Ibrutinib is a BTK inhibitor primarily used for the treatment of B-cell malignancies and chronic graft-versus-host disease. The usage and dosage should be adjusted according to the indications, age, and liver and kidney function. Common adverse reactions include bleeding, infection, and arrhythmia, which require close monitoring. 

Usage and Dosage

1. Recommended dosage for children

(1) Chronic graft-versus-host disease: 420mg per day for children aged 12 and above; 240mg/m ² per day for children aged 1 to 12 (maximum 420mg) until disease progression or unacceptable toxicity occurs.

(2) Discontinue medication when there is no need for treatment for recurrent basic malignant tumors or chronic GVHD.

2. Recommended dose for adults

(1) Chronic lymphocytic leukemia/small lymphocytic lymphoma: 420mg per day, used alone or in combination with rituximab, etc.

(2) Fahrenheit macroglobulinemia: 420mg per day, monotherapy or in combination with rituximab, priority should be given to Ibrutinib when administered on the same day.

Precautions

1. Risk of bleeding

Serious bleeding events include intracranial hemorrhage, which increases the risk when combined with anticoagulants. It is necessary to weigh the pros and cons and monitor bleeding manifestations.

2. Infection and Reduction of Blood Cells

Possible opportunistic infections or reduced blood cell count may occur, requiring regular blood routine testing and preventive anti infection measures.

3. Cardiac toxicity

May cause arrhythmia, heart failure, and even sudden death, especially for those with a history of cardiovascular disease who need to be closely monitored.

4. Other risks

Including hypertension, hepatotoxicity, secondary primary cancer, and fetal harm, contraception and regular assessment of liver function are necessary during treatment.

Adjustment for special populations

1. Liver function impairment

Mild to moderate damage should be reduced (140mg or 70mg per day), and Child Pugh Class C is contraindicated.

2. Pregnancy and lactation

Pregnant women should avoid breastfeeding within one week after discontinuing medication during lactation.

3. Handling of missed services

Supplement on the same day, take medication normally the next day, and prohibit double dose supplementation.