Common Side Effects of Calquence
Calquence (acalabrutinib) commonly causes infections, bleeding, anemia, neutropenia, headache, dizziness, diarrhea, nausea, fatigue, bruising, muscle pain, rash, and upper respiratory tract infections. These occur in more than 10% of patients in clinical trials.[1]
Serious Side Effects and Warnings
Serious risks include severe bleeding (sometimes fatal), infections (like pneumonia or sepsis), atrial fibrillation or flutter, second primary malignancies (such as skin cancers), and cytopenias (low blood cell counts). It carries a black box warning for hemorrhage and infections.[1][2]
Patients on blood thinners or with bleeding history face higher hemorrhage risk. Cardiac monitoring is advised due to arrhythmia potential.
Side Effects by Frequency
- Very common (≥20%): Upper respiratory infections, headache, diarrhea, nausea, bruising, rash.[1]
- Common (5-20%): Fatigue, cough, musculoskeletal pain, abdominal pain, vomiting, edema, constipation, fever.[1]
- Less common but serious: Hemorrhage (e.g., gastrointestinal bleeding), atrial fibrillation (4-7% in trials), pneumonia, neutropenia.[1][2]
What Patients Report Experiencing
Real-world feedback highlights fatigue, easy bruising, frequent infections, and gastrointestinal issues as most disruptive. Some note hair thinning or joint pain not emphasized in trials.[2]
How Side Effects Compare to Imbruvica (ibrutinib)
Calquence has lower rates of atrial fibrillation (4-7% vs. 10-15%) and hypertension but similar bleeding and infection risks. It's often chosen to avoid ibrutinib's cardiac issues.[1][2]
Managing Side Effects
Dose interruptions or reductions help with cytopenias and bleeding. Antivirals or antibiotics prevent infections. Report severe bleeding, chest pain, or fever immediately.[1]
Who’s at Higher Risk
Elderly patients, those with heart disease, or on anticoagulants see amplified risks. Pediatric use lacks data.[1][2]
[1]: Calquence Prescribing Information, AstraZeneca, https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/210259s017lbl.pdf
[2]: Drugs.com, Calquence Side Effects, https://www.drugs.com/sfx/calquence-side-effects.html