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Care During Chemotherapy and Beyond

Idelalisib

Generic name: Zydelig®

Chemocare.com uses generic names in all descriptions of drugs. Idelalisib is the generic name for the trade chemotherapy drug Zydelig®. In some cases, health care professionals may use the trade name Zydelig® when referring to the generic drug idelalisib.

Drug type: Idelalisib is a targeted therapy. It is an oral Phosphatidylinositol 3-kinase inhibitor - (For more detail, see "How this drug works," below).

What Idelalisib Is Used For:

Chronic lymphocytic leukemia: Treatment of relapsed chronic lymphocytic leukemia (CLL) (in combination with rituximab) when rituximab alone is appropriate therapy due to other comorbidities.

Follicular B-cell non-Hodgkin lymphoma: Treatment of relapsed follicular B-cell non-Hodgkin lymphoma after at least 2 prior systemic therapies.

Small lymphocytic lymphoma: Treatment of relapsed small lymphocytic lymphoma (SLL) after at least 2 prior systemic therapies.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Idelalisib Is Given:

  • Idelalisib is a tablet, taken by mouth: the recommended maximum starting dose is 150mg administered orally twice daily. It can be taken with or without food.
  • Dosage may be adjusted based on side effects.
  • Take idelalisib exactly as prescribed.
  • Swallow idelalisib tablets whole. Do not crush or dissolve tablets.
  • Do not change your dose or stop idelalisib. If you miss a dose of idelalisib by less than 6 hours, take the missed dose right away. Then take your next dose as usual. If you miss a dose of idelalisib by more than 6 hours, wait and take the next dose of idelalisib at your usual time.
  • Do not take more than 1 dose of idelalisib at one time. Call your health care provider right away if you take too much.
  • The amount of idelalisib that you will receive depends on many factors, your general health or other health problems, and the type of cancer or condition being treated.

Side Effects:

Important things to remember about the side effects of idelalisib:

  • Most people do not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset and duration.
  • Side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

Side effects in patients with CLL taking idelalisib monotherapy:

The following side effects are common (occurring in greater than 30%) for patients taking idelalisib & Rituxin:

These side effects are less common side effects (occurring in about 10-29%) of patients receiving idelalisib & Rituxin:

Side effects in patients with indolent non-Hodgkin lymphoma taking only idelalisib

The following side effects are common (occurring in greater than 30%) for patients taking idelalisib monotherapy:

These side effects are less common side effects (occurring in about 10-29%) of patients receiving idelalisib monotherapy:

Some more uncommon, but very serious side effects of idelalisib are:

Liver problems . Your provider will do blood tests before and during your treatment with idelalisib to check for liver problems. Contact your provider right away if you get any of the following symptoms of liver problems:

  • Yellowing of your skin or the white part of your eye (jaundice)
  • Dark or brown urine
  • Pain in the upper right side of your stomach area
  • Bleeding or bruising more easily than normal

Severe diarrhea or colitis. Diarrhea is common with idelalisib and can sometimes be severe. Tell your provider right away if the number of bowel movements you have in a day increases up to 4-6 or more.

Lung or breathing problems (pneumonitis). Tell your provider right away if you develop a new or worsening cough, shortness of breath, difficulty breathing or wheezing.

Tear in the intestinal wall (perforation). Tell your provider and seek help right away if you develop new or worsening stomach pain, chills, fever, nausea, or vomiting.

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4° F (38° or higher, chills)
  • Sudden onset of shortness of breath, cough, shortness of breath, difficulty breathing or wheezing
  • New or worsening stomach pain, chills, fever, nausea, or vomiting

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Diarrhea (4-6 episodes in a 24-hour period)
  • Nausea (interferes with ability to eat and unrelieved with prescribed medication).
  • Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness
  • Skin or the whites of your eyes turn yellow
  • Itchy skin
  • Urine turns dark or brown (tea color)
  • Decreased appetite
  • Signs of an infection (cough with or without mucus, nasal drainage, burning with urination, redness or swelling, pus formation at the site of an injury or incision)
  • Fatigue that interfere with activities of daily living (showering, bathing, making meals, etc.)
  • Painful sores or ulcers on your skin, lips or in your mouth
  • Rash, blisters, or peeling skin

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

  • Before starting idelalisib treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking idelalisib.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (idelalisib may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
  • For both men and women: Do not conceive a child (get pregnant) while taking idelalisib. Barrier methods of contraception, such as condoms, are recommended during treatment and for at least 1 month after completing therapy. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking this medication.

Self-Care Tips:

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • If you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may also help.
  • Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your healthcare provider.
  • Wash your hands often. Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Ask your doctor or nurse before scheduling dental appointments or procedures.
  • Use an electric razor to minimize bleeding.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

You will be checked regularly by your health care professional while you are taking idelalisib to monitor side effects and check your response to therapy.

How Idelalisib Works:

Targeted therapy is the result of about 100 years of research dedicated to understanding the differences between cancer cells and normal cells. To date, cancer treatment has focused primarily on killing rapidly dividing cells because one feature of cancer cells is that they divide rapidly. Unfortunately, some of our normal cells divide rapidly too, causing multiple side effects.

Targeted therapy is about identifying other features of cancer cells. Scientists look for specific differences in the cancer cells and the normal cells. This information is used to create a targeted therapy to attack the cancer cells without damaging the normal cells, thus leading to fewer side effects. Each type of targeted therapy works a little bit differently but all interfere with the ability of the cancer cell to grow, divide, repair and/or communicate with other cells.

There are different types of targeted therapies, defined in three broad categories. Some targeted therapies focus on the internal components and function of the cancer cell. The targeted therapies use small molecules that can get into the cell and disrupt the function of the cells, causing them to die. There are several types of targeted therapy that focus on the inner parts of the cells. Other targeted therapies target receptors that are on the outside of the cell. Therapies that target receptors are also known as monoclonal antibodies. Antiangiogenesis inhibitors target the blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.

Idelalisib is a targeted therapy. Idelalisib is an oral inhibitor of phosphoinositide 3-kinase (PI3K) delta, a protein that plays a role in the activation, proliferation and viability of B cells, a critical component of the immune system. PI3K delta signaling is active in many B-cell leukemias and lymphomas, and by inhibiting the protein, idelalisib blocks several cellular signaling pathways that drive B-cell viability. By binding to these receptors idelalisib blocks an important pathway that promotes cell division.

Research continues to identify which cancers may be best treated with targeted therapies and to identify additional targets for more types of cancer.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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