Venetoclax is a targeted tablet for chronic lymphocytic leukaemia (CLL) and small lymphocytic lymphoma, and — with azacitidine, decitabine or low-dose cytarabine — for acute myeloid leukaemia (AML) in people who cannot have intensive chemotherapy. It works in a different way from most cancer medicines: it removes a protein that stops leukaemia cells from dying.
Because it can kill large numbers of leukaemia cells quickly, treatment starts with a five-week 'ramp-up' — 20 mg, then 50, 100, 200 and finally 400 mg daily, each for a week — with blood tests and plenty of fluids so that the breakdown products of dying cells do not overload the kidneys (tumour lysis syndrome). The first doses of each step may be given in hospital depending on your risk.
Venetoclax is taken once a day with food. In CLL it is usually combined with obinutuzumab or rituximab for a fixed period, or with ibrutinib; in AML it continues as long as it works. It is a prescription-only medicine; a valid prescription must be provided at checkout.