Ixazomib

What is Ixazomib for?

Ixazomib is commonly used to treat multiple myeloma. The medication works by blocking the action of proteasomes, which help to break down proteins that the cells do not need. Protein builds up in the cancer cells and causes them to die. Cancer cells require more proteasomes to function and are hence more prone to the effect of ixazomib.

How should I take or use Ixazomib?

Ixazomib should be taken once a week for 3 weeks followed by 1 week rest. It should be taken on the same day each week, at approximately the same time. Take on an empty stomach, at least 1 hour before or 2 hours after food. Swallow the capsules whole. Do not crush, chew or open the capsules.

Do not stop taking your medication without checking with your healthcare professional.

Special handling of the medication is required. Check with your healthcare professional before handling the drug.

What should I do if I forget to take or use Ixazomib?

Take the missed dose as soon as you remember if it is more than 72 hours from the next scheduled dose.

If it is less than 72 hours to the next scheduled dose, skip the missed dose and take it at the next scheduled time. Do not take two doses at the same time.

What precautions should I take when taking or using Ixazomib?

Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication
• You or your partner is pregnant or planning to become pregnant
  • Use effective birth control during and for at least 90 days after stopping Ixazomib
• You are breastfeeding or plan to breastfeed
  • Do not breastfeed during treatment and for at least 90 days after stopping Ixazomib
• You are taking any other medications, including over-the-counter medications, vitamins, supplements and herbal products

What food or medication should I avoid when I take or use Ixazomib?

Avoid raw, uncooked, undercooked food.

Inform your healthcare provider before taking new medications, supplements or herbal preparations.

What are some common side effects of Ixazomib?

• Temporary decrease in blood cells counts
  • This may put you at higher risk of infections, bleeding or bruising and feeling tired
  • Reduce your risk of getting an infection by:
    • Maintaining good hand hygiene. Wash your hands often during the day especially before you eat or after using the toilet.
    • Avoid crowds and do not go near people who are sick. Wear a mask if necessary.
    • Eating freshly cooked food. Avoid raw meats, vegetables, eggs, half-cooked or uncooked food.
    • Taking prophylactic medications, including antivirals, as instructed to reduce the risk of getting some viral infections.
  • Brush teeth gently with a soft bristle toothbrush to prevent gum bleeding
  • Be careful when handling sharp objects such as scissors or knives
• Loose and frequent stools (diarrhoea)
  • Reduce consumption of foods high in fibre such as raw fruits and vegetables which cause softer and more frequent stools
  • Have foods such as porridge or soups which are gentler on the stomach
  • Ensure you are drinking sufficient fluid (at least 2 litres or 8 cups of water or fluids a day)
  • Avoid spicy and/or fried food
  • Avoid alcohol
  • Avoid coffee, tea, milk and dairy products
  • Take antidiarrheal medicine as instructed to manage your diarrhoea. Inform your doctor if the antidiarrhoeal medicine does not help with your diarrhoea.
• Hard stools (constipation). Manage this by:
  • Increasing intake of foods high in fibre such as fruits and vegetables, and ensure you are drinking at least 6-8 glasses of fluid each day unless otherwise advised by your doctor.
  • Increasing daily activity may also help to improve constipation.
• Nausea and/or vomiting. Manage this by:
  • Taking small and frequent meals, rather than 3 large meals.
  • Consuming food that is cold or at room temperature to avoid becoming nauseated from the smell.
• Numbness/tingling sensation of fingers and toes
  • This is often temporary and can improve after you finish treatment.
  • Tell your doctor if you have new or worsening symptoms (such as burning feeling in your feet or hands, tingling, numbness, and/or pain in your hands or feet).
• Swelling of hands, feet or lower legs due to water build-up. Manage this by:
  • Elevating legs on a stool, cushion or pillow when sitting or sleeping.
  • Inform your doctor if you develop swelling in your arms, hands, legs, ankles or feet, or if you gain weight from swelling.
• Back pain. Manage this by:
  • Taking prescribed painkillers when necessary.
  • Informing your doctor if the pain is severe or not relieved despite use of medications.
• Skin rash. Manage this by:
  • Using mild soap and unscented detergent.
  • Informing your doctor if rashes are severe, covers large areas of the body or is associated with skin peeling.

What are some rare but serious side effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

Other serious side effects include:

• Blistering, peeling, red skin rash due to Stevens-Johnson syndrome (SJS)
  • SJS is a serious skin reaction. Symptoms include face swelling, blisters on skin, skin rashes or severe mouth sores that spread within hours to days. It usually occurs within the first few months (monitor closely for the first 3 months) of treatment.
  • As SJS progresses rapidly, please consult your healthcare professional if you show the first sign of a rash.
• Infections:
  • Signs of an infection include:
    • Fever (temperature over 38°C)
    • Chills
    • Severe sore throat
    • Cough with thick or green phlegm
    • Cloudy or foul smelling urine
    • Painful, tender, or swollen and red skin wounds or sores
• Unusual bleeding
  • Signs of unusual bleeding include:
    • Bruising without a cause or bruising that gets bigger
    • Dark (black or red), sticky stools
    • Coughing out blood
    • Vomit that looks like coffee grounds
    • Blood in the urine
    • Bleeding which cannot be stopped
• Liver problems
  • Signs of liver problems may include but is not limited to (the following):
    • Dark or tea-coloured urine
    • Pale or light-coloured stools
    • Yellowing of skin or eyes
• Eye problems, including blurred vision, red eyes, dry eyes, sensitivity to light, or pain in the eyes.
• Significant reduction in amount of urine passed

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

How should I store Ixazomib?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How do I throw away Ixazomib safely?

Pack the medication into a bag and bring it back to the pharmacy where you received the medication from.