Care During Chemotherapy and Beyond



Trade Name: Brukinsa®

Zanubrutinib is the generic name for the trade name drug Brukinsa®. In some cases, health care professionals may use the trade name Brukinsa® when referring to the generic drug name zanubrutinib.

Drug Type: Zanubrutinib is a targeted therapy. This medication is classified as a Bruton’s tyrosine kinase inhibitor (for more detail, see "How Zanubrutinib Works" below).

What Zanubrutinib Is Used For

  • Mantle cell lymphoma (MCL) who have received at least one prior therapy

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 Zanubrutinib Is Given

  • Zanubrutinib is an 80 mg capsule. It is typically dosed as 2 capsules (160 mg) by mouth twice daily or 4 capsules (320 mg) by mouth once daily.
  • Capsules should be swallowed whole with at least 8 ounces of water. Do not open, break, dissolve, or chew the capsules.
  • Zanubrutinib may be taken with or without food.
  • Take zanubrutinib at approximately the same time each day.
  • Take zanubrutinib exactly as prescribed.
  • If you miss a dose, take it as soon as you remember it on the same day. Return to your normal schedule the next day. Do not take extra capsules of zanubrutinib to make up the next dose.

The amount of zanubrutinib that you will receive depends on many factors, including other medications you are taking, your general health or other health problems, and the type of cancer or condition you have. Your doctor will determine your exact dosage and schedule.

Side Effects

Important things to remember about the side effects of zanubrutinib:

  • Most people will not experience all of the side effects listed
  • Side effects are often predictable in terms of their onset, duration, and severity
  • Most side effects will improve after therapy is complete
  • There may be actions your treatment team can take to minimize or prevent side effects

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

These are less common side effects (occurring in 10-29%) for patients receiving zanubrutinib:

These are rare serious side effects for patients receiving zanubrutinib:

Not all side effects are listed above. Side effects that are rare -- occurring in less than about 10 percent of patients -- are not listed here. But 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 100.4º F (38º C) or higher, chills (possible signs of infection)
  • Shortness of breath or trouble breathing
  • Any bleeding that won't stop

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:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4-5 times in a 24-hour period)
  • Diarrhea (4-6 episodes in a 24-hour period)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools
  • Blood in the urine
  • Pain or burning with urination
  • Extreme fatigue (unable to carry on self-care activities)
  • Mouth sores (painful redness, swelling or ulcers)
  • Skin or the whites of your eyes turn yellow

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


  • Drug interactions may increase the side effects or impact of how zanubrutinib works. Before starting zanubrutinib 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 take aspirin, products containing aspirin unless your doctor specifically permits this.
  • Do not drink grapefruit juice, eat grapefruit or eat Seville oranges (often used in marmalades) while you are taking zanubrutinib. These products may increase the amount of zanubrutinib in your blood.
  • Do not receive any kind of immunization or vaccination without your doctor’s approval while taking zanubrutinib.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. This drug must not be given to a pregnant woman or a woman who intends to become pregnant. If you become pregnant while taking zanubrutinib, stop taking the medication immediately and call your doctor for further instructions.
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking zanubrutinib. Barrier methods of contraception, such as condoms, are recommended for at least 1 week after the last dose of zanubrutinib.
  • Do not breast feed while taking and for 2 weeks after your last dose of zanubrutinib.

Self-Care Tips

  • Drink at least two to three quarts (64-96 fl oz) of fluid every 24 hours, unless you are instructed otherwise.
  • 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 health care provider.
  • Wash your hands often.
  • To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1 teaspoon of baking soda mixed with 8 ounces of water.
  • Use an electric razor and a soft toothbrush to minimize bleeding.
  • Avoid contact sports or activities that could cause injury.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • Follow regimen of anti-diarrhea medication as prescribed by your health care professional.
  • Eat foods that may help reduce diarrhea (see managing side effects - diarrhea).
  • Avoid sun exposure. Wear SPF 30 (or higher) sunblock 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.
  • Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
  • 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 While Taking Zanubrutinib

You will be checked regularly by your doctor while you are taking zanubrutinib, to monitor side effects and check your response to therapy. Periodic blood work will be obtained to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor. Your doctor may check your heart rhythm periodically.

How Zanubrutinib Works

Cancer is a disease caused by changes, also known as mutations, in DNA that change the way cells grow and divide. Cancer cells can be destroyed using many different types of medications that work in very different ways. Examples of medications that destroy cancer cells include cytotoxic chemotherapy, targeted therapy, immunotherapy, and antibody-drug conjugates.

Zanubrutinib is a "targeted therapy." Targeted therapy is the result of years of research dedicated to understanding the difference between cancer cells and normal cells. To date, cancer treatment has focused primarily on killing rapidly dividing cells because on 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 the 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. Many targeted therapies are small molecule drugs. These drugs are small enough to enter the cell and affect other molecules such as proteins or DNA. 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.

Zanubrutinib is a small-molecule inhibitor of Bruton’s tyrosine kinase (BTK). BTK is a protein inside of cells that may be overexpressed in certain types of cancer. It is involved in a signaling pathway that increases B-cell replication and activity. By inhibiting this signaling pathway, zanubrutinib decreases the growth and survival of the malignant B-cells that are involved in mantle cell lymphoma.

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. is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit