names; Zydelig
- Antineoplastics, PI3K Inhibitors
Description
Phosphatidylinositol 3-kinase inhibitor
Used in adults for the treatment of relapsed chronic lymphocytic leukemia in combination with rituximab and as a single-agent for the treatment of relapsed follicular lymphoma or small lymphocytic lymphoma following at least 2 prior therapies
Black box warning for fatal and/or serious cases of hepatotoxicity and severe diarrhea, colitis, infection, intestinal perforation, and pneumonitis
Indications
Indicated, in combination with rituximab, for relapsed chronic lymphocytic leukemia (CLL) in patients for whom rituximab alone would be considered appropriate therapy due to other comorbidities
Also indicated for
- Follicular B-cell Non-Hodgkin Lymphoma
- Small Lymphocytic Lymphoma
Contraindications
History of serious allergic reactions including anaphylaxis and history of toxic epidermal necrolysis
Adverse Effects
- Decreased ANC, Grade 3-4 (37%)
- Pyrexia (3-35%)
- Neutropenia, Grade 3 or 4 (31%)
- Nausea (27%)
- Pneumonia (16-23%)
- Chills (2-21%)
- Diarrhea, any grade (32%)
- Diarrhea or colitis, >Grade 3 (14-19%)
- Increased lymphocyte count, Grade 3-4 (18%)
- Rash (4-18%)
- Hepatotoxicity, fatal/serious (14%)
- Vomiting (13%)
- Hypoglycemia, any grade (11%)
- Pneumonia, Grade ≥3 (16%)
- Diarrhea, Grade ≥3 (14%)
- ANC decreased, Grade 3-4 (11-14%)
- ALT increased, Grade 3-4 (5-14%)
Warnings
Fatal and serious pneumonitis reported; evaluate patients with pulmonary symptoms (eg, cough, dyspnea, hypoxia, interstitial infiltrates on a radiologic examination, or oxygen saturation decline of >5%); if symptomatic pneumonitis or organizing pneumonia is diagnosed, initiate appropriate treatment with corticosteroids and permanently discontinue therapy
Pregnancy and Lactation
There are no available data in pregnant women to inform the drug-associated risk In animal reproduction studies, administration of idelalisib to pregnant rats during organogenesis resulted in decreased fetal weight and congenital malformations in rats at maternal exposures (AUC) 12 times those reported in patients at the recommended dose of 150 mg twice daily
No data are available regarding the presence of idelalisib or its metabolites in human milk or its effects on the breastfed child or on milk production
Maximum Dosage
150 mg PO twice daily.
150 mg PO twice daily.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Idelalisib
tablet
- 100mg
- 150mg