Summary for doctors
- Newly diagnosed AML at age 75 and over or with coexisting conditions [1].
- Venetoclax ramp-up 100, 200, 400 mg over the first 3 days [1].
- White cell count below 25,000 before starting (hydroxyurea).
- With azoles, the venetoclax dose must be reduced.
Dose and schedule
Aza/Ven
AML, unfit for intensive treatmentEach drug’s schedule in the table
AML, unfit for intensive treatment
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Azacitidine | 75 mg/m² | Subcutaneous or IV | Days 1 to 7 |
| Venetoclax | 100 mg on day 1, 200 on day 2, then 400 mg | Oral, with food | Days 1 to 28 (continuous) |
As in VIALE-A [1]. With posaconazole, venetoclax 70 mg; with voriconazole 100 mg.
Evidence: VIALE-A (2020)
Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.
Premedication and supportive care
- Tumour lysis prevention in cycle 1: hydration, allopurinol, blood tests before each dose increase and 6 to 8 hours afterwards.
- Antifungal (with venetoclax dose adjustment) and antiviral prophylaxis.
Monitoring and dose adjustment
- Bone marrow at the end of cycle 1 (around day 21 to 28): if blasts are below 5% and counts are low, hold venetoclax until recovery and shorten it in later cycles (for example 21 or 14 days).
- Febrile neutropenia is common; G-CSF in complete remission with prolonged neutropenia.
Main evidence
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VIALE-A: median survival 14.7 vs 9.6 months with azacitidine alone; complete remission or complete remission with incomplete count recovery 66.4% vs 28.3% [1].
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Treatment regimens (physicians)
Physician tools and lessons
References
3 referencesShow all references, 1 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1
- 2VENCLEXTA (VENETOCLAX) — Prescribing Information
- 3VIDAZA (AZACITIDINE) — Prescribing Information
This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/azacitidine-venetoclax/