Imbruvica's Side Effects: What to Know

Medically Reviewed By Amber R. Watson, PharmD

Imbruvica: Introduction

Imbruvica is a brand-name prescription drug. It’s a type of medication called a kinase inhibitor, and it contains the active drug ibrutinib. Imbruvica comes as a tablet and a capsule, and it’s taken by mouth.

This medication is approved by the Food and Drug Administration (FDA) to treat:

Imbruvica is a long-term treatment. If you’re using it to treat cancer, you’ll take it until it’s no longer effective or until you can’t tolerate its side effects. If you’re using it to treat cGVHD, you’ll stop taking it when your doctor recommends doing so.


Similar to other drugs, Imbruvica may cause side effects. Read below for information about possible side effects, including common, mild, and serious ones.

For a general overview of Imbruvica, including details about its uses, see this article.

If you’d like to take Imbruvica, search here to find a healthcare professional who might prescribe it.

Imbruvica: More common side effects

Some of Imbruvica’s side effects may be more common than others.

These side effects may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about any side effects with Imbruvica.

Some of the more common side effects of Imbruvica that occurred during clinical studies are listed below. These side effects can vary depending on the condition Imbruvica is being used to treat.

More common side effects of Imbruvica in people with certain types of blood cancer include:

More common side effects of Imbruvica in people with chronic graft-versus-host disease (cGVHD) include:

Imbruvica: Mild side effects

Imbruvica can cause mild side effects, which are listed below. However, this list doesn’t include all possible mild side effects. To learn more about Imbruvica’s side effects, view the drug’s prescribing information.

Imbruvica’s mild side effects include:

  • diarrhea
  • fatigue
  • muscle pain or spasms
  • skin side effects,* such as rash and bruising
  • mouth sores
  • nausea
  • eye-related side effects, such as blurry vision and dry eyes

The side effects listed above may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about side effects with Imbruvica.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Imbruvica and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Imbruvica: Side effects explained” below.

Imbruvica: Serious side effects

It’s possible to have serious side effects with Imbruvica. Serious side effects are listed below, but this list may not include all possibilities. To learn more about Imbruvica’s side effects, view the drug’s prescribing information.

Call your doctor right away if you have serious side effects with Imbruvica. However, if you think you’re having a medical emergency or life threatening side effects, call 911 or your local emergency number.

Serious side effects of Imbruvica and their possible symptoms include:

* For more information about this side effect, see “Imbruvica: Side effects explained” below.
† An allergic reaction is possible after taking Imbruvica. However, this side effect was not reported in clinical studies.

Imbruvica: Common questions about side effects

Here are some common questions about the drug’s side effects and answers to them. Talk with your doctor if you have other questions about this drug.

Does stopping Imbruvica cause side effects?

Yes, it may. After Imbruvica became available to the public, there were reports of side effects happening when Imbruvica was stopped. Typically, these side effects went away when the drug was started again.

Examples of these side effects include:

If your doctor recommends that you stop taking Imbruvica, tell them right away if you develop any side effects. They can suggest ways to manage the side effects.

Will I have eye-related side effects with Imbruvica?

It’s possible. In clinical studies, some people who took Imbruvica for certain types of blood cancer reported eye-related side effects.

Symptoms included:

If you develop eye-related side effects while taking Imbruvica, let your doctor know. They’ll advise you on how to manage your symptoms.

What’s to know about side effects of Imbruvica vs. side effects of Calquence?

Imbruvica and Calquence are both prescribed to treat certain types of blood cancer.

These medications contain different active drugs, but they have similar side effects. (The active drug in Imbruvica is ibrutinib, while the active drug in Calquence is acalabrutinib.)

See the sections directly above to learn about Imbruvica’s side effects. And view this article for an overview of Calquence’s side effects.

Common side effects of Calquence are similar to those of Imbruvica and may include:

Mild side effects of Calquence are similar to those of Imbruvica and may include:

  • nausea, vomiting, and diarrhea
  • joint pain or muscle pain
  • fatigue
  • headache
  • skin rash or bruising*
  • cold symptoms

Serious side effects of Calquence are similar to those of Imbruvica and may include:

* For more information about this side effect, see “Imbruvica: Side effects explained” below.

Is hair loss a side effect of Imbruvica?

No, in clinical studies, hair loss wasn’t reported as a side effect of Imbruvica. Some other cancer treatments, such as chemotherapy, may cause hair loss. However, this isn’t known to happen with Imbruvica.

If you have concerns about hair thinning or hair loss while taking Imbruvica, talk with your doctor. They may be able to recommend ways to help manage it.

Are there long-term side effects of Imbruvica?

Yes, possibly. While most of Imbruvica’s side effects last for only a short period, some may last longer. These include developing new cancer and having certain heart problems. For more information about these side effects, see “Imbruvica: Side effects explained” below.

If you have concerns about long-term side effects from Imbruvica, talk with your doctor. And let them know if you develop new side effects during or after treatment.

Imbruvica: Side effects explained

Here’s detailed information about some of Imbruvica’s side effects.

Skin side effects

In clinical studies, skin-related side effects were common in people taking Imbruvica. These side effects include rash and bruising. Itchy skin may also occur, but less commonly.

In most cases, skin side effects with Imbruvica are expected to be mild. However, in rare cases, more severe skin side effects may occur.

What to do

If you’re bruising more easily than usual while taking Imbruvica, tell your doctor. This may be a symptom of bleeding, which is a serious side effect of the drug.

If you notice swelling of your skin or a rash that’s painful and itchy, tell your doctor. They may recommend medication to help ease your symptoms. Keep in mind, though, skin rash can be a symptom of allergic reaction. (For more information about this, see the “Allergic reaction” section below.)

If you have a rash that indicates a possible allergic reaction, call your doctor. However, if your symptoms are severe or feel life threatening, call 911 or your local emergency number.

Cardiac side effects

It’s possible to have heart-related side effects with Imbruvica. During clinical studies, the drug caused cardiac side effects in some people.

These heart-related side effects included:

What to do

Tell your doctor if you have any heart or blood pressure problems before you take Imbruvica. They’ll likely check your heart function before prescribing this drug.

Also, tell your doctor if you have any heart-related side effects during treatment with Imbruvica. Your doctor may order certain tests, such as an echocardiogram, to check your heart function.

That said, if you have severe or concerning heart-related symptoms, call 911 or your local emergency number.

Bleeding

In clinical studies, mild bleeding was a common side effect of Imbruvica. This includes bleeding problems such as nosebleeds. However, in rare cases, Imbruvica can also cause more serious bleeding, such as bleeding in the digestive tract.

Symptoms can include:

  • feeling weak or dizzy
  • confusion
  • easily bruising
  • pink- or brown-colored urine
  • blood in the stool or stool that appears black
  • bleeding that won’t stop
  • vomiting blood or vomiting a coffee ground-like substance
  • severe headache that won’t go away
  • changes in speech

If you take any blood thinners or antiplatelet drugs with Imbruvica, your risk of serious bleeds may increase. Examples of blood thinners include warfarin (Jantoven), apixaban (Eliquis), and rivaroxaban (Xarelto). Aspirin, clopidogrel (Plavix), and ticagrelor (Brilinta) are examples of antiplatelet drugs.

What to do

Before starting treatment with Imbruvica, tell your doctor if you take any blood thinners or antiplatelet drugs. Your doctor can discuss your risk of bleeding and recommend whether it’s safe for you to take both medications together.

If you develop any of the symptoms listed above, tell your doctor immediately. However, if your symptoms are severe or feel life threatening, call 911 or your local emergency number.

Cancer

Although Imbruvica is used to treat certain types of blood cancer, it can also cause cancer. Specifically, the drug can cause skin cancer and cancer in other organs of the body.

Symptoms of skin cancer can include:

  • sores on the skin that are itchy, burning, or don’t heal like usual
  • moles that bleed or change in color or shape
  • areas of skin that are raised, rough, or have a different color

Symptoms of other types of cancer may vary depending on the type of cancer involved. They can include:

What to do

Tell your doctor if you develop any of the symptoms listed above. Your doctor can recommend if any tests are needed to evaluate your symptoms. If you have certain skin changes, your doctor may recommend that you see a dermatologist to check your skin.

Infections

Bacterial, fungal, and viral infections were common with Imbruvica in clinical studies. Examples of infections that were reported in studies include pneumonia, urinary tract infection (UTI), and sinus infection.

Symptoms of infections will vary depending on the infection involved, but they may include:

  • fever or chills
  • weakness
  • coughing up phlegm
  • chest pain
  • nausea, vomiting, or diarrhea

What to do

Tell your doctor if you develop a fever or any other symptoms of infection. Your doctor may recommend stopping Imbruvica or lowering your dosage until the infection gets better. They can advise the treatment plan that’s right for you. If you’re found to have an infection, your doctor will prescribe the treatment that’s best for your condition.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Imbruvica. A more severe allergic reaction is rare but possible.

Possible symptoms of mild and serious allergic reactions are listed in the table below.

Mild allergic reaction symptoms Serious allergic reaction symptoms
• itching trouble breathing
rash • swelling in your throat or mouth
flushing • swelling under your skin, possibly in your hands, feet, lips, or eyelids

If you have an allergic reaction to Imbruvica, call your doctor right away. This is important to do because  the reaction could become severe.

However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Imbruvica: Precautions

Be sure to talk with your doctor about your health history before you take Imbruvica. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health.

The conditions and factors to consider include those described below.

Bleeding problems. Imbruvica can cause bleeding. If you’ve had bleeding problems in the past, you may have an increased risk of this with Imbruvica. Before taking this drug, tell your doctor if you’ve had any bleeding problems.

Recent or planned surgery. Imbruvica can cause bleeding. If you’ve recently had surgery or are planning to do so, let your doctor know. They’ll likely recommend that you wait until after your procedure to start taking Imbruvica.

Allergic reaction. If you’ve had an allergic reaction to Imbruvica or any of its ingredients, your doctor will likely not prescribe Imbruvica. Ask your doctor what other medications may be better options for you.

Infections. Imbruvica can increase your risk of certain infections, such as pneumonia. Tell your doctor if you’ve recently been ill or received treatment for an infection. Your doctor will likely recommend that your infection be fully treated before you start Imbruvica treatment.

Liver problems. Before taking Imbruvica, tell your doctor if you have any problems with your liver. Your body processes and breaks down Imbruvica in your liver. If you have liver problems, your body may not be able to break down the drug like usual. And this could increase your risk of side effects. Your doctor may prescribe a lower dosage than usual to help reduce your risk of side effects with Imbruvica.

Certain health problems, including high blood pressure. Imbruvica can cause heart problems, including irregular heartbeat. Tell your doctor if you have diabetes, high blood pressure, heart rhythm problems, or any infections. These health problems can increase your risk of heart problems while taking Imbruvica. Your doctor may recommend monitoring your heart more closely than usual during treatment. Also, if you’re taking medication to treat high blood pressure, your doctor may increase your dosage or change the medication to keep your blood pressure managed.

Consuming alcohol during Imbruvica treatment

There are no known interactions between alcohol and Imbruvica. If you have questions about drinking alcohol during Imbruvica treatment, talk with your doctor.

Pregnancy and breastfeeding during Imbruvica treatment

Imbruvica is not safe to take while pregnant or breastfeeding.

This medication can harm a developing fetus. So your doctor may order a pregnancy test for you before prescribing Imbruvica.

Females* taking Imbruvica should use effective birth control during treatment with Imbruvica and for 1 month after their last dose. Males* taking the drug who have a partner that is able to become pregnant should do the same.

It’s not known if Imbruvica passes into breast milk. However, because this drug could potentially harm a breastfed child, you should not breastfeed while taking it. And you should continue to avoid breastfeeding for at least 1 week after your last dose.

* Sex and gender exist on spectrums. In this article, use of the terms “female” and “male” refers to sex assigned at birth.

Imbruvica: What to discuss with your doctor

Talk with your doctor or pharmacist to find out more about Imbruvica. If you have questions about the drug’s side effects, your pharmacist or healthcare professional can help answer them for you.

In addition to discussing Imbruvica with your doctor, you may find the following articles helpful in learning more.

  • Overview of Imbruvica. To read an overview of Imbruvica, see this article.
  • Drug comparison. To learn how Imbruvica compares with Venclexta, read this article.
  • Details about Imbruvica’s uses. To learn more about the conditions Imbruvica is approved to treat, see these articles about:

Disclaimer: Healthgrades 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 another 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.

Medical Reviewer: Amber R. Watson, PharmD
Last Review Date: 2022 Jun 7
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.