Isazomib is an oral, highly selective proteasome inhibitor. By inhibiting the function of proteasomes within cells, blocking the normal metabolism and breakdown mechanisms of cancer cells, cancer cell death is caused.

1、 Drug name

1. Common name: Ixazomib

2. Product Name: NINLARO ®

2、 Indications

1. Combination of lenalidomide and dexamethasone for the treatment of multiple myeloma patients who have received at least one previous treatment.

2. Not recommended for maintenance therapy or newly diagnosed multiple myeloma (unless in controlled clinical trials).

3、 Specifications and characteristics

Capsule size: 4mg

4、 Main components

1. Active ingredient: ixazomib

2. Accessories: Microcrystalline cellulose, magnesium stearate, talc powder, etc.

5、 Usage and dosage

1. Standard dose: 4mg once a week, taken orally on the 1st, 8th, and 15th days of the 28 day treatment cycle.

2. Combination therapy: Lenalidomide (25mg/day, days 1-21) and dexamethasone (40mg, days 1, 8, 15, 22) should be taken simultaneously.

3. Medication time: It should be taken on an empty stomach, at least 1 hour before meals or at least 2 hours after meals.

6、 Dose adjustment

1. Liver injury: The initial dose for patients with moderate to severe liver injury is reduced to 3mg.

2. Renal injury: For severe renal injury or those requiring dialysis, the starting dose is reduced to 3mg.

3. Adverse reaction adjustment:

Thrombocytopenia (<30000/mm ³) or neutropenia (<500/mm ³): Discontinue medication and reduce dosage after recovery.

4. Peripheral neuropathy (≥ grade 2 with pain): reduce dosage or discontinue medication.

5. Rash (≥ grade 2): Adjust dosage or discontinue medication.

7、 Medication precautions

1. Medication method: Swallow the whole capsule, do not crush, chew or open the capsule.

2. Omission treatment: If it is ≥ 72 hours before the next medication, it can be taken again, otherwise it will be skipped.

3. Post vomiting treatment: No need to take additional medication, follow the original plan for the next dose.

4. Avoid taking dexamethasone with food: Dexamethasone needs to be taken with food, while Isazomib needs to be taken on an empty stomach.

8、 Medication for special populations

1. Pregnant women: May cause fetal damage, contraception should be used until 90 days after the last dose.

2. Breastfeeding period: Breastfeeding is prohibited during the treatment period and within 90 days after the last dose.

3. Children: Safety and efficacy have not been established.

9、 Adverse reactions

1. Common (≥ 20%): thrombocytopenia, neutropenia, diarrhea, constipation, peripheral neuropathy, nausea, peripheral edema, rash, vomiting, bronchitis.

2. Serious adverse reactions: thrombotic microvascular disease, Stevens Johnson syndrome, hepatotoxicity, etc.

10、 Contraindications

There are no clear contraindications, but attention should be paid to allergic reactions.

11、 Drug interactions

Avoid using strong CYP3A inducers (such as rifampicin and phenytoin) in combination, as it may reduce the efficacy of isazomib.

12、 Storage method

Store at room temperature (≤ 30 ° C), do not freeze.

Keep the original packaging until before taking, avoiding direct contact with the contents of the capsule.

Ixazomibinformation