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Home > LEU CLL - zanubrutinib

LEU CLL - zanubrutinib

Treatment Overview

Cycle 1 (and all further cycles) - 30 days

Cycle length:
30

zanubrutinib: Alternatively, can be given as zanubrutinib 160 mg TWICE daily at clinician's discretion. 

Cycle details

Cycle 1 (and all further cycles) - 30 days

Medication Dose Route Days Max Duration
zanubrutinib 320 mg Once daily oral administration 1 to 30

zanubrutinib: Alternatively, can be given as zanubrutinib 160 mg TWICE daily at clinician's discretion. 

Full details

Cycle 1 (and all further cycles) - 30 days

Day: 1

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 2

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 3

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 4

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 5

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 6

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 7

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 8

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 9

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 10

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 11

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 12

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 13

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 14

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 15

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 16

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 17

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 18

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 19

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 20

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 21

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 22

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 23

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 24

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 25

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 26

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 27

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 28

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 29

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Day: 30

Medication Dose Route Max duration Details
zanubrutinib 320 mg Once daily oral administration
Instructions:
  • Swallow whole with a glass of water, do not crush, chew or open capsule.
  • Avoid grapefruit or grapefruit juice and Seville oranges as they may interact with this medicine.
  • Alternatively, can be given as 160 mg TWICE daily at clinician's discretion. 

Supportive Care Factors

Factor Value
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis may be considered
Emetogenicity: Minimal to low
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: Routine antibiotic prophylaxis may be considered
Tumour lysis syndrome prophylaxis: Tumour lysis syndrome prophylaxis may be considered

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.

References

Brown JR, Eichhorst B, Hillmen P, et al. Zanubrutinib or Ibrutinib in Relapsed or Refractory Chronic Lymphocytic Leukemia. N Engl J Med. 2023 Jan 26;388(4):319-332. , PMID: 36511784

Tam CS, Brown JR, Kahl BS, et al. Zanubrutinib versus bendamustine and rituximab in untreated chronic lymphocytic leukaemia and small lymphocytic lymphoma (SEQUOIA): a randomised, controlled, phase 3 trial. Lancet Oncol. 2022 Aug;23(8):1031-1043., PMID: 35810754

Tam CS, Robak T, Ghia P, et al. Zanubrutinib monotherapy for patients with treatment naïve chronic lymphocytic leukemia and 17p deletion. Haematologica. 2021 Sep 1;106(9):2354-2363. , PMID: 33054121

BeiGene NZ Unlimited. BRUKINSA New Zealand Data Sheet. 25 January 2024. https://www.medsafe.govt.nz/profs/datasheet/b/brukinsacap.pdf (accessed 5 February 2026).

* 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.