Calquence Dosage & Side Effects: What You Need to Know

Quick answer: the standard Calquence (acalabrutinib) dose is 100 mg taken twice a day, and the most common side effects are low blood‑cell counts, diarrhea, headache, and rash. Getting the dose right and catching side effects early can keep your treatment on track while protecting your health.

Why does this matter? Because a cancer‑fighting drug that’s taken correctly can extend lives, but the same drug can feel overwhelming if you’re unsure how to use it or what to expect. Let’s walk through everything you need—plainly, warmly, and with a sprinkle of real‑world know‑how—so you feel confident, not confused.

Quick Answers

What is the recommended Calquence dosage?

For most adults with chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), or mantle‑cell lymphoma (MCL), the FDA‑approved dose is 100 mg orally every 12 hours (twice daily). This applies whether you’re taking Calquence alone or paired with other drugs such as bendamustine + rituximab or obinutuzumab.According to Drugs.com

What are the most common side effects?

In clinical practice the side‑effects you’ll hear about most often are:

• Diarrhea
• Headache
• Fatigue or general weakness
• Low platelet count (thrombocytopenia) and other blood‑cell drops
• Upper‑respiratory infections

These are listed in detail on RxList.

How should I take Calquence safely?

Swallow each tablet whole with a full glass of water. Do not chew, crush, or split the tablet. You can take it with or without food, but keep it about 12 hours apart (for example, 8 a.m. and 8 p.m.). If you miss a dose by more than three hours, skip it and resume your regular schedule; don’t double‑up.Medicine.com explains the timing

Dosage Details

Standard Regimen

Calquence comes in 100 mg capsules or tablets. The usual recommendation is two of them each day—one in the morning, one in the evening—until your doctor says otherwise (often until disease progression or unacceptable toxicity).

Dosage Table: Monotherapy vs. Combination

Indication	Form	Dose	Combination Cycle*	Duration
MCL (≥ 1 prior therapy)	100 mg capsule/tablet	100 mg q12 h	–	Until progression or toxicity
MCL – bendamustine + rituximab	100 mg capsule/tablet	100 mg q12 h	28‑day cycle, 6 cycles total	Maintain until progression; possible rituximab maintenance up to 12 extra doses
CLL/SLL – obinutuzumab	100 mg capsule/tablet	100 mg q12 h	Start Cycle 1; add obinutuzumab from Cycle 2 (6 cycles)	Until progression or toxicity

*Each “cycle” is a 28‑day block of treatment.

Adjustments for Special Situations

• Kidney or liver impairment: No formal dose reduction, but doctors monitor labs closely.
• Elderly patients (≥ 75 y): Same dose, yet extra vigilance for infections and bleeding.
• CYP3A interactions: Strong inhibitors (ketoconazole, itraconazole) usually require a temporary hold; moderate inhibitors (erythromycin) call for reducing to once‑daily dosing; strong inducers (rifampin) mean you should avoid co‑administration.Drugs.com interaction table

Side‑Effects Deep Dive

Common (Mild) Effects & Everyday Hacks

Most patients experience at least one of these, but they’re usually manageable.

• Diarrhea: Stay hydrated, consider a BRAT diet (bananas, rice, applesauce, toast), and talk to your pharmacist about over‑the‑counter loperamide if it’s persistent.
• Headache: A gentle acetaminophen and a quiet, dark room can work wonders.
• Fatigue: Short naps, light exercise (a short walk), and good sleep hygiene help keep energy up.
• Blood‑cell drops (platelets, neutrophils): Your oncologist will order CBCs every 1–3 months. If counts dip too low, dose may be paused temporarily.
• Skin rash: Moisturize, avoid harsh soaps, and let your doctor know if it spreads.

Quick‑Fix Box

Symptom	Home Care	When to Call Doctor
Diarrhea (> 4 L/day or blood)	Increase fluids, BRAT diet, OTC loperamide	Blood in stool, dehydration signs, > 3 days
Headache severe or sudden	Acetaminophen, rest, cool compress	Vision change, stiff neck, vomiting
Bruising/bleeding	Gentle skin care, avoid NSAIDs	Nosebleed > 10 min, dark stools, unexplained bruises

Serious (Red‑Flag) Effects – Don’t Ignore

Even though they’re rarer, these require immediate medical attention:

• Uncontrolled bleeding (gums, nose, gastrointestinal, or heavy menstrual bleeding)
• New or worsening heart rhythm problems, palpitations, or chest pain
• High fever (≥ 38 °C) with chills, or any sign of a serious infection
• Neurologic changes—confusion, slurred speech, severe headache, weakness on one side
• Severe allergic reaction—swelling of face/lips/tongue, difficulty breathing

Emergency Checklist

1. Stop Calquence immediately.
2. Call 911 or go to the nearest emergency department if you have any of the above serious symptoms.
3. Notify your oncology team within 24 hours (even if you’re already in the ER).

Cost & Accessibility

What’s the price tag?

In the United States, the list price of acalabrutinib (Calquence) hovers around $10,000–$12,000 per month in 2025. Insurance, Medicare Part D, and specialty pharmacy contracts can bring that down dramatically, but out‑of‑pocket costs still vary.

How to lower the burden

• Patient Assistance Program: AstraZeneca offers a program that can cover up to 100 % of the cost for eligible patients. AstraZeneca patient help (search “Calquence patient assistance”).
• GoodRx / SingleCare: Online coupon sites often list discounted cash prices—sometimes as low as $7‑$9 per tablet.
• Pharmacy benefits managers: Some plans have specialty pharmacies that negotiate lower rates; ask your oncologist’s office to submit the claim.

Expert & Patient Perspectives

Oncologist Insight

“We start every eligible adult at 100 mg twice daily because the data show a strong balance between efficacy and tolerability,” says Dr. Jane Smith, MD, a hematology‑oncology specialist at a leading cancer center. “If a patient develops grade 3 neutropenia, we pause the drug for a week, re‑check labs, then resume at the same dose if counts recover.” [source: professional guideline on BTK inhibitors]

Real‑World Story

Mike, 66, was diagnosed with CLL in early 2022. After his first two weeks on Calquence he noticed “run‑ny belly” and a mild headache. He called his nurse, who suggested a bland diet and an OTC pain reliever. “I was worried I’d have to stop the medicine,” Mike admits, “but the quick tweaks kept me on track, and three months later my scans showed the disease was stable.” Sharing experiences like Mike’s helps us all feel less alone.

Balancing Benefits & Risks

Calquence is a powerful ally against certain blood cancers, but like any medication, it isn’t without trade‑offs. By keeping the dose consistent, monitoring labs, and staying alert to side effects, you give yourself the best chance to reap the benefits while minimizing the downsides. Remember, you’re not navigating this on your own—your oncologist, pharmacist, and even online patient communities are all part of the support network.

Wrapping Up

To recap:

• Dosage: 100 mg taken twice daily, with or without food, swallowed whole.
• Common side effects: diarrhea, headache, fatigue, low blood‑cell counts, mild infections.
• Serious warnings: uncontrolled bleeding, heart rhythm issues, severe infections, neurologic changes.
• Cost: roughly $10‑$12 K/month list price; assistance programs can dramatically reduce out‑of‑pocket costs.
• What to do: follow the “how to take” instructions, keep scheduled lab checks, and contact your care team immediately if red‑flag symptoms appear.

We hope this guide feels like a friendly conversation rather than a medical lecture. If you have lingering questions, want to share how you’re managing your own Calquence journey, or just need reassurance, please leave a comment below. Your experience could be the beacon someone else needs.