Venetoxen medicine pack picture[/caption]Venetoclax is an oral BCL-2 inhibitor primarily used to treat chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and certain forms of acute myeloid leukemia (AML). Dosage and administration vary depending on the condition being treated, as well as patient factors like age, comorbidities, and prior treatments. The following is a general guideline; however, treatment should always be personalized and managed by a healthcare professional.
1. Starting Dose and Ramp-Up Phase:
- For CLL/SLL: Venetoclax dosing typically begins with a gradual ramp-up over five weeks to minimize the risk of tumor lysis syndrome (TLS), a potentially serious side effect caused by rapid cancer cell breakdown.
- Week 1: 20 mg once daily
- Week 2: 50 mg once daily
- Week 3: 100 mg once daily
- Week 4: 200 mg once daily
- Week 5 and beyond: 400 mg once daily (maintenance dose)
- For AML: Venetoclax is commonly combined with azacitidine, decitabine, or low-dose cytarabine. The starting dose may vary, but it is often between 100 mg and 400 mg daily, with adjustments depending on the treatment regimen and patient tolerability.
2. Maintenance Dose:
- After reaching the target dose of 400 mg daily, patients continue this dose as their maintenance therapy for CLL/SLL, usually until disease progression or intolerable side effects.
- For AML, the duration and dose may vary and often depend on clinical response.
3. Administration:
- Venetoclax should be taken once daily with a meal and water, preferably at the same time each day to maintain consistent blood levels.
- Tablets should be swallowed whole and should not be crushed, chewed, or broken.
4. Monitoring:
- Tumor Lysis Syndrome (TLS): Due to the risk of TLS, patients may undergo blood monitoring before each dose increase during the ramp-up phase. Hydration and possibly medications like allopurinol may be used to help prevent TLS.
- Blood Counts and Liver Function: Regular monitoring of blood cell counts and liver function tests is important to manage potential side effects.
5. Dose Adjustments:
- Dose adjustments may be necessary for patients with kidney or liver impairment.
- If used with other medications that inhibit or induce CYP3A (an enzyme that metabolizes venetoclax), dose modifications are required to avoid adverse interactions.
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