An oral medicine for multiple myeloma
Ixazomib
An oral capsule used to treat multiple myeloma, taken together with lenalidomide and a steroid.
What is Ixazomib?
Ixazomib is a specialist oral medicine used to treat multiple myeloma, a cancer of certain blood cells in the bone marrow. It is taken as a capsule, usually once a week on set days, together with two other medicines (lenalidomide and the steroid dexamethasone). It works by blocking the cell's protein-clearing machinery (the proteasome), which the cancer cells rely on. Common effects include a drop in platelets (raising bruising and bleeding risk), nerve problems in the hands and feet, tummy upset and rash. It is prescribed and closely monitored by a cancer specialist.
Education and reference only. This is a plain-language guide to Ixazomib — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Ixazomib is a medicine used to treat multiple myeloma, a cancer of plasma cells in the bone marrow. It belongs to a group called proteasome inhibitors, and unlike some others in this group it is taken by mouth as a capsule rather than by injection. It is used in combination with lenalidomide and the steroid dexamethasone, usually in people who have had previous treatment. Because it is a cancer treatment with important side effects, it is prescribed and supervised by a specialist haematology or oncology team, with regular blood tests and reviews.
How it works
Cells use a structure called the proteasome to break down and clear away unwanted proteins. Cancerous plasma cells in myeloma make large amounts of protein and depend heavily on the proteasome to cope. Ixazomib blocks the proteasome, so faulty proteins build up inside the cancer cells and push them towards dying. Used alongside lenalidomide and dexamethasone, it helps control the myeloma. Because it is taken by mouth on a weekly schedule, sticking to the set days and the cycle plan is an important part of treatment.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist oral medicine used in the UK for multiple myeloma, taken in combination with two other medicines.
Practical use
How to take Ixazomib
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the capsule whole by mouth on the set days of your cycle, usually once a week, at about the same time.
- Take it on an empty stomach, at least an hour before or two hours after food, and swallow it whole without crushing or chewing.
- Take it together with your other myeloma medicines exactly as your specialist team has planned.
- Report numbness, tingling or pain in your hands or feet, and any unusual bruising or bleeding, promptly.
- Keep all your blood-test and clinic appointments so treatment can be monitored and adjusted.
Weighing it up
Advantages & disadvantages of Ixazomib
Advantages
- An effective treatment for multiple myeloma when used with lenalidomide and a steroid.
- Taken by mouth as a once-weekly capsule rather than by injection.
- Allows much of the treatment to be managed at home between clinic reviews.
Disadvantages
- Can lower platelets, increasing the risk of bruising and bleeding.
- Can cause nerve problems such as numbness, tingling or pain in the hands and feet.
- Commonly causes tummy upset and skin rash, and needs regular blood monitoring.
Practical use
Good to know
The key thing to know is that ixazomib is part of a three-medicine combination, taken with lenalidomide and dexamethasone, and is usually taken once a week on the same days during each treatment cycle, on an empty stomach. The most important side effects to watch for are a fall in platelets, which can cause easy bruising or bleeding and is checked with regular blood tests, and nerve problems (peripheral neuropathy) such as numbness, tingling or pain in the hands and feet, which should be reported early. Tummy upset, including nausea, diarrhoea or constipation, and skin rash are also common. It is a specialist treatment that needs regular blood monitoring, so attending appointments and reporting new symptoms promptly is essential.
Who should not take it / use with caution
- People who have had a serious allergic reaction to ixazomib should not take it.
- It is not used in pregnancy, and effective contraception is needed, partly because it is combined with lenalidomide.
- It is used with care, with dose adjustment, in people with significant liver or kidney problems.
- It should only be used under specialist haematology or oncology supervision.
Monitoring
- Regular blood tests to check platelets and other blood counts.
- Watching for and reviewing nerve symptoms in the hands and feet.
- Checking liver function and overall response to treatment over time.
Side effects
- A drop in platelets, causing easy bruising or bleeding.
- Nerve problems such as numbness, tingling or pain in the hands and feet.
- Tummy upset, including nausea, diarrhoea or constipation.
- Skin rash, tiredness and swelling of the lower legs.
Key interactions
- Some medicines that strongly affect the liver enzymes can change ixazomib levels, so give a full medicines list.
- It is used alongside lenalidomide and dexamethasone, which have their own effects and precautions.
- Tell your team about all medicines, supplements and herbal products, including St John's wort.
Available as: Capsules taken by mouth.
Answers
Ixazomib: frequently asked questions
What is ixazomib used for?
It is used to treat multiple myeloma, a cancer of plasma cells in the bone marrow, taken in combination with lenalidomide and the steroid dexamethasone.
How is it taken?
It is taken by mouth as a capsule, usually once a week on set days during each treatment cycle, on an empty stomach and swallowed whole.
Why are blood tests needed?
Ixazomib can lower platelets and other blood cells, so regular blood tests are used to check counts and to guide whether the dose needs adjusting.
What are the nerve problems to watch for?
Some people get numbness, tingling or pain in the hands and feet (peripheral neuropathy), which should be reported early so it can be managed.
Can I take it during pregnancy?
No. It is not used in pregnancy and effective contraception is needed, partly because it is combined with lenalidomide, which can harm a developing baby.
Authoritative sources
- BNF
- NICE CKS
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