How it is administered

Ixazomib is taken by mouth as a capsule. It is available in 2.3 mg, 3 mg, and 4 mg strengths. The usual recommended starting dose is 4 mg, taken once a week on the same day and at the same time for the first three weeks of a four-week cycle. The capsule should be swallowed whole with water, at least one hour before or at least two hours after food. Do not crush, chew, or open the capsule.

Ixazomib is used in combination with lenalidomide and dexamethasone for multiple myeloma. Each medication in the combination has its own schedule, so it’s important to follow your healthcare provider’s instructions closely.

How it works

Ixazomib is a type of medicine called a proteasome inhibitor. It works by blocking the action of proteasomes, which are structures inside cells that break down proteins. By inhibiting proteasomes, ixazomib causes an accumulation of unwanted proteins in cancer cells, leading to stress and eventually cell death (apoptosis).

In multiple myeloma, the abnormal plasma cells are especially sensitive to proteasome inhibition. Ixazomib has been shown to kill myeloma cells, including those that have become resistant to other treatments. It is often used in combination with other medications (lenalidomide and dexamethasone) to enhance its effectiveness. This combination can help slow the progression of the disease and improve response rates in patients who have already received at least one prior therapy.

Who Should take it

Ixazomib is indicated for adults with multiple myeloma who have received at least one prior therapy. It is always used in combination with lenalidomide and dexamethasone, not as a single agent.

This medication is not recommended for newly diagnosed patients or for maintenance therapy unless you are part of a controlled clinical trial. Your doctor may recommend ixazomib if your multiple myeloma has come back or has not responded to previous treatments. It is important to discuss your full medical history and other medications with your healthcare provider to determine if ixazomib is appropriate for you.

Who should not take it

There are no absolute contraindications listed for ixazomib, but certain patients should use caution or may need dose adjustments. Patients with moderate or severe liver impairment, severe kidney impairment, or end-stage renal disease may require a lower starting dose.

Ixazomib can cause harm to an unborn baby, so it should not be used during pregnancy. Women of childbearing potential should use effective contraception during treatment and for 90 days after the last dose. Men with female partners of reproductive potential should also use contraception. Ixazomib is not recommended for use in children, as its safety and effectiveness have not been established in pediatric patients.

Commonly used with

Ixazomib is always used in combination with lenalidomide and dexamethasone for the treatment of multiple myeloma. Lenalidomide is an immunomodulatory drug, and dexamethasone is a corticosteroid. This combination has been shown to be more effective than lenalidomide and dexamethasone alone.

Your healthcare provider may also recommend supportive medications, such as antivirals to prevent herpes zoster (shingles), antiemetics for nausea, or medications to manage diarrhea or constipation.

Commonly tested with

Ixazomib has been tested in combination with lenalidomide and dexamethasone in clinical trials for multiple myeloma. It has also been studied with other proteasome inhibitors and immunomodulatory drugs in research settings, but its FDA-approved use is specifically in combination with lenalidomide and dexamethasone for patients who have received at least one prior therapy.