The usual recommended starting dose of oral NINLARO is one 4 mg capsule taken once a week with lenalidomide and dexamethasone at standard dosing2
NINLARO + Rd offers the convenience of all-oral administration2
- Should be taken at least 1 hour before or at least 2 hours after food2
- Should be swallowed whole with a glass of water2
- Antiviral prophylaxis should be considered to reduce the risk of herpes zoster reactivation2
If a dose of NINLARO is delayed or missed, the dose should be taken only if the next scheduled dose is ≥72 hours away2
NINLARO should be stored in the original packaging and the capsules should be removed just prior to dosing2
The recommended starting dose of oral NINLARO is 3 mg for patients with moderate or severe hepatic impairment, severe renal impairment or end-stage renal disease requiring dialysis2
Adding oral NINLARO to Rd requires no additional planned hospital visits2
Minimum number of planned hospital visits required for administration/collection of multiple myeloma treatments over 18 cycles2,5-7†
NINLARO + Rd
Carfilzomib + Rd
Daratumumab + Vd**
†Patients are treated until progression or unacceptable toxicity. Calculation excludes visits for monitoring. Standard carfilzomib regimen is 18 cycles; number of administrations of carfilzomib per cycle: cycle 1-12 = 6 doses (2 consecutive doses each week for 3 weeks), cycle 13-18 = 4 doses (2 consecutive doses during 1st and 3rd week). Treatment with carfilzomib + Rd for longer than 18 cycles should be based on an individual benefit risk assessment, as the data on the tolerability and toxicity of carfilzomib beyond 18 cycles are limited7
**When given in combination with bortezomib (3-week cycle), daratumumab is dosed weekly in weeks 1-9, with bortezomib twice weekly in the first 2 weeks of each cycle (15 visits), then once per three weeks in weeks 10-24, with bortezomib twice weekly in the first 2 weeks of each cycle (20 visits), and then once per 4 weeks in cycles 9-18 without bortezomib (10 visits).8
- Moreau P, Masszi T, Grzasko N. N Engl J Med. 2016;374:1621-34.
- NINLARO (ixazomib capsules) Summary of Product Characteristics.
- Avet-Loiseau H, Bahlis N, Chng W-J, et al. Haematologica 2016;101(S1) Abstract p269.
- Moreau P, Masszi T, Grzasko N. N Engl J Med. 2016;374:1621-34, Supplemental Appendix. Available at http://www.nejm.org/doi/suppl/10.1056/NEJMoa1516282/suppl_file/nejmoa1516282_appendix.pdf. Accessed May 2019.
- REVLIMID 25 mg Summary of Product Characteristics. Available at https://www.medicines.org.uk/emc/medicine/29490. Accessed May 2019.
- Dexamethasone 2 mg Tablets Summary of Product Characteristics. Available at https://www.medicines.org.uk/emc/medicine/28919. Accessed May 2019.
- KYPROLIS Summary of Product Characteristics. Available at https://www.medicines.org.uk/emc/medicine/31222. Accessed May 2019.
- DARZALEX Summary of Product Characteristics. Available at https://www.medicines.org.uk/emc/product/7250. Accessed May 2019.