Drug Action
Ixazomib is a proteasome inhibitor.
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Drug reference
Ixazomib is a proteasome inhibitor.
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Multiple myeloma in patients who have received at least one prior therapy, in combination with lenalidomide and dexamethasone (specialist use only) ▶BY MOUTH ▶Adult: 4 mg once weekly on days 1, 8, and 15 of a 28-day treatment cycle, for dose adjustments due to side-effects, consult product literature
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Risk of herpes zoster reactivation CAUTIONS, FURTHER INFORMATION ▶Herpes zoster reactivation Manufacturer advises consider concomitant antiviral prophylaxis to decrease the risk of herpes zoster reactivation.
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NICE decisions ▶Ixazomib with lenalidomide and dexamethasone for treating relapsed or refractory multiple myeloma (February 2018) NICE TA505 Ixazomib, with lenalidomide and dexamethasone, is recommended for use within the Cancer Drugs Fund as an option for treating multiple myeloma in adults only if: . they have already had 2 or 3 lines of therapy, and . the conditions in the managed access agreement for ixazomib are followed. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta505
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RISKS OF INCORRECT DOSING OF ORAL ANTI-CANCER MEDICINES See Cytotoxic drugs p. 938.
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→Appendix 1: ixazomib
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▶Common or very common Back pain. constipation. diarrhoea. increased risk of infection. nausea. neutropenia. peripheral neuropathy (monitor for symptoms). peripheral oedema. rash. thrombocytopenia. vomiting ▶Frequency not known Posterior reversible encephalopathy syndrome (PRES) (discontinue)
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Manufacturer advises effective contraception in women of child-bearing potential and in men with a partner of child-bearing potential, during treatment and for at least 90 days after stopping treatment; additional barrier method recommended in women using hormonal contraceptives.
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Manufacturer advises avoid—toxicity in animal studies. See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Manufacturer advises avoid—no information available.
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Manufacturer advises caution in moderate to severe impairment (risk of increased exposure). Dose adjustments Manufacturer advises dose reduction to 3 mg in moderate to severe impairment.
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Dose adjustments Manufacturer advises reduce dose to Immune system and malignant disease 3 mg in severe impairment (creatinine clearance less than 30 mL/min).
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Manufacturer advises to monitor hepatic function regularly and adjust dose accordingly—consult product literature.
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There can be variation in the licensing of different medicines containing the same drug. Capsule CAUTIONARY AND ADVISORY LABELS 23, 25 ▶Ninlaro (Takeda UK Ltd) A Ixazomib (as Ixazomib citrate) 2.3 mg Ninlaro 2.3mg capsules | 3 capsule P £6,336.00 Ixazomib (as Ixazomib citrate) 3 mg Ninlaro 3mg capsules | 3 capsule P £6,336.00 Ixazomib (as Ixazomib citrate) 4 mg Ninlaro 4mg capsules | 3 capsule P £6,336.00 ANTINEOPLASTIC DRUGS › PROTEIN KINASE INHIBITORS
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Missed doses Manufacturer advises if less than 72 hours remain before the next scheduled dose, the missed dose should not be taken and the next dose should be taken at the normal time.
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4 mg once weekly on days 1, 8, and 15 of a
First-line fragment. Read the complete Indications and Dose section above.
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