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Generic Name: Ninlaro
Dosage form: oral capsule (2.3 mg; 3 mg; 4 mg)
Drug class: antiprotease inhibitors

What is Ixazomib?

Ixazomib can be used to treat multiple myeloma in adults in combination with lenalidomide or dexamethasone. This combination is typically given when at least one other cancer medication has failed.

Ixazomib is not recommended for people receiving maintenance treatment or newly diagnosed with myeloma. This does not apply to participants in controlled clinical trials. Ixazomib can be used in other ways not mentioned in this guide.

Side effects of Ixazomib

If you experience symptoms of an allergic reaction, such as hives, difficulty breathing, swelling on your face or in your throat, or a severe reaction to the skin (fever or sore throat with mouth sores or burning eyes), or if there is a severe reaction to the skin (red or purple skin rash, blisters and peeling, or skin pain), seek emergency medical attention.

Ixazomib may cause dangerous blood clots inside the small vessels of your organs, such as your kidneys or brain. If you experience symptoms such as fever, fatigue, decreased urination, or nosebleeds, seek medical attention immediately.

Ixazomib can cause serious side effects. If you experience:

  • Severe ongoing nausea, vomiting, diarrhoea, or constipation;
  • A new rash or one that is worsening;
  • Blurred vision or dry eyes
  • Backache
  • Fluid retention: swelling of the hands and feet; rapid weight increase;
  • Jaundice (yellowing skin or eyes) is a sign of liver disease.
  • Low levels of platelets can cause easy bruising, unusual blood loss, or purple or red patches under the skin.
  • Low white blood cell count—fever or cold symptoms; cough; sore throats, swollen lips, skin lesions, swollen gingiva, and sore throats
  • Nerve problems: numbness, tingling, or burning in the hands or feet; weakness in the arms or legs.
  • Signs of shingles include flu-like symptoms and a tingly or painful blistering skin rash on the affected side.

Side effects of ixazomib include:

  • You may have swelling or nerve pain in your hands and feet.
  • Low blood platelets
  • Diarrhoea, constipation;
  • Nausea, vomiting,
  • Back pain is a common complaint.

There may be other side effects. For medical advice on side effects, call your doctor. The FDA can be contacted at 1-800-FDA-1088 to report side effects.

Similar/related drugs

Blenrep, Tecvayli, Xpovio, Kyprolis, Elrexfio, Talvey, and Revlimid


If you or your partner are pregnant or taking lenalidomide, it can cause serious birth defects and even death for the baby.

Before you take this drug

If you have an allergy to ixazomib, then it is best not to use it.

Inform your doctor of any of the following conditions:

  • Liver disease
  • Kidney disease (or dialysis if you have it)

Ixazomib can harm an unborn child. Both women and men should use effective contraception during treatment with ixazomib and for 90 days following the last dose. Use a barrier birth control method such as a diaphragm or cervical cap or a contraceptive sponge if you also take dexamethasone.

Ixazomib and lenalidomide are used together. If you are pregnant or your partner is pregnant, do not take ixazomib and lenalidomide together. Follow all instructions for birth control when using ixazomib and lenalidomide, whether you are a woman or a man. If you become pregnant while taking these medications, either as a mother or father, tell your doctor immediately. Do not breastfeed if you are taking ixazomib or for 90 days following your last dose.

How to take Ixazomib?

Follow all instructions or guides included with your medication and follow them accordingly. Sometimes, your doctor will change the dose. You must take the medication exactly as prescribed.

The 28-day cycle of treatment will include your combination chemotherapy. During the first three weeks of every cycle, you will take ixazomib on the same weekday. You can take your other medications daily or once a week during the entire cycle.

If you have ever had chickenpox or shingles after taking ixazomib, this virus can become active again. Antiviral medications may be prescribed to prevent shingles. Follow your doctor's instructions carefully for the dosage of all your medications. Take ixazomib every day at the same time, on an empty stomach. This should be at least one hour before or two hours after eating.

Take your dexamethasone dosage separately from ixazomib. Dexamethasone is best taken with food, while ixazomib can be taken without. Do not open, crush, chew or break the capsule. Swallow it whole. Take it with water. Do not take a second dose if you vomit soon after taking ixazomib. Do not take another dose until you have taken your next scheduled dose.

You should not use an ixazomib-broken capsule. Do not use a broken ixazomib capsule. Your pharmacist can tell you how to safely dispose of a broken tablet.

It is possible that you will need to undergo frequent medical tests in order to ensure that ixazomib does not cause harmful side effects. These tests may delay your cancer treatment. Store away from moisture or heat at room temperature. Do not freeze. Do not freeze.

Details on dosage

Adult dose for multiple myeloma:

Starting dose: Orally 4 mg once a week, on days 1, 8, and 15 of the 28-day cycle.
Duration of treatment: until disease progression or unacceptable toxicities
Limitations: It is not recommended to use this drug in conjunction with dexamethasone and lenalidomide in patients newly diagnosed with multiple myeloma outside of controlled trials.
The recommended dose for lenalidomide on days 1 through 21 is 25 mg orally every day; the dose for dexamethasone on days 1, 8, 15, and 22 is 40 mg orally.
Consult the manufacturer's product information on lenalidomide or dexamethasone.
Use: For the treatment of multiple myeloma patients who have had at least one prior therapy, in combination with dexamethasone and lenalidomide.

What happens if I miss the dose?

If you miss a dose, take it as soon as possible. Skip the missed dose when your next dose is less than 72 (three) hours away. Never take two doses in one go.

What happens if I overdose?

Call 1-800-222-1222 for poison help or seek immediate medical attention.

What should be avoided?

If your doctor prescribes any restrictions regarding food, beverage, or activity, follow their instructions.

Interaction with other drug

Other drugs, such as vitamins and herbal remedies, may also affect ixazomib. Inform your doctor of all the medicines you are taking and those that you stop or start using.



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