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Ixazomib (Ninlaro®)

UPMC Content 2

About This Drug

Ixazomib is used to treat cancer. It is given orally (by mouth).

  • Nausea and throwing up (vomiting).
  • Constipation (not able to move bowels)
  • Loose bowel movements (diarrhea)
  • Back pain
  • Swelling of your legs, ankles and/or feet
  • A decrease in the number of platelets. This may raise your risk of bleeding.
  • Effects on the nerves are called peripheral neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped but it does not get better in all people.

Note: Each of the side effects above was reported in 20% or greater of patients treated with Ixazomib. Not all possible side effects are included above.

Warnings and Precautions

  • Changes in liver function. Your doctor will check your liver function as needed.
  • Rash

How to Take Your Medication

  • Swallow the medicine whole with a full glass of water (8 ounces). Do not crush, chew or open the capsules.
  • Take this drug by mouth without food, at least 1 hour before you eat or 2 hours after you eat, at approximately the same time each time it is scheduled.
  • Do not take your dexamethasone at the same time you take ixazomib. Take dexamethasone with food, take ixazomib without food.
  • Missed dose: If you miss a dose, and it is less than 72hrs until your next dose, then skip the missed dose and go back to your normal schedule. If you miss a dose, and it is more than 72hrs until your next dose, take it as soon as you think about it. Do not take 2 doses at the same time or extra doses. Do not make up a vomited dose.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • If you get any of the content of a broken capsules on your skin or in your eyes, you should wash the area of the skin well with soap and water right away. Wash your eyes with flowing water for at least 15 minutes and call your doctor. Call your doctor if you get a skin reaction
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • Ask your doctor or nurse about medicines that are available to help stop or lessen constipation, diarrhea and/or nausea.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping. Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • Manage tiredness by pacing your activities for the day. Be sure to include periods of rest between energy-draining activities.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • Talk to your doctor or nurse about precautions you can take to avoid infections and/or bleeding.

Food and Drug Interactions

  • There are no known interactions of ixazomib with food.
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are a lot of known drug interactions with ixazomib. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions.
  • Avoid the use of St. John’s Wort while taking ixazomib as this may lower the levels of the drug in your body, which can make it less effective.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Easy bleeding or bruising
  • Wheezing or trouble breathing
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or lightheadedness
  • Blurred vision or other changes in eyesight
  • Confusion or agitation
  • Nausea that stops you from eating or drinking, and/or that is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • No bowel movement for 3 days or you feel uncomfortable
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and
  • Heavy menstrual period that lasts longer than normal
  • If you think you are pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. It is recommended that effective methods of birth control should be used by women who could become pregnant and by men with partners who could become pregnant during cancer treatment and for at least 90 days after treatment. Females are strongly encouraged to use both hormonal birth control (i.e., pill) and a barrier method (i.e., condom, diaphragm).
  • Breast feeding warning: Women should not breast feed during treatment and for 90 days after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.

New June 2017