PI3Kδ inhibitor
Idelalisib (Specialist drug)
Brand names: Zydelig
Adult dose
Dose: Specialist initiation only — refer to BNF/SmPC
Route: PO
Frequency: BD
Clinical pearls
- CLL, follicular lymphoma; PJP prophylaxis required (co-trimoxazole or pentamidine)
Contraindications
- Severe hepatic impairment
- Hypersensitivity
Side effects
- Hepatotoxicity (severe)
- Severe diarrhoea/colitis
- Pneumonitis
- Severe infections (esp. PJP, CMV)
- Cytopenias
Interactions
- Strong CYP3A4 modulators
- Many drug interactions — refer pharmacist
Monitoring
- LFTs
- FBC
- CMV PCR
- Pulmonary symptoms
Reference: BNF; NICE TA359/TA604; SmPC; https://bnf.nice.org.uk/drugs/idelalisib-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Vancomycin Dosing Calculator · Drug Dosing
- Phenytoin Correction for Albumin / Renal Failure · Drug Dosing
- Local Anaesthetic Maximum Dose Calculator · Drug Dosing
- Tisdale Risk Score for QT Prolongation · Arrhythmia
- Bazett Corrected QT Interval (QTc) Calculator · Arrhythmia
- DAPT Score for Dual Antiplatelet Therapy Duration · Antiplatelet Therapy
Pathways
- Acute Myeloid Leukaemia Presentation · BSH; NICE — NG146
- Tumour Lysis Syndrome · Cairo-Bishop; BSH; NICE — Best Practice
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158