Ixazomib Citrate
Class: Antineoplastic Agents
- Proteasome Inhibitors
Chemical Name: 2-[(1R)-1-[[2-[(2,5-Dichlorobenzoyl)amino]acetyl]amino]-3-methylbutyl]-5-oxo-1,3,2-Dioxaborolane-4,4-diacetic acid
Molecular Formula: C20H23BCl2N2O9
CAS Number: 1239908-20-3
Brands: Ninlaro
Introduction
Antineoplastic agent; inhibitor of 20S proteasome.
Uses for Ixazomib Citrate
Multiple Myeloma
Used in combination with lenalidomide and dexamethasone for previously treated (≥1 prior therapy) multiple myeloma (designated an orphan drug for this use).
Ixazomib Citrate Dosage and Administration
General
Pretreatment Screening
Confirm absolute neutrophil count (ANC) is ≥1000/mm3 and platelet count ≥75,000/mm3 before initiating each cycle of therapy.
Verify pregnancy status in females of reproductive potential.
Patient Monitoring
Monitor platelet counts at least monthly. Consider more frequent monitoring during the first 3 treatment cycles.
Monitor patients for symptoms of peripheral neuropathy.
Monitor for signs and symptoms of thrombotic thrombocytopenic purpura or hemolytic uremic syndrome.
Monitor hepatic enzymes regularly.
Premedication and Prophylaxis
Consider antiviral prophylaxis to decrease risk of herpes zoster virus reactivation. In clinical studies, antiviral prophylaxis was associated with reduced incidence of herpes zoster infection.
Dispensing and Administration Precautions
- Handling and Disposal
Consult specialized references for procedures for proper handling and disposal of antineoplastics.
Avoid direct contact with capsule contents. If capsule breakage occurs, avoid direct contact of contents with skin or eyes. If contact occurs, wash skin thoroughly with soap and water; flush eyes thoroughly with water.
Other General Considerations
When used in combination with lenalidomide and dexamethasone, consider cautions, precautions, and contraindications of lenalidomide and dexamethasone.
Administration
Oral Administration
Administer orally once weekly on the same day and at approximately the same time for the first 3 weeks of each 4-week cycle.
Administer orally at least 1 hour before or at least 2 hours after food.
Do not administer ixazomib and dexamethasone simultaneously on days when both drugs are scheduled; administer dexamethasone with food and give ixazomib on an empty stomach.
Swallow capsules whole with water; do not crush, chew, or open.
If vomiting occurs following administration, do not repeat the dose. Resume therapy at time of next scheduled dose.
If a dose is delayed or missed, administer the dose only if there are at least 72 hours until the next scheduled dose. Do not administer a missed dose within 72 hours of the next scheduled dose; .
