GAZYVA® (obinutuzumab) Considerations
Refer to GAZYVA Prescribing Information for recommended premedications, recommended prophylactic hydration and anti-hyperuricemics for patients at high risk of TLS, and administration guidelines.
Rituximab Considerations
Refer to the rituximab Prescribing Information for recommended premedication and prophylactic medications, and administration guidelines.
Acalabrutinib Considerations
Refer to the acalabrutinib Prescribing Information for detailed information on administration.
VENCLEXTA Initiation Considerations1
* Anti-hyperuricemic agent: Start allopurinol or xanthine oxidase inhibitor 2 to 3 days prior to initiation of VENCLEXTA.
† Hydration: It is important for patients to stay hydrated throughout VENCLEXTA treatment by drinking at least 56 oz (1.5 to 2 L) of water per day. Patients who cannot tolerate oral hydration should be hydrated intravenously. Start 2 days before the first dose, on the day of the first dose, and each time the dose is increased.
‡ Additional hydration: For patients with medium tumor burden, consider additional IV hydration.
§ Blood chemistry labs: Evaluate blood chemistries (potassium, uric acid, phosphorus, calcium, and creatinine); review in real time.
VENCLEXTA Initiation Considerations1
* Anti-hyperuricemic agent: Start allopurinol or xanthine oxidase inhibitor 2 to 3 days prior to initiation of VENCLEXTA.
† Hydration: It is important for patients to stay hydrated throughout VENCLEXTA treatment by drinking at least 56 oz (1.5 to 2 L) of water per day. Patients who cannot tolerate oral hydration should be hydrated intravenously. Start 2 days before the first dose, on the day of the first dose, and each time the dose is increased.
‡ Blood chemistry labs: Evaluate blood chemistries (potassium, uric acid, phosphorus, calcium, and creatinine); review in real time.
Continuing VEN+G Dosing1
- Administer 1000 mg of obinutuzumab on Day 1 of Cycles 2 to 6
- After completing the dose ramp-up phase on Cycle 2, Day 28, continue VENCLEXTA at a dose of 400 mg orally once daily from Cycle 3, Day 1 until the last day of Cycle 12
Continuing VEN+R Dosing1
- Administer rituximab at 500 mg/m2 on Day 1 of Cycles 2 to 6
- Continue VENCLEXTA 400 mg once daily for 24 months from Cycle 1, Day 1 of rituximab
Continuing VEN+A Dosing1
- Acalabrutinib is taken orally 100 mg approximately every 12 hours and continued until completion of 14 cycles or until disease progression or unacceptable toxicity
- After completing the ramp-up phase on Cycle 4, Day 7, continue VENCLEXTA at a dose of 400 mg orally once daily until disease progression, unacceptable toxicity, or until the last day of Cycle 14
The example calendar represents a patient who does not require dose modifications or interruptions and is based on the dosing, administration, and management information in the Prescribing Information of the referenced products. When making treatment decisions, refer to the full Prescribing Information for complete management considerations. Please verify this schedule is correct for your patient.
TLS=tumor lysis syndrome; VEN=VENCLEXTA; VEN+G=VENCLEXTA + GAZYVA.