Hair loss (alopecia) has not been noted as a side effect of ibrutinib (Imbruvica) in the product label. Textural hair changes (softening, straightening or curliness) and nail changes (brittle fingernails and toenails) were reported in a study evaluating ibrutinib use over the long term for treatment of chronic lymphocytic leukemia (CLL).

• In this survey, textural hair changes were reported in 17 out of 66 patients (25.7%) after a median of 9 months after starting treatment for CLL (but ranged from 6 to 12 months). Seven males (16%) and 10 females (43%) reported hair changes in the study.
• Over half of patients reported a negative impact of hair changes on their quality of life.
• On average, textural hair changes were graded 1-2 on a side effect scale, meaning this side effect was considered to be mild to moderate in severity.

Hair straighteners and perming agents used to change hair texture work by changing the disulfide bonds in hair. Ibrutinib, a Bruton Tyrosine Kinase (BTK) inhibitor, binds to the cysteine residue at the active site of Bruton's tyrosine kinase (BTK) and can change the disulfide bonds between cysteine residues. Whether this cancer mechanism may lead to the observed hair changes is not known.

If you are using ibrutinib in combination with other cancer treatments, those cancer treatments may cause hair loss (alopecia). Ibrutinib can be used in combination with rituximab to treat CLL. Rituximab has been reported to cause hair loss in 13% of patients being treated for pemphigus vulgaris, a skin condition that causes blisters. Hair loss was not reported when rituximab was used in studies to treat CLL.

The most common side effects of ibrutinib (Imbruvica) in adults being treated for B-cell malignancies like CLL include: diarrhea, tiredness, muscle and bone pain, rash, and bruising.

This is not all the information you need to know about ibrutinib (Imbruvica) for safe and effective use and does not take the place of talking to your doctor about your treatment. Review the full Imbruvica information here, and discuss this information and any questions you have with your doctor or other health care provider.