Uses
What is Ninlaro used for?
Ninlaro (ixazomib) is commonly used to treat a blood cancer called multiple myeloma.
Ninlaro may also be used for other conditions as determined by your healthcare provider.
How does Ninlaro work (mechanism of action)?
Ninlaro is a type of medicine called a proteasome inhibitor. It works by blocking multiple myeloma cells from being able to break down protein. The buildup of protein in the cell causes the cell to die.
How is Ninlaro supplied (dosage forms)?
Ninlaro is available in the following dosage forms that are taken by mouth.
- 2.3 mg oral capsules
- 3 mg oral capsules
- 4 mg oral capsules
How should I store Ninlaro?
Ninlaro should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Keep Ninlaro in the original packaging and store in a cool, dry place.
Side Effects
What are the most common side effects of Ninlaro?
The most common side effects of Ninlaro are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Low platelet levels (see below)
- Low white blood cell levels
- Stomach issues, including diarrhea, constipation, nausea, and vomiting (see below)
- Nerve problems (see below)
- Fluid retention in your arms or legs (see below)
- Rash and skin reactions (see below)
- Lung infections, such as bronchitis
You should also tell your healthcare provider if you have a skin rash and pain (shingles) or if you have blurred vision, changes to your vision, dry eye, or pink eye. These are additional side effects that can happen with Ninlaro.
There may be other side effects of Ninlaro that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of Ninlaro?
While less common, the most serious side effects of Ninlaro are described below, along with what to do if they happen.
Severe Allergic Reactions. Ninlaro may cause allergic reactions, which can be serious. Stop taking Ninlaro and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Severely Low Platelet Levels. Ninlaro can cause you to have a severely low number of platelets in your blood, also called thrombocytopenia. Platelets help to form blood clots. Having a low level of platelets may increase your risk of bleeding. Tell your healthcare provider if you have any of the following symptoms of low platelet levels.
- Easy bruising or bleeding
- Bleeding that does not stop
- Nosebleeds
Stomach Issues. Ninlaro can cause stomach issues, including diarrhea, constipation, nausea, and vomiting. If you are given medicine to prevent or treat diarrhea, nausea, or other stomach issues, take it exactly as your healthcare provider tells you. Call your healthcare provider right away if you have any of the following.
- Severe diarrhea
- Diarrhea that does not go away
- Diarrhea with weakness, dizziness, or fever
- Severe nausea or vomiting
- Severe constipation
Nerve Problems. Nerves are the fibers that carry sensations from your body to the brain. Damage to these nerves, called peripheral neuropathy, can happen in people who are taking Ninlaro. Stop taking Ninlaro and call your healthcare provider if you develop pain, burning, tingling, numbness, or weakness in your arms, hands, legs, or feet.
Fluid Retention (Edema). Ninlaro can cause fluid retention in your arms or legs, also called peripheral edema. Fluid retention can cause serious issues in people with certain conditions, such as heart failure or kidney disease. Call your healthcare provider right away if you have any of the following symptoms.
- Chest pain
- Irregular heartbeat
- Shortness of breath
- Stretched or shiny skin
- Swelling in your face, arms, hands, legs, ankles, or feet
- Weight gain
Severe Skin Reactions. Ninlaro can cause severe rashes and skin reactions, called Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop Ninlaro and call your healthcare provider right away. Get emergency help right away if you have any of the following symptoms of SJS or TEN.
- Painful red or purple skin that looks burned and peels off
- Flat red rash or blisters on your skin, mouth, nose, and genitals
- Red, painful, watery eyes
Blood Clots. Ninlaro may cause blood clots in your small blood vessels, which could lead to a condition called thrombotic microangiopathy. These blood clots can cause damage to your kidneys, brain, or other organs, which can be serious and even life-threatening. Stop taking Ninlaro and get emergency help right away if you have any of the following signs of blood clots.
- Fever
- Bruising
- Nose bleeds
- Tiredness
- Decreased urination (pee)
Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking Ninlaro. Call your healthcare provider right away if you have any of the following symptoms of liver damage.
- Nausea or vomiting
- Stomach or belly pain
- Fever
- Weakness or unusual tiredness
- Itching
- Loss of appetite
- Light-colored poop
- Dark-colored urine (pee)
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Warnings & Precautions
Who should not use Ninlaro?
Allergies to Ingredients. People who are allergic to any of the following should not take Ninlaro.
- Ninlaro
- Ixazomib
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in Ninlaro.
What should I know about Ninlaro before using it?
Do not take Ninlaro unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share Ninlaro with other people, even if they have the same condition as you. It may harm them.
Keep Ninlaro out of the reach of children.
Take Ninlaro on the same day each week and at the same time in the day. Follow your healthcare provider’s instructions for the weeks to take Ninlaro and the weeks to not take it. You should take Ninlaro without food and at least one hour before you eat or two hours after you have eaten.
Swallow Ninlaro capsules whole and do not crush, chew, or open the capsule. You should not touch or allow any of your skin to touch the medicine inside of the capsules. If you accidentally get powder from the capsule on your skin, wash your skin with soap and water right away. If you get the capsule powder in your eye, flush your eyes with water right away.
What should I tell my healthcare provider before using Ninlaro?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Ninlaro is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Liver problems
- Kidney problems or are on dialysis
- Past or current shingles
Pregnancy. Ninlaro may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. You must not be pregnant before starting Ninlaro. If you can become pregnant, use effective birth control while taking Ninlaro and for 90 days after your last dose. If you are assigned male at birth and have a partner that can become pregnant, use effective birth control during treatment with Ninlaro and for 90 days after your last dose.
Breastfeeding. Do not take Ninlaro while you are breastfeeding and do not breastfeed for 90 days after your last dose of Ninlaro. It is not known if Ninlaro passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.
Other Medicines and Supplements. Ninlaro may interact with other medicines and supplements. Before taking Ninlaro, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
How can I get more information about Ninlaro?
For more information about Ninlaro, you can visit the manufacturer’s website at www.ninlaro.com or call them at 844-817-6468.
Interactions
Does Ninlaro interact with foods or drinks?
There are no known interactions between Ninlaro and foods and drinks. Avoid taking Ninlaro within one hour before eating or within two hours after eating.
It is unknown if drinking alcohol will affect Ninlaro.
Does Ninlaro interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are taking rifampin, which is a medicine commonly used to treat an infection called tuberculosis.
Some other medicines may alter the blood levels of Ninlaro. Tell your healthcare provider about all medicines that you take or have recently taken.
This may not be a complete list of medicines that can interact with Ninlaro. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much Ninlaro?
If you or someone else has used too much Ninlaro, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of Ninlaro?
If you miss a dose of Ninlaro, take it as soon as you remember. If your next scheduled dose is less than three days (72 hours) away, skip the missed dose. Do not take two doses of Ninlaro at the same time or within 72 hours of each other.
If you vomit after taking Ninlaro, skip the dose you vomited. Do not take an extra dose. Take your next dose at the usual time.
Are you currently using Ninlaro (ixazomib)?
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