Your Health, We Care
The recommended starting dose of Ixazomib is 4 mg administered orally once a week on Days 1, 8, and 15 of a 28-day treatment cycle.
The recommended starting dose of lenalidomide is 25 mg administered daily on Days 1 through 21 of a 28-day treatment cycle.
The recommended starting dose of dexamethasone is 40 mg administered on Days 1, 8, 15, and 22 of a 28-day treatment cycle.
For additional information regarding lenalidomide and dexamethasone, refer to their prescribing information.
Ixazomib should be taken once a week on the same day and at approximately the same time for the first three weeks of a four week cycle. The importance of carefully following all dosage instructions should be discussed with patients starting treatment. Instruct patients to take the recommended dosage as directed, because overdosage has led to deaths.
Ixazomib should be taken at least one hour before or at least two hours after food. The whole capsule should be swallowed with water. The capsule should not be crushed, chewed or opened.
If a Ixazomib dose is delayed or missed, the dose should be taken only if the next scheduled dose is ≥ 72 hours away. A missed dose should not be taken within 72 hours of the next scheduled dose. A double dose should not be taken to make up for the missed dose.
If vomiting occurs after taking a dose, the patient should not repeat the dose. The patient should resume dosing at the time of the next scheduled dose.
Prior to initiating a new cycle of therapy:
• Absolute neutrophil count should be at least 1,000/mm3
• Platelet count should be at least 75,000/mm3
• Non-hematologic toxicities should, at the healthcare provider’s discretion, generally be recovered to patient’s baseline condition or Grade 1 or lower
Treatment should be continued until disease progression or unacceptable toxicity.
Consider antiviral prophylaxis in patients being treated with Ixazomib to decrease the risk of herpes zoster reactivation.
The Ixazomib dose reduction steps are presented in Table 2 and the dosage modification guidelines are provided in Table 3.
An alternating dose modification approach is recommended for Ixazomib and lenalidomide for thrombocytopenia, neutropenia, and rash as described in Table 3. Refer to the lenalidomide prescribing information if dose reduction is needed for lenalidomide.
Reduce the starting dose of Ixazomib to 3 mg in patients with moderate (total bilirubin greater than 1.5-3 x ULN) or severe (total bilirubin greater than 3 x ULN) hepatic impairment.
Reduce the starting dose of Ixazomib to 3 mg in patients with severe renal impairment (creatinine clearance less than 30 mL/min) or end-stage renal disease (ESRD) requiring dialysis. Ixazomib is not dialyzable and therefore can be administered without regard to the timing of dialysis.
Refer to the lenalidomide prescribing information for dosing recommendations in patients with renal impairment.
from FDA,2024.07
Multiple myeloma is a relatively rare hematologic malignancy, and the dosage of ···【more】
Release date：2024-12-03Recommended：95
