Skip to main content

Venetoclax Dosage

Medically reviewed by Drugs.com. Last updated on May 27, 2024.

Applies to the following strengths: 10 mg; 50 mg; 100 mg; 10 mg-50 mg-100 mg

Usual Adult Dose for:

Usual Geriatric Dose for:

Additional dosage information:

Usual Adult Dose for Lymphoma

Weekly ramp-up schedule over 5 weeks (CLL/SLL):
Week 1: 20 mg orally once a day
Week 2: 50 mg orally once a day
Week 3: 100 mg orally once a day
Week 4: 200 mg orally once a day
Week 5 and beyond: 400 mg orally once a day

MONOTHERAPY:


IN COMBINATION WITH OBINUTUZUMAB:

IN COMBINATION WITH RITUXIMAB:

Comments:

Uses:

Usual Adult Dose for Leukemia

Weekly ramp-up schedule over 5 weeks (CLL/SLL):
Week 1: 20 mg orally once a day
Week 2: 50 mg orally once a day
Week 3: 100 mg orally once a day
Week 4: 200 mg orally once a day
Week 5 and beyond: 400 mg orally once a day

MONOTHERAPY:


IN COMBINATION WITH OBINUTUZUMAB:

IN COMBINATION WITH RITUXIMAB:

Comments:

Uses:

Usual Geriatric Dose for Acute Myeloid Leukemia

75 years and older:
NOTE: The dose and ramp-up of venetoclax depends on the combination agent:
Start venetoclax on Cycle 1 Day 1 in combination with:
Azacitidine 75 mg/m2 IV or subcutaneously once daily on Days 1 through 7 of each 28-day cycle
OR
Decitabine 20 mg/m2 IV once daily on Days 1 through 5 of each 28-day cycle
OR
Cytarabine 20 mg/m2 subcutaneously once daily on Days 1 through 10 of each 28-day cycle
DOSE SCHEDULE FOR RAMP-UP PHASE IN PATIENTS WITH AML:
Day 1: 100 mg orally
Day 2: 200 mg orally
Day 3: 400 mg orally
Day 4 and beyond: 400 mg orally once a day of each 28-day cycle when dosing in combination with azacytidine or decitabine OR 600 mg orally once a day of each 28-day cycle when dosing in combination with low dose cytarabine until disease progression or unacceptable toxicity

Comments:


Use: This drug in combination with azacitidine, or decitabine, or low dose cytarabine for newly diagnosed acute myeloid leukemia (AML) in adults who are age 75 years or older, or who have comorbidities that preclude use of intensive induction chemotherapy

Renal Dose Adjustments

Liver Dose Adjustments

Dose Adjustments

RISK ASSESSMENT AND PROPHYLAXIS FOR TUMOR LYSIS SYNDROME (TLS):


CHRONIC LYMPHOCYTIC LEUKEMIA (CLL)/SMALL LYMPHOCYTIC LYMPHOMA (SLL):

RECOMMENDED TLS PROPHYLAXIS BASED ON TUMOR BURDEN IN PATIENTS WITH CLL/SLL:
LOW TUMOR BURDEN (All lymph node [LN] less than 5 cm AND absolute lymphocyte count [ALC] less than 25 x 10(9)/L):
MEDIUM TUMOR BURDEN (Any LN 5 cm to less than 10 cm OR ALC 25 x 10(9)/L or greater):
HIGH TUMOR BURDEN (Any LN 10 cm or greater OR ALC 25 x 10(9)/L or greater AND any LN 5 cm or greater:

ACUTE MYELOID LEUKEMIA (AML):

DOSAGE MODIFICATIONS BASED ON TOXICITIES:
CLL/SLL:

RECOMMENDED DOSE MODIFICATIONS FOR TOXICITIES IN CLL/SLL:
TUMOR LYSIS SYNDROME (TLS):
Blood chemistry changes or symptoms of TLS:
NONHEMATOLOGIC TOXICITIES:
Grade 3 or 4 nonhematologic toxicities:
HEMATOLOGIC TOXICITIES:
Grade 3 neutropenia with infection or fever or Grade 4 hematologic toxicities (except lymphopenia):
NOTE: Consider discontinuing therapy for patients who require dose reductions to less than 100 mg for more than 2 weeks.

DOSE REDUCTION FOR TOXICITY DURING TREATMENT IN CLL/SLL:

ACUTE MYELOID LEUKEMIA (AML):

RECOMMENDED DOSE MODIFICATIONS FOR TOXICITIES IN AML:
HEMATOLOGIC TOXICITIES:
Grade 4 neutropenia with or without fever or infection or Grade 4 thrombocytopenia:
dose cytarabine due to cytopenias prior to achieving remission.
NONHEMATOLOGIC ADVERSE REACTIONS:

DOSE MODIFICATIONS FOR CONCOMITANT USE WITH MODERATE OR STRONG CYP450 3A INHIBITORS OR P-GP INHIBITORS:
Note: Resume the venetoclax dose that was used prior to concomitant use of a strong or moderate CYP450 3A inhibitor or P-gp inhibitor 2 to 3 days after discontinuation of the inhibitor.
VENETOCLAX COADMINISTERED WITH POSACONAZOLE IN CLL/SLL:
VENETOCLAX COADMINISTERED WITH POSACONAZOLE IN AML:
VENETOCLAX COADMINISTERED WITH OTHER STRONG CYP450 3A INHIBITOR IN CLL/SLL:
VENETOCLAX COADMINISTERED WITH OTHER STRONG CYP450 3A INHIBITOR IN AML:
VENETOCLAX COADMINISTERED WITH MODERATE CYP450 3A INHIBITOR: Reduce the venetoclax dose by at least 50%.
VENETOCLAX COADMINISTERED WITH P-GP INHIBITOR: Reduce the venetoclax dose by at least 50%.

Precautions

CONTRAINDICATIONS:


Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration Advice:


Storage requirements:
Grapefruit products, Seville oranges, and starfruit (carambola) should be avoided during treatment with venetoclax as they contain inhibitors of CYP450 3A.

General:

Monitoring:

Perform tumor burden assessments, including radiographic evaluation (e.g., CT scan), assess blood chemistry (potassium, uric acid, phosphorus, calcium, and creatinine) in all patients and correct pre-existing abnormalities prior to initiation of treatment

Patient Advice:

Frequently asked questions

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.