It’s important that you partner with your healthcare team to create a treatment plan that works for you.

• have had recent surgery or plan to have surgery. Your doctor may stop CALQUENCE^® for any planned medical, surgical or dental procedure
• have bleeding problems
• have or had heart rhythm problems
• have an infection
• have or had liver problems, including hepatitis B virus (HBV) infection
• are pregnant or plan to become pregnant. CALQUENCE^® may harm your unborn baby and cause problems during childbirth
• are breastfeeding or plan to breastfeed. It is not known if CALQUENCE^® passes into your breast milk. Do not breastfeed during treatment with CALQUENCE^® and for at least 2 weeks after your final dose of CALQUENCE^®.

Before we discuss how to take CALQUENCE^®, remember that your doctor knows you and your treatment goals, which is why it’s important to take CALQUENCE^® exactly as prescribed.

Here are some tips to help you remember to take CALQUENCE^® twice a day (and avoid accidentally missing a dose):

• Set 2 separate alarms — like 8 am and 8 pm — for the times when you’re supposed to take CALQUENCE^®
• Keep CALQUENCE^® somewhere easy to see and easy to remember, like the kitchen

The best way to continuously block the target, BTK, is by taking CALQUENCE^® as your doctor recommends: twice a day — approximately every 12 hours. Missing doses may negatively impact your treatment goals. And, of course, please talk with your doctor before doing or changing anything.

• If you miss a dose of CALQUENCE^®, take it as soon as you remember
• If it’s more than 3 hours past your usual dosing time, skip the missed dose and take your next dose of CALQUENCE^® at your regularly scheduled time
• Definitely don’t take an extra dose to make up for missing one
• Don’t change your dose or stop taking CALQUENCE^® even if you do not have symptoms or your condition seems improved, unless your doctor tells you to do so
• Your doctor may decrease your dose, stop treatment temporarily, or take you off CALQUENCE^® completely if certain side effects develop
• It is important to understand why your doctor has changed your dose, so always ask this question
• If you take too much CALQUENCE^®, call your doctor or the Poisons Information Centre (13 11 26) for advice, or go to the nearest hospital or emergency room right away.

You may have side effects with CALQUENCE^®, and it’s important to know what they might be and how you may be able to manage some of them. Remember that everyone’s treatment experience is different, so talk with your doctor about any side-effects you experience. Preventing and managing side effects from treatment may help you stay on treatment, so be sure to keep your doctor updated in real time.

Some side effects of CALQUENCE^® are more common than others in people with MCL or CLL, they include:

That said, there are also more serious side effects that can occur:

Bleeding problems (haemorrhage) may happen during treatment with CALQUENCE^®, and can be serious. Risk of bleeding may increase if you are also taking a blood thinner medicine. Tell your doctor if you have any signs or symptoms of bleeding, including:

• Blood in your stools or black stools (looks like tar)
• Pink or brown urine
• Unexpected bleeding, or bleeding that is severe or you cannot control
• Vomiting blood or vomit that looks like coffee grounds
• Coughing up blood or blood clots

Infections can happen during treatment with CALQUENCE^®. These infections can be serious. Tell your doctor right away if you have fever, chills, body aches, cold or flu symptoms, feel tired or feel short of breath.

Decrease in blood cell counts. Decreased blood counts (white blood cells, platelets and red blood cells) are common with CALQUENCE^®, but can also be severe. Your doctor will do blood tests to check your blood counts and will decide how often to do blood tests.

Second primary cancers. Like other cancer medicines, new cancers, including skin cancers, have been known to occur in patients taking CALQUENCE^®. It is therefore important to use sun protection when you are outside in sunlight.

Heart rhythm problems (atrial fibrillation and atrial flutter) have happened in people treated with CALQUENCE^®. Your doctor may do a test to check your heart. Tell your doctor if you have (or have had in the past) any of the following signs or symptoms:

• Fast or irregular heartbeat
• Dizziness
• Feeling faint
• Chest discomfort
• Shortness of breath

• If you’re travelling, take CALQUENCE^® with you and make a plan for when to take it
• If you’re travelling for a while, double check that you packed the right number of doses: 2 tablets or capsules for each day you’ll be away, unless your doctor has prescribed a different dose
• It is always good to have an extra couple of days of tablets or capsules, in case the trip lasts longer than expected
• CALQUENCE^® should always be stored in a safe place, at room temperature and out of reach of children
• If the trip involves air travel, medicines should be kept in a carry-on bag to reduce the chance of missing a dose or losing them
• Be sure you travel with your doctor's contact details in case you become unwell
• Talk with your doctor about whether there are potential health risks associated with travelling before you leave

Regular check-ups and occasional blood tests will help your doctor determine whether CALQUENCE^® is effective in treating your condition. It’s very important to keep your appointments with your doctor – it’s the only way your doctor can monitor how you’re responding to your treatment.

If your disease is responding to treatment and not progressing, your doctor may want you to stay on CALQUENCE^® for a very long time. Unlike some chemotherapy treatments that you receive at intervals, CALQUENCE^® is taken every day, twice a day. This is because it only works when it's in your body, and each dose needs to be replaced.

To benefit from treatment, it’s important to continue taking CALQUENCE^® exactly as prescribed by your doctor.

• As an average appointment with a doctor can last 15 minutes or less, it’s best to be prepared. If you or your friend or loved one have questions, take a list to each appointment. Topics can include:
• Your general wellbeing since the last visit
• Side effects and how to manage them
• Problems taking CALQUENCE^® as prescribed
• Any questions you may want to discuss like travel plans or other vaccinations; no questions are silly

• Take a notebook so you can keep track of results or questions you may have to review later

Ensure you keep your doctor's contact details and the hospital clinic number handy in case you have a question. As it is common for patients to be taking multiple medications for different health conditions, it is a good idea to keep a list of your prescribed medicines and supplements for your doctor to review at each visit.