Rilzabrutinib (Wayrilz™)

How to Take Rilzabrutinib (Wayrilz ™) 

 Rilzabrutinib comes as a tablet you take by mouth twice daily. Take each dose with a whole glass of water around the same time each day. You can take this with or without food. Do not cut, crush, or chew the tablets. If you miss a dose, take the dose as soon as possible on the same day and at least 2 hours apart from the next regular scheduled dose.

It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed.

Some medications, foods, and supplements can interact with rilzabrutinib. This can cause the blood levels of these medications to be higher than expected. These include: grapefruit, starfruit, Seville oranges, simvastatin, atorvastatin, amlodipine, cyclosporine, amiodarone, midazolam, digoxin, and rosuvastatin, among others. Be sure to tell your healthcare provider about all medications and supplements you take.

You should not take rilzabrutinib at the same time as "heartburn" medications, as these may affect how the medication is absorbed. These include proton pump inhibitors such as Prilosec (omeprazole), Nexium (esomeprazole), Protonix (pantoprazole); H2 blockers, like Pepcid (famotidine); and antacids, such as Tums (calcium-carbonate) and Rolaids (Calcium Carbonate and Magnesium Hydroxide). If needed, please ask your provider for the best “heartburn” medication to use and when to take it.

Storage and Handling

 Store your medication in the original, labeled container at room temperature and in a dry location (unless otherwise directed by your healthcare provider or pharmacist) to protect the medication from light and moisture. This medication should not be stored in a pillbox. Keep containers out of reach of children and pets.

Store your medication in the original container with the label. If you want to use a pillbox, talk to your pharmacist. Keep it in a dry place at room temperature and protect it from light and moisture

If a caregiver prepares your dose for you, they should consider wearing gloves or pour the pills directly from their container into the cap, a small cup, or directly into your hand. They should avoid touching the pills. They should always wash their hands before and after giving you the medication. Pregnant or nursing women should not prepare the dose for you. Ask your oncology team where to return any unused medication for disposal. Do not flush down the toilet or throw in the trash.

 Where do I get this medication?

 Rilzabrutinib is available through select specialty pharmacies . Some cancer medications are only available through specialty pharmacies. Your care team or pharmacist will start this process. Your insurance plan may also affect where you can get your medication.  Call your prescription plan provider to find out which specialty pharmacies are in-network.

Insurance Information

This medication may be covered by your prescription plan.

If you qualify, you may be able to get financial help through patient assistance programs (PAP). Co-pay cards may also be available to lower your out-of-pocket cost if you have commercial (not Medicare/Medicaid/Tricare) insurance.

Your pharmacist, social worker, or navigator can help find resources for financial support.

Possible Side Effects of Rilzabrutinib

There are many things you can do to manage the side effects of rizabrutinib. Talk to your provider about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:

Diarrhea

Diarrhea is when you pass three or more stools in a day. Your providers can suggest medications to relieve diarrhea. Do not take any medications to manage your diarrhea without talking to your provider first, as your stool may need to be tested. To manage it, try eating foods that are low in fiber and bland, like white rice and boiled or baked chicken. Try not to eat raw fruits, vegetables, whole grain breads, cereals, and seeds. Soluble fiber is a type of fiber found in some foods that helps absorb (soak up) fluid. Foods high in soluble fiber are applesauce, bananas (ripe), canned fruit, oranges, boiled potatoes, white rice, foods made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Stay hydrated by drinking 8 to 10 glasses of non-alcoholic, non-caffeinated fluid each day.

Nausea and/or Vomiting

Talk to your provider if you have nausea and/or vomiting. They can prescribe medications to help you. Making changes to your diet can also help. Avoid things that make your symptoms worse, like heavy or greasy/fatty, spicy, or acidic foods like tomatoes, lemons, and oranges. Try saltines or ginger ale to help your symptoms.

Call your provider if you cannot keep fluids down for more than 12 hours or if you feel lightheaded or dizzy.

Headache

 Your provider can recommend medications and other strategies to help relieve pain.

Important but Less Common Side Effects

• Infection: This medication increases your risk for infection. You should let your provider know right away if you have:
  • A fever. Call for a temperature over 100.4°F or 38°C or as directed by your provider.
  • Sore throat or cold.
  • Shortness of breath.
  • A cough.
  • A sore that doesn't heal. 
  • Burning with urination, having to go to the bathroom often, or a strong urge to urinate.
• Tips for preventing infection:
  • Washing hands, both yours and your visitors, is the best way to prevent the spread of infection.
  • Avoid large crowds and people who are sick (i.e., those who have a cold, fever, or cough or live with someone with these symptoms).
  • When working in your yard, wear protective clothing, including long pants and gloves.
  • Do not handle pet waste.
  • Keep all cuts or scratches clean.
  • Shower or bathe daily and perform frequent mouth care.
  • Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
  • Ask your provider before scheduling dental appointments or procedures.
  • Ask your provider before you, or someone you live with, has any vaccinations.
• Liver Toxicity: This medication can cause liver toxicity, or liver problems, which your provider may monitor for with blood tests called liver function tests. Symptoms may be:
  • Yellowing of your skin or eyes.
  •  Dark or brown urine.
  • Pain in your abdomen (belly).
  • Tell your provider if you have any of these symptoms.

Reproductive Concerns 

There is a higher risk of health problems for your baby if you are pregnant, become pregnant, or get someone pregnant while on this medication. To lower the risk of birth defects, you should use birth control (contraception) to avoid pregnancy.

If you can become pregnant, you will need to use effective birth control for 1 month after the last dose of this medication, even if your menstrual cycle has stopped or changed.

If you can get someone pregnant, you will need to use effective birth control for 1 month after the last dose of this medication, even if you believe you are not producing sperm.

You should not breastfeed during treatment and for 1 month after the last dose of this medication.