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Overview: Beqalzi is used to treat a certain type of blood cancer called mantle cell lymphoma (MCL). It works by blocking a protein called BCL-2, causing cancer cells to break apart and die. Common Beqalzi side effects include infections, such as pneumonia, and tiredness. Drink plenty of water while taking Beqalzi. Contact your health care provider or get medical care right away if you have a fever, chills, nausea, vomiting, confusion, shortness of breath, seizures, an irregular heartbeat, decreased urination, or muscle cramps.

Uses

What is Beqalzi used for?

Beqalzi (sonrotoclax) is commonly used to treat certain people with mantle cell lymphoma (MCL). MCL is a type of blood cancer that starts in B cells, a kind of white blood cell that normally helps your body fight infections.

Navigating Mantle Cell Lymphoma: What to Know About Beqalzi

Beqalzi may also be used for other conditions as determined by your health care provider.

How does Beqalzi work (mechanism of action)?

Some cancer cells have high levels of a protein called BCL-2, which helps them stay alive longer than normal and makes the cancer harder to treat. Beqalzi works by blocking this protein, causing cancer cells with high BCL-2 levels to break apart and die.

How is Beqalzi supplied (dosage forms)?

Brands and other names

  • Beqalzi

Dosage forms and strengths

  • 1 mg, 5 mg, 20 mg, 80 mg oral tablets

How should I store Beqalzi?

Store Beqalzi at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Do not remove Beqalzi from its blister pack until you are ready to take it.

Side Effects

What are the most common side effects of Beqalzi?

The most common side effects of Beqalzi are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Infections, including pneumonia (see below) 
  • Tiredness
  • Low white blood cell levels (see below)

There may be other side effects of Beqalzi that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Beqalzi?

While less common, the most serious side effects of Beqalzi are described below, along with what to do if they happen.

Severe Allergic Reactions. Beqalzi may cause allergic reactions, which can be serious. Stop taking Beqalzi and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Tumor Lysis Syndrome. Beqalzi can cause a fast breakdown of cancer cells. This can lead to a condition called tumor lysis syndrome (TLS), which can be serious. It is important to drink plenty of water before and while taking Beqalzi. Keep all appointments for blood work so your health care provider can see how your body is responding to Beqalzi. Tell your health care provider right away if you have any of the following signs of TLS. 

  • Nausea and vomiting
  • Weakness
  • Swelling or fluid retention
  • Shortness of breath
  • Muscle cramps
  • Seizures

Low White Blood Cell Levels. Beqalzi may cause low levels of white blood cells, including neutrophils and lymphocytes. These white blood cells are important for fighting off infections. Having low white blood cells may increase your risk of infection. Keep all appointments to have your blood counts checked. Tell your health care provider right away if you have any of the following signs of low white blood cell levels.

  • Fever, chills, or sweats
  • Tiredness
  • Sore throat, cough, or shortness of breath
  • Mouth or throat sores
  • Swollen lymph nodes

Infections. Beqalzi can increase your risk of infections, including serious ones like pneumonia. Call your health care provider right away if you have an infection or any of the following symptoms.

  • Burning or stinging when you pee 
  • Cough or coughing up blood
  • Fever, sweats, chills, or muscle aches
  • Shortness of breath
  • Diarrhea or stomach pain
  • Weight loss

Warnings & Precautions

Who should not use Beqalzi?

Allergies to Ingredients. People who are allergic to any of the following should not take Beqalzi.

  • Beqalzi
  • Sonrotoclax
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Beqalzi.

Drug Interactions. Beqalzi should not be taken while you are using certain other medicines. Before taking Beqalzi, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about Beqalzi before taking it?

Do not take Beqalzi unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share Beqalzi with other people, even if they have the same condition as you. It may harm them.

Keep Beqalzi out of the reach of children.

Take Beqalzi around the same time each day with a meal. Swallow the tablets whole with a glass of water. Do not chew, cut, or crush the tablets.

While taking Beqalzi, it is important to keep all scheduled appointments for blood tests and other lab work so your health care provider can monitor your treatment and check for side effects. In some cases, you may need to take Beqalzi in a hospital or medical office so your care team can watch for a serious condition called tumor lysis syndrome (TLS). See the Side Effects section for more details.

To help lower your risk of TLS, it is important to stay well hydrated while taking Beqalzi. Drink about 6 to 8 glasses (about 1.5 to 2 liters) of water each day starting 1 to 2 days before your first dose, on the day of your first dose, and each day your dose is increased. Follow all instructions from your health care provider.

Contact your health care provider right away if you have a fever or any symptoms of an infection, such as chills, cough, sore throat, or feeling unusually weak or ill.

People who are 65 and older can be at greater risk of serious side effects from Beqalzi. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before taking Beqalzi?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Beqalzi is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Kidney or liver problems
  • Problems with the balance of fluids and electrolytes in your blood
  • Gout or history of high uric acid levels in your blood

Pregnancy. Beqalzi may cause harm to a fetus. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider may do a pregnancy test before you start Beqalzi. If you or your partner can get pregnant, use effective birth control or condoms while taking Beqalzi and for at least 1 week after your last dose. 

While pregnancy should be avoided during treatment, Beqalzi may make it hard for you to get pregnant or get your partner pregnant in the future. If you have concerns about this, talk to your health care provider.

Breastfeeding. Breastfeeding is not recommended while taking Beqalzi and for at least 1 week after your last dose. It is not known if Beqalzi passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. 

How can I get more information about Beqalzi?

For more information about Beqalzi, you can visit the drugmaker’s website at www.beonemedicines.com or call them at 877-828-5568.

Interactions

Does Beqalzi interact with foods or drinks?

Take Beqalzi with a meal. Do not eat grapefruit, Seville oranges, star fruit, or any foods or drinks that contain these fruits while taking Beqalzi. Consuming these fruits could increase the levels of Beqalzi in your body and raise the risk of side effects. 

It is unknown if drinking alcohol will affect Beqalzi, but heavy drinking can slow your immune response and make it harder for your body to fight infections and cancer.

Does Beqalzi interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking Beqalzi.

  • Carbamazepine (Carbatrol, Tegretol, and others), which is a medicine commonly used to treat seizures or nerve pain
  • Clarithromycin or erythromycin (Ery-Tab), which is a medicine used for bacterial infections
  • Diltiazem (Cardizem CD and others) or verapamil (Verelan, Verelan PM), which is a medicine used for high blood pressure or other conditions
  • Efavirenz, which is a medicine commonly used to treat HIV
  • Fluconazole (Diflucan), itraconazole (Sporanox, Tolsura), posaconazole (Noxafil), or voriconazole (Vfend), which is a medicine used for fungal infections
  • Phenobarbital, phenytoin (Dilantin, Phenytek, and others), or primidone, which is a medicine for seizures
  • Rifampin (Rifadin), which is a medicine used to treat an infection called tuberculosis
  • Ritonavir (Norvir), lopinavir/ritonavir (Kaletra), or nelfinavir (Viracept), which is a medicine used to treat HIV
  • St. John’s wort, which is a supplement that may be used for depression

Some other medicines may alter the blood levels of Beqalzi. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Beqalzi. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Beqalzi?

If you or someone else has used too much Beqalzi, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Beqalzi?

Beqalzi should be taken at the same time each day. If you miss a dose by less than 8 hours of when you normally take it, take your dose as soon as possible with a meal. If you miss a dose by more than 8 hours, skip the missed dose and take your next dose the following day at your usual time. Do not take double or extra doses.

If you vomit after taking Beqalzi, do not take another dose that day. Take your next dose the following day at your usual time.