Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
BTK inhibitor (specialist)

Zanubrutinib

Brand names: Brukinsa

Zanubrutinib is a second-generation Bruton tyrosine kinase (BTK) inhibitor used in B-cell malignancies including Waldenstrom macroglobulinaemia, chronic lymphocytic leukaemia/small lymphocytic lymphoma, mantle cell lymphoma and marginal zone lymphoma.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It irreversibly inhibits BTK, a key signalling kinase in the B-cell receptor pathway, thereby blocking malignant B-cell proliferation and survival.

Prescribing in practice

  • Confers a risk of serious haemorrhage; assess bleeding risk and withhold around surgery, and use caution with anticoagulants and antiplatelets.
  • Can cause cytopenias, infections and atrial fibrillation/flutter, so cardiac and haematological status should be monitored.
  • Exposure is altered by CYP3A inhibitors and inducers, and dose adjustment may be required as directed by the SPC.

Monitoring

Monitor full blood count regularly and assess for signs of bleeding, infection, new arrhythmia and second primary malignancies (especially skin).

Counselling the patient

  • Report unusual bruising, bleeding, fever or signs of infection promptly.
  • Tell your team about any new palpitations or breathlessness.
  • Use sun protection and report new skin lesions.

Evidence & guidelines

Randomised trials (including ALPINE in chronic lymphocytic leukaemia and ASPEN in Waldenstrom macroglobulinaemia) support its efficacy, and it is recommended within its licensed indications.

Reference: NICE TA836 (CLL); NICE TA862 (WM); SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways