Ixazomib

ESRD requiring dialysis: Reduce initial dose to 3 mg.

CrCl (mL/min)	Dosage
<30	Reduce initial dose to 3 mg.

Moderate to severe: Reduce initial dose to 3 mg.

cap: Should be taken on an empty stomach. Swallow whole w/ water, do not crush/chew/open.

Lactation.

Severe renal and moderate to severe hepatic impairment. Pregnancy.

Significant: Thrombocytopenia, peripheral neuropathy, peripheral oedema, rash, herpes zoster infection; gastrointestinal toxicity (e.g. nausea, diarrhoea, constipation, vomiting); posterior reversible encephalopathy syndrome (PRES). Rarely, hepatotoxicity (e.g. drug-induced liver injury, hepatocellular injury, hepatic steatosis, hepatitis cholestatic).
Blood and lymphatic system disorders: Neutropenia.
Eye disorders: Cataract, conjunctivitis, blurred vision, dry eye syndrome.
Musculoskeletal and connective tissue disorders: Back pain.
Respiratory, thoracic and mediastinal disorders: URTI, bronchitis.
Potentially Fatal: Thrombotic microangiopathy (including thrombotic thrombocytopenic purpura), Stevens-Johnson syndrome.

This drug may cause dizziness or fatigue, if affected, do not drive or operate machinery.

Confirm pregnancy status before starting treatment in females of reproductive potential. Monitor platelet counts monthly during treatment or more frequently during the 1st 3 cycles; CBC with differential, renal function tests and LFTs. Assess for signs and symptoms of skin reactions, peripheral neuropathy, peripheral oedema, and gastrointestinal toxicity.

Symptoms: Aspiration pneumonia, severe nausea, and multiple organ failure. Management: Supportive treatment.

May decrease efficacy with strong CYP3A inducers (e.g. rifampicin, carbamazepine, phenytoin); avoid concomitant use.

May decrease efficacy with St. John's wort; avoid concomitant use. Decreased exposure with high-fat meals.

Description:
Mechanism of Action: Ixazomib is a highly selective and reversible proteasome inhibitor. It binds and inhibits the chymotrypsin-like activity of the β5 subunit of the 20S proteasome, leading to activation of signalling cascades, cell-cycle arrest, and apoptosis.
Pharmacokinetics:
Absorption: Decreased exposure with high-fat meals. Bioavailability: 58%. Time to peak plasma concentration: Approx 1 hour.
Distribution: Plasma protein binding: 99%.
Metabolism: Metabolised in the liver by multiple CYP enzymes and non-CYP proteins.
Excretion: Via urine (62%, <3.5% as unchanged drug); faeces (22%). Terminal elimination half-life: 9.5 days.

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 25183872, Ixazomib. https://pubchem.ncbi.nlm.nih.gov/compound/Ixazomib. Accessed Oct. 24, 2023.

Store below 30°C. Do not freeze. This is a cytotoxic drug. Follow applicable procedures for receiving, handling, administration, and disposal.

Liệu pháp nhắm trúng đích

L01XG03 - ixazomib ; Belongs to the class of proteasome inhibitors. Used in the treatment of cancer.

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Anon. Ixazomib. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 11/04/2023.

Buckingham R (ed). Ixazomib. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 11/04/2023.

Joint Formulary Committee. Ixazomib. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 11/04/2023.

Ninlaro 2.3 mg Hard Capsules (Takeda Pharma A/S). MHRA. https://products.mhra.gov.uk. Accessed 11/04/2023.

Ninlaro Capsule (Takeda Pharmaceuticals America, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 11/04/2023.

Ninlaro Hard Capsule (Takeda Malaysia Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 11/04/2023.