The usual recommended starting dose of oral NINLARO is one 4 mg capsule taken once a week with lenalidomide and dexamethasone at standard dosing2
Extended Efficacy. Extended Possibilities.
NINLARO + Rd significantly extends PFS vs Rd alone and offers a manageable side effect profile with the convenience of an all‑oral regimen 1,2
NINLARO is the first and only oral PI licensed in combination with Rd for the treatment of adult patients with MM who have received at least 1 prior therapy 2
Oral NINLARO was studied in a broad group of RRMM patients who were treated to progression. 1 TOURMALINE‑MM1 is the first global, phase III, double‑blind, placebo‑controlled study investigating an oral PI in RRMM patients. The trial compared NINLARO + Rd as part of an all‑oral regimen versus placebo + Rd in 722 RRMM patients treated with 1‑3 prior therapies 1
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
†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
- 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 January 2017.
- REVLIMID 25 mg Summary of Product Characteristics. Available at https://www.medicines.org.uk/emc/medicine/29490.
- Dexamethasone 2 mg Tablets Summary of Product Characteristics. Available at https://www.medicines.org.uk/emc/medicine/28919.
- KYPROLIS Summary of Product Characteristics. Available at https://www.medicines.org.uk/emc/medicine/31222.