Posology: MCL: The recommended dose of CALQUENCE for the treatment of MCL is 100 mg (1 capsule) twice daily.
CLL/SLL: The recommended dose of CALQUENCE for the treatment of CLL/SLL is 100 mg (1 capsule) twice daily, either as monotherapy or in combination with obinutuzumab. Refer to the obinutuzumab prescribing information for recommended obinutuzumab dosing information. (For details of the combination regimen, see Pharmacology: Pharmacodynamics under Actions.)
Doses should be separated by approximately 12 hours.
Treatment with CALQUENCE should continue until disease progression or unacceptable toxicity.
Missed Dose: If a patient misses a dose of CALQUENCE by more than 3 hours, instruct the patient to take the next dose at its regularly scheduled time. Extra capsules of CALQUENCE should not be taken to make up for a missed dose.
Dose Adjustments: Adverse Reactions: Recommended dose modifications of CALQUENCE for Grade ≥3 adverse reactions are provided in Table 9.
Temporarily interrupt CALQUENCE to manage a Grade ≥3 non-haematological treatment-related adverse reaction, Grade 3 thrombocytopenia with significant bleeding, Grade 4 thrombocytopenia, or Grade 4 neutropenia lasting longer than 7 days. Upon resolution of the adverse reaction to Grade 1 or baseline (recovery), restart CALQUENCE as recommended in Table 9. (See Tables 9 and 10.)


Method of Administration: CALQUENCE should be swallowed whole with water at approximately the same time each day. CALQUENCE can be taken with or without food. The capsule should not be chewed, dissolved, or opened.
Special patient populations: Elderly (≥65 years): No dose adjustment is necessary based on age (see Pharmacology: Pharmacokinetics under Actions).
Renal Impairment: No dose adjustment is recommended in patients with mild to moderate renal impairment (eGFR greater than or equal to 30 mL/min/1.73m2 as estimated by MDRD (modification of diet in renal disease equation)). The pharmacokinetics and safety of CALQUENCE in patients with severe renal impairment (eGFR less than 29 mL/min/1.73m2) or end-stage renal disease have not been studied (see Pharmacology: Pharmacokinetics under Actions).
Hepatic Impairment: No dose adjustment is recommended in patients with mild or moderate hepatic impairment (Child-Pugh A, Child-Pugh B, or total bilirubin between 1.5-3 times the upper limit of normal [ULN] and any AST). Avoid administration of CALQUENCE in patients with severe hepatic impairment (Child-Pugh C or total bilirubin >3 times ULN and any AST) (see Pharmacology: Pharmacokinetics under Actions).
Severe Cardiac Disease: Patients with severe cardiovascular disease were excluded from CALQUENCE clinical studies.
Paediatric and adolescents: The safety and efficacy of CALQUENCE in children and adolescents aged less than 18 years have not been established.