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Systemic Anti-Cancer Therapy Regimen Library

Home > LEU AML - azacitidine and venetoclax

LEU AML - azacitidine and venetoclax

Treatment Overview

Frequency of cycles of azacitidine can be variable and may be repeated once every 28 to 42 days depending on clinical response and patient factors.

Venetoclax, give continuously until disease progression or unacceptable toxicity.


A bone marrow is required at day 28 of cycle 1.


Venetoclax is not funded for AML treatment. Some centres may choose to use an azole antifungal for CYP3A4 inhibition in combination with venetoclax so that lower doses of venetoclax can be prescribed.

Cycle 1 - 28 days - venetoclax titration

Cycle length:
28

venetoclax:

To reduce the risk of developing tumour lysis syndrome (TLS) white cell count should be 25 × 10⁹/L or lower before commencing venetoclax treatment.

Specific TLS monitoring, hydration and dosing precautions apply to venetoclax dose titration. Consult product literature for details.


azacitidine: Days of treatment may be altered to omit weekend administration with remainder of treatment recommencing within 3 days as per institutional practice.


A bone marrow is required at day 28 of cycle 1.

Cycle 2 (and all further cycles) - 28 days

Cycle length:
28

azacitidine: Days of treatment may be altered to omit weekend administration with remainder of treatment recommencing within 3 days as per institutional practice.

Cycle details

Cycle 1 - 28 days - venetoclax titration

Medication Dose Route Days Max Duration
aLLOPURINol 300 mg Once daily oral administration -3 to 28
azacitidine 75 mg/m² Once daily subcutaneous injection 1 to 7
venetoclax 100 mg Once daily oral administration 1
venetoclax 200 mg Once daily oral administration 2
venetoclax 400 mg Once daily oral administration 3 to 28

venetoclax:

To reduce the risk of developing tumour lysis syndrome (TLS) white cell count should be 25 × 10⁹/L or lower before commencing venetoclax treatment.

Specific TLS monitoring, hydration and dosing precautions apply to venetoclax dose titration. Consult product literature for details.


azacitidine: Days of treatment may be altered to omit weekend administration with remainder of treatment recommencing within 3 days as per institutional practice.


A bone marrow is required at day 28 of cycle 1.

Cycle 2 (and all further cycles) - 28 days

Medication Dose Route Days Max Duration
azacitidine 75 mg/m² Once daily subcutaneous injection 1 to 7
venetoclax 400 mg Once daily oral administration 1 to 28

azacitidine: Days of treatment may be altered to omit weekend administration with remainder of treatment recommencing within 3 days as per institutional practice.

Full details

Cycle 1 - 28 days - venetoclax titration

Day: -3

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.

Day: -2

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.

Day: -1

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.

Day: 0

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.

Day: 1

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 100 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 2

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 200 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 3

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 4

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 5

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 6

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 7

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 8

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 9

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 10

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 11

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 12

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 13

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 14

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 15

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 16

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 17

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 18

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 19

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 20

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 21

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 22

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 23

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 24

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 25

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 26

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 27

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 28

Medication Dose Route Max duration Details
aLLOPURINol 300 mg Once daily oral administration
Instructions:
Take with food.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Cycle 2 (and all further cycles) - 28 days

Day: 1

Medication Dose Route Max duration Details
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 2

Medication Dose Route Max duration Details
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 3

Medication Dose Route Max duration Details
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 4

Medication Dose Route Max duration Details
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 5

Medication Dose Route Max duration Details
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 6

Medication Dose Route Max duration Details
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 7

Medication Dose Route Max duration Details
azacitidine 75 mg/m² Once daily subcutaneous injection
Instructions:

Injection site reactions are common with subcutaneous azacitidine. Ensure injection sites are rotated and that new injections are at least 2.5 cm from the previous site.
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 8

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 9

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 10

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 11

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 12

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 13

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 14

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 15

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 16

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 17

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 18

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 19

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 20

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 21

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 22

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 23

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 24

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 25

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 26

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 27

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Day: 28

Medication Dose Route Max duration Details
venetoclax 400 mg Once daily oral administration
Instructions:
Take with food and a large glass of water. Swallow tablets whole, do not crush or chew. Avoid foods containing grapefruit, starfruit or Seville oranges during treatment as they may interact with this medicine. Discuss with your pharmacist.

Supportive Care Factors

Factor Value
Antifungal prophylaxis: Routine antifungal prophylaxis may be considered
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis may be considered
Emetogenicity: Variable
Tumour lysis syndrome prophylaxis: Tumour lysis syndrome prophylaxis is mandatory

Antifungal prophylaxis: If an azole is used, the dose of venetoclax must be reduced. Consult product literature.

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.

Emetogenicity: MEDIUM days 1 to 7; MINIMAL to LOW days 8 to 28.

Growth factor support: Consider from cycle 2 onwards.

Tumour lysis syndrome prophylaxis: Specific tumour lysis syndrome monitoring, hydration and dosing precautions apply to venetoclax dose titration. Consult product literature for details.

References

Lyons, R. M., T. M. Cosgriff, S. S. Modi, et al. 2009. "Hematologic response to three alternative dosing schedules of azacitidine in patients with myelodysplastic syndromes." J Clin Oncol 27(11):1850-1856., PMID: 19255328

Gore, S. D. 2011. "New ways to use DNA methyltransferase inhibitors for the treatment of myelodysplastic syndrome." Hematology Am Soc Hematol Educ Program 2011:550-555., PMID: 22160088

DiNardo, C. D., B. A. Jonas, V. Pullarkat, et al. 2020. "Azacitidine and Venetoclax in Previously Untreated Acute Myeloid Leukemia." N Engl J Med 383(7):617-629., PMID: 32786187

Batty, G. N., H. Kantarjian, J. P. Issa, et al. 2010. "Feasibility of therapy with hypomethylating agents in patients with renal insufficiency." Clin Lymphoma Myeloma Leuk 10(3):205-210., PMID: 20511166

DiNardo, C. D., K. Pratz, V. Pullarkat, et al. 2019. "Venetoclax combined with decitabine or azacitidine in treatment-naive, elderly patients with acute myeloid leukemia." Blood 133(1):7-17., PMID: 30361262

DiNardo, C. D., K. W. Pratz, A. Letai, et al. 2018. "Safety and preliminary efficacy of venetoclax with decitabine or azacitidine in elderly patients with previously untreated acute myeloid leukaemia: a non-randomised, open-label, phase 1b study." Lancet Oncol 19(2):216-228., PMID: 29339097

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* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.