Brukinsa (Zanubrutinib)


Zanubrutinib, sold under the brand name Brukinsa, is a medication for the treatment of mantle cell lymphoma (MCL) and Waldenstrom’s macroglobulinemia (WM). In fact, Zanubrutinib is a class of medicines called kinase inhibitors. It works by blocking the action of the abnormal protein that signals cancer cells to multiply. This however helps stop the spread of cancer cells. Therefore, the U.S Food and Drug Administration (FDA) granted zanubrutinib priority review, accelerated approval, breakthrough therapy designation, and orphan group designation. Also, the FDA approved zanubrutinib in November 2019 and granted the application for Brukinsa to BeiGene USA. Lastly, in September 2021, the FDA approved zanubrutinib for the treatment of Waldenström’s macroglobulinemia.

Zanubrutinib comes as a capsule to take by mouth. It is usually taken once or twice daily with or without food. Firstly, take zanubrutinib at around the same time(s) a day. Follow the directions on your prescription label carefully, and also ask your doctor or pharmacist to elucidate any part you are doing not understand. Take zanubrutinib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the capsules whole with a glass of water; do not split, chew, or crush them.

Mechanism of Action:

Brukinsa (zanubrutinib) is a small-molecule inhibitor of BTK. Zanubrutinib forms a chemical bond with a cysteine residue within the BTK site, resulting in inhibition of BTK activity. BTK may be a signalling molecule of the B-cell antigen receptor (BCR) and cytokine receptor pathways. In B-cells, BTK signalling leads to the activation of pathways necessary for B-cell proliferation, trafficking, chemotaxis, and adhesion.

Side effects:

  • Diarrhoea
  • Constipation
  • Cough
  • muscle, joint, or back pain

If you experience any of those symptoms, call your doctor immediately:

  • fever, pharyngitis, chills, or other signs of infection
  • painful, frequent, or urgent urination
  • cough, shortness of breath, pain once you breathe or cough, or fever
  • unusual bruising or bleeding
  • blood in your stools or black, tarry stools; pink or brown urine; vomiting blood or coffee-ground vomit; expulsion blood
  • feeling dizzy, weak, or confused; changes in speech; a headache that lasts an extended time
  • Rash
  • fast or irregular heartbeat, palpitations, feeling lightheaded or dizzy, fainting, shortness of breath, pain 


  • Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you’re taking or decide to take.
  • Tell your doctor if you’ve got an infection or recently had surgery. Also tell your doctor if you’ve got or have ever had an irregular heartbeat, high vital signs, bleeding problems, or heart or disease.
  • Tell your doctor if you’re pregnant, decide to become pregnant, or if you propose fathering a toddler. You should not become pregnant while you are taking zanubrutinib.
  • If you’re female, you’ll get to take a bioassay before you begin treatment and will use contraception to stop pregnancy during your treatment and for 1 week after your final dose. If you’re male, you and your female partner should use contraception during your treatment with zanubrutinib and continue for 1 week after your final dose. In case you or your partner become pregnant while taking zanubrutinib, call your doctor immediately. Zanubrutinib can cause fetal harm.
  • Tell your doctor if you are breastfeeding. Do not breastfeed while you are taking zanubrutinib and for 2 weeks after your final dose.