How it Works

Ninlaro (ixazomib) works by inhibiting proteasomes. These proteasomes are necessary for many critical cellular functions (growth, division, and survival). 

When Ninlaro (Ixazomib) inhibits proteasome function, the normal balance within a cell is disrupted, the myeloma cells stop digesting proteins (leading to a large protein buildup, which becomes toxic for the cell), halting the cell division and chemical production that stimulate other myeloma cells, resulting in the myeloma cells’ death. 

It is important to mention that myeloma cells are more sensitive to these effects than normal cells, so myeloma cells die while normal cells can recover.

How it’s Administered

NINLARO (ixazomib) is a capsule you take once a week for three weeks of a 4-week cycle. NINLARO is typically taken along with two other medications, REVLIMID (lenalidomide) and dexamethasone, in 4-week cycles.

If you miss a dose of NINLARO, you can take the missed dose as long as the next scheduled one is more than three days away. NINLARO is absorbed into your body very quickly.

Who Should Take Ninlaro

NINLARO is currently approved for:

• People who have received at least one prior treatment for their multiple myeloma

Who Shouldn’t Take Ninlaro

• Pregnant patients
• Patients currently taking strong CYP3A inducers (such as rifampin, phenytoin, carbamazepine, and St. John’s Wort)

The Most Common Side Effects of Taking Ninlaro Include: 

• Thrombocytopenia (low platelet counts)
• Gastrointestinal Toxicities (diarrhea, constipation, nausea, and vomiting)
• Peripheral Neuropathy
• Peripheral Edema (swelling of the hands and feet)
• Cutaneous Reactions (rash)
• Damage that can occur in the smallest blood vessels
• It can cause toxicity in the liver

Commonly Used With

• Combination chemotherapy with lenalidomide and dexamethasone.

Currently Being Tested With Ninlaro

• Immunomodulators (IMiDs): Lenalidomide,Pomalidomide
• Corticosteroid: Dexamethasone
• Monoclonal Antibodies: Daratumumab, Nivolumab
• Alkylating Agents: Cyclophosphamide
• Antibiotics with antineoplastic activity: Clarithromycin

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