Skip to Content

Ixazomib Dosage

Applies to the following strength(s): 2.3 mg ; 3 mg ; 4 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Multiple Myeloma

This drug is only given in combination with lenalidomide and dexamethasone; consult the manufacturer product information for dosing of lenalidomide and dexamethasone.

Recommended dose: 4 mg orally on Days 1, 8, and 15 of a 28-day cycle

Comments:
-Prior to initiating a new cycle of therapy:
1) Absolute neutrophil count should be at least 1,000/mm3
2) Platelet count should be at least 75,000/mm3
3) Nonhematologic toxicities should, at physician discretion, generally be recovered to patient baseline condition or Grade 1 or lower
-This drug should be taken once a week on the same day and at approximately the same time for the first 3 weeks of a 4 week cycle.
-This drug should be taken at least 1 hour before or at least 2 hours after food.
-The whole capsule should be swallowed with water (not crushed, chewed, or opened)
-If a dose is delayed or missed, the dose should be taken only if the next scheduled dose is 72 or more hours away. A missed dose should not be taken within 72 hours of the next scheduled dose. A double dose should not be taken to make up for the missed dose.
-If vomiting occurs after taking a dose, the patient should not repeat the dose. The patient should resume dosing at the time of the next scheduled dose.
-Treatment should be continued until disease progression or unacceptable toxicity.

Use: Treatment of multiple myeloma (in combination with lenalidomide and dexamethasone) in patients who have received at least one prior therapy

Renal Dose Adjustments

See dose adjustments

Liver Dose Adjustments

See dose adjustments

Dose Adjustments

DOSE REDUCTIONS DUE TO ADVERSE REACTIONS:
-Recommended starting dose is 4 mg
-First reduction recommendation is 3 mg
-Second reduction recommendation is 2.3 mg
-Discontinue therapy

DOSE MODIFICATION GUIDELINES FOR THIS DRUG IN COMBINATION WITH LENALIDOMIDE AND DEXAMETHASONE:
-THROMBOCYTOPENIA:
Platelet count less than 30,000/mm3:
-Withhold this drug and lenalidomide until platelet count is at least 30,000/mm3. Following recovery, resume lenalidomide at the next lower dose according to its prescribing information and resume this drug at its most recent dose.
-If platelet count falls to less than 30,000/mm3 again, withhold this drug and lenalidomide until platelet count is at least 30,000/mm3. Following recovery, resume this drug at the next lower dose and resume lenalidomide at its most recent dose.
NEUTROPENIA:
Absolute neutrophil count less than 500/mm3:
-Withhold this drug and lenalidomide until absolute neutrophil count is at least 500/mm3. Consider adding granulocyte colony-stimulating factor (G-CSF) as per clinical guidelines. Following recovery, resume lenalidomide at the next lower dose according to its prescribing information and resume this drug at its most recent dose.
-If absolute neutrophil count falls to less than 500/mm3 again, withhold this drug and lenalidomide until absolute neutrophil count is at least 500/mm3. Following recovery, resume this drug at the next lower dose and resume lenalidomide at its most recent dose.

NONHEMATOLOGIC TOXICITIES RECOMMENDED DOSE MODIFICATIONS:
RASH (GRADE 2 OR 3):
-Withhold lenalidomide until rash recovers to Grade 1 or lower. Following recovery, resume lenalidomide at the next lower dose according to its prescribing information.
-If Grade 2 or 3 rash occurs again, withhold this drug and lenalidomide until rash recovers to Grade 1 or lower. Following recovery, resume this drug at the next lower dose and resume lenalidomide at its most recent dose.
-Grade 4: Discontinue therapy.

PERIPHERAL NEUROPATHY RECOMMENDED DOSE MODIFICATIONS:
GRADE 1 PERIPHERAL NEUROPATHY WITH PAIN OR GRADE 2 PERIPHERAL NEUROPATHY:
-Withhold this drug until peripheral neuropathy recovers to Grade 1 or lower without pain or patient baseline. Following recovery, resume this drug at its most recent dose.
GRADE 2 PERIPHERAL NEUROPATHY WITH PAIN OR GRADE 3 PERIPHERAL NEUROPATHY:
-Withhold this drug. Toxicities should, at the physician discretion, generally recover to patient baseline condition or Grade 1 or lower prior to resuming this drug. Following recovery, resume this drug at the next lower dose.
GRADE T PERIPHERAL NEUROPATHY:
-Discontinue therapy.

OTHER NON-HEMATOLOGICAL TOXICITIES RECOMMENDED DOSE MODIFICATIONS:
OTHER GRADE 3 OR 4 NONHEMATOLOGIC TOXICITIES:
-Withhold this drug. Toxicities should, at the physician discretion, generally recover to patient baseline condition or Grade 1 or lower prior to resuming this drug. If attributable to this drug, resume this drug at the next lower dose following recovery.

DOSAGE IN PATIENTS WITH HEPATIC IMPAIRMENT:
-The starting dose of this drug should be reduced to 3 mg in patients with moderate (total bilirubin greater than 1.5 to 3 x upper limit of normal [ULN]) or severe (total bilirubin greater than 3 x ULN) hepatic impairment.

DOSAGE IN PATIENTS WITH RENAL IMPAIRMENT:
-The starting dose of this drug should be reduced to 3 mg in patients with severe renal impairment (CrCl less than 30 mL/min) or end-stage renal disease (ESRD) requiring dialysis. This drug is not dialyzable and therefore can be administered without regard to the timing of dialysis.
-Refer to the lenalidomide prescribing information for dosing recommendations in patients with renal impairment.

Precautions

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

This drug is not dialyzable.

Other Comments

Administration advice:
-This drug is cytotoxic. Capsules should not be opened or crushed. Direct contact with the capsule contents should be avoided. In case of capsule breakage, direct contact of capsule contents with the skin or eyes should be avoided. If contact occurs with the skin, wash thoroughly with soap and water. If contact occurs with the eyes, flush thoroughly with water.
-Any unused medicinal product or waste material should be disposed in accordance with local requirements.

Patient advice:
-The patient should be advised to read the approved patient labeling.
-Patients should be advised to take this drug exactly as prescribed.
-Patients should be advised to take this drug at least 1 hour before or at least 2 hours after food.
-Patients should be advised that this drug and dexamethasone should not be taken at the same time, because dexamethasone should be taken with food.
-Patients should swallow the capsule whole with water. The capsule should not be crushed, chewed or opened.
-Patients should be advised that direct contact with the capsule contents should be avoided.

Hide