Nitib (Ibrutinib) 140 mg

Indicated for the treatment of:

• Chronic Lymphocytic Leukemia (CLL) / Small Lymphocytic Lymphoma (SLL).
• Mantle Cell Lymphoma (MCL): For patients who have received at least one prior therapy.
• Waldenström's Macroglobulinemia (WM).

Strength: 140 mg per capsule.

Daily Regimen (Once Daily):

• CLL & Waldenström's: 420 mg = Take 3 capsules daily.
• Mantle Cell Lymphoma: 560 mg = Take 4 capsules daily.

⚠️ Instructions: Swallow whole with water at the same time each day. Avoid Grapefruit and Seville oranges completely.

🚫 SURGERY WARNING (Bleeding Risk):

Ibrutinib increases the risk of bleeding. Therapy should be interrupted for 3 to 7 days prior to and after any surgery (including dental work), depending on the surgery type and bleeding risk.

Other Contraindications:

• Severe hepatic impairment.
• Pregnancy and breastfeeding.
• Concomitant use of Warfarin (increases hemorrhage risk).

Monitor for the following:

• Bleeding/Bruising: Very common. Report severe bleeding immediately.
• Diarrhea: Stay hydrated.
• Cardiac Arrhythmias: Atrial fibrillation (irregular heartbeat) may occur.
• Musculoskeletal pain and fatigue.