Calquence (acalabrutinib) is a prescription drug that’s used to treat certain types of leukemia and lymphoma. This drug can interact with other medications and some supplements. For example, Calquence can interact with ketoconazole and carbamazepine.

Calquence is used in adults to treat:

Calquence contains the active ingredient acalabrutinib. (An active ingredient is what makes a drug work.) It comes as a tablet that you swallow.

An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.

Keep reading to learn about Calquence’s possible interactions. And for more information about Calquence, including details about its uses, see this article.

There’s no known interaction between Calquence and alcohol.

Talk with your doctor if you have questions about consuming alcohol while you’re taking Calquence.

Before you start taking Calquence, tell your doctor and pharmacist about any prescription or over-the-counter drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Calquence interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Calquence?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Calquence. Keep in mind that this table does not include all drugs that may interact with Calquence. For more information about these interactions, see the “Drug interactions explained” section below.

Drug group or drug nameDrug examplesWhat can happen
drugs that block the CYP3A4 enzyme*• ketoconazole
• clarithromycin		can increase the risk of side effects from Calquence
drugs that speed up the CYP3A4 enzyme*• carbamazepine (Tegretol, others)
• phenytoin (Dilantin)		can make Calquence less effective
drugs affected by BCRP†• topotecan (Hycamtin)
• ubrogepant (Ubrelvy)		can increase the risk of side effects from these drugs

* CYP3A4 is an enzyme that breaks down certain drugs in your body. To learn more, see the “Drug interactions explained” section just below.
† BCRP is a transport protein that moves drugs in and out of cells in your body. To learn more, see the “Drug interactions explained” section just below.

Keep reading to learn more about certain drug interactions that can occur with Calquence.

Interaction with drugs that block the CYP3A4 enzyme

Calquence interacts with drugs that block the CYP3A4 enzyme (a kind of protein). This enzyme helps break down drugs in your body, including Calquence. Examples of drugs that decrease the activity of the CYP3A4 enzyme include:

What could happen

Taking Calquence together with a drug that blocks the CYP3A4 enzyme increases the amount of Calquence in your body. This raises your risk of side effects from Calquence, including mild side effects such as headache and more serious side effects such as bleeding.

What you can do

Due to this interaction, your doctor will likely suggest that you avoid taking drugs known to significantly block the CYP3A4 enzyme if you’re taking Calquence. Your doctor can discuss alternative treatments with you.

Interaction with drugs that speed up the CYP3A4 enzyme

Calquence interacts with drugs that speed up the CYP3A4 enzyme. This enzyme helps break down drugs in your body, including Calquence. Examples of drugs that increase the activity of the CYP3A4 enzyme include:

What could happen

Taking Calquence with a drug that increases the activity of the CYP3A4 enzyme can cause the level of Calquence in your body to decrease. This can make Calquence less effective.

What you can do

Due to this interaction, your doctor will likely suggest that you avoid taking drugs known to significantly increase the activity of the CYP3A4 enzyme if you’re taking Calquence. They can discuss alternative treatments with you.

Interaction with drugs transported by BCRP

Calquence interacts with drugs transported (moved) by a certain transport protein called BCRP. Transport proteins move drugs in and out of cells in your body.

Calquence can slow down the activity of BCRP in your body. This can make it difficult for your body to remove drugs that depend on BCRP. And this can cause a buildup of these drugs in your body.

Examples of drugs that are transported by BCRP include:

What could happen

Taking Calquence with a drug transported by BCRP increases the risk of side effects from that drug.

What you can do

Certain drugs depend on BCRP more than others. Depending on the expected level of interaction between Calquence and the other drug, your doctor may:

  • monitor you closely for side effects from the BCRP-transported drug
  • reduce your dose of the BCRP-transported drug
  • suggest a treatment other than Calquence for your condition

If you have questions about this interaction, talk with your doctor.

Calquence may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Calquence.

Does Calquence interact with supplements?

Before you start taking Calquence, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Calquence interactions with herbs

Calquence interacts with St. John’s wort. This is an herbal supplement that some people take to support their mood.

St. John’s wort speeds up the activity of the CYP3A4 enzyme. This enzyme helps break down drugs in your body, including Calquence. St. John’s wort can cause Calquence to break down faster in your body. This can reduce the amount of Calquence in your body and decrease its effectiveness.

Your doctor will likely suggest that you not take St. John’s wort with Calquence. They can recommend an alternative to St. John’s wort or Calquence instead. If there are no suitable alternatives, your doctor may prescribe a higher dosage of Calquence.

Calquence and vitamins

There are currently no reports of Calquence interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Calquence.

Does Calquence interact with food?

Calquence interacts with grapefruit.

Grapefruit interferes with the enzyme that breaks down Calquence. Consuming grapefruit or grapefruit juice while taking Calquence may lead to the drug building up in your body. This increases the risk of side effects from Calquence.

Your doctor may suggest avoiding grapefruit and grapefruit juice during your treatment with Calquence. Talk with your doctor if you have additional questions about Calquence and its interactions with food.

Does Calquence interact with vaccines?

Calquence isn’t known to interact with any vaccines.

Ask your doctor or pharmacist if you have questions about receiving vaccines while taking Calquence.

Does Calquence interact with lab tests?

Calquence isn’t known to interact with any lab tests.

Talk with your doctor if you have questions about getting lab tests done while taking Calquence.

Does Calquence interact with cannabis or CBD?

There are currently no reports of Calquence interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Calquence.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Calquence. Before taking Calquence, talk with your doctor about your health history. They’ll determine whether Calquence is right for you.

Health conditions or other factors that might interact with Calquence include:

Bleeding problem. Be sure to let your doctor know if you have a bleeding problem, such as hemophilia, before taking Calquence. Bleeding is a rare but serious side effect of Calquence. You may have an increased risk if you have an existing bleeding problem.

Irregular heart rhythm. Rarely, treatment with Calquence can cause an irregular heart rhythm, including atrial fibrillation. If your heart rhythm is irregular, taking Calquence could worsen your condition. Your doctor can determine whether it’s safe for you to take Calquence.

Liver problem, including hepatitis B virus (HBV) infection. It’s not known whether Calquence is safe to take if you have a moderate or severe liver problem, such as liver cirrhosis. And if you’ve ever had hepatitis B, taking Calquence could reactivate the hepatitis B virus and cause you to have symptoms again. Your doctor can determine whether Calquence is safe to take with your liver condition.

Current infection. Serious and even life threatening infections are a rare but possible side effect of Calquence. If you have a current infection, taking Calquence could make it harder to treat. Your doctor may decide to delay starting treatment with Calquence until after the infection is treated.

Recent or planned surgery. Taking Calquence increases the risk of bleeding. If you’ve had recent surgery or have an upcoming surgery scheduled, your doctor may delay starting treatment with Calquence.

Pregnancy. It’s not known whether Calquence is safe to take while pregnant. Talk with your doctor to learn about the risks and benefits of treatments for your condition, including Calquence, if taken during pregnancy.

Breastfeeding. It’s advised that you avoid breastfeeding your child while taking Calquence and for at least 2 weeks following your last dose of the drug. Talk with your doctor if you have further questions about breastfeeding while taking Calquence.

Allergic reaction. If you’ve had an allergic reaction to Calquence or any of its ingredients, your doctor will likely not prescribe Calquence. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Taking certain steps can help you avoid interactions with Calquence. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

  • Whether you drink alcohol or use cannabis.
  • Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
  • What to do if you start taking a new drug during your Calquence treatment.

It’s also important to understand Calquence’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Calquence, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking Calquence exactly as prescribed can also help prevent interactions.

If you still have questions about Calquence and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

  • If Calquence interacts with a medication I take, will I be monitored more closely during treatment?
  • Do other drugs used to treat my condition have similar interactions as Calquence?
  • Does my Calquence dosage affect my risk of an interaction?
  • If Calquence interacts with a health condition I have, is the drug still safe for me to take?

To learn more about Calquence, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.