Carfilzomib

Generic name: Carfilzomib
Brand names: Kyprolis
Dosage form: intravenous (infusion) injection
Drug class: Proteasome inhibitors

Usage of Carfilzomib

Carfilzomib is a type of chemotherapy drug called a proteasome inhibitor. It is used alone or in combination with other medications to treat a blood cancer called multiple myeloma.

People with multiple myeloma have abnormal plasma cells, which are a type of white blood cell found in your bone marrow that secrete antibodies (immunoglobulins). These antibodies are protective proteins that help fight infection. When plasma cells become cancerous they grow out of control and make an abnormal antibody.

Carfilzomib works by inhibiting the growth of myeloma cells and encouraging them to self-destruct. Myeloma cells use proteasomes to break down proteins within them. Carfilzomib blocks the action of proteasomes, causing the proteins to build up inside the cells and the cells to die.

Carfilzomib was approved by the US Food and Drug Administration (FDA) in 2012. It is a second generation proteasome inhibitor that was designed to overcome toxicity and resistance issues that some patients experienced with an older proteasome inhibitor called Bortezomib (Velcade). Carfilzomib is available under the brand name Kyprolis. A generic version is also available.

Carfilzomib side effects

Carfilzomib can cause serious side effects including:

See "Important information" above.

The most common side effects occurring in at least 20 percent of patients receiving carfilzomib in the combination therapy trials are:

anaemia

diarrhea

tiredness (fatigue)

high blood pressure (hypertension)

fever

upper airway (respiratory tract) infection

low platelets (thrombocytopenia)

cough

difficulty breathing (dyspnea)

sleeplessness (insomnia)

The most common side effects occurring in at least 20 percent of patients receiving carfilzomib therapy alone in trials are:

anaemia

fatigue

high blood pressure

fever

upper respiratory tract infection

low platelets

cough

difficulty breathing

sleeplessness

These are not all the possible side effects of carfilzomib. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. Contact your doctor about any side effects that bother you or do not go away.

You may report side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Before taking Carfilzomib

Tell your doctor if you are pregnant or plan to become pregnant. Carfilzomib can cause harm to a fetus (unborn baby) when given to a pregnant woman. Women should use effective contraception during treatment with carfilzomib and for 6 months following the final dose.

Men should use effective contraception during treatment with carfilzomib and for 3 months following the final dose.

Carfilzomib can cause harm to a fetus if used during pregnancy or if you or your partner become pregnant during treatment with carfilzomib.

Tell your doctor if you are breastfeeding or plan to breastfeed. Do not breastfeed while receiving carfilzomib. and for 2 weeks after the last dose. Talk to you doctor about the best way to feed your baby while receiving carfilzomib.

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How to use Carfilzomib

The recommended dose of carfilzomib varies depending on your treatment regimen. See table below.

Regimen Dosage Infusion time (minutes)

Carfilzomib and Dexamethasone

Carfilzomib, daratumumab and dexamethasone

Daratumumab, Hyaluronidase-fihj and dexamethsone

20/70 mg/m2 once weekly 30

Carfilzomib and dexamethasone

Carfilzomib, daratumumab and dexamethasone

Daratumumab, hyaluronidase-fihj and dexamethsone

Carfilzomib alone

20/56 mg/m2 twice weekly 30

Carfilzomib, lenalidomide and dexamethasone

Carfilzomib alone

20/27 mg/m2 twice weekly 10

See full prescribing information for further information about carfilzomib dosing.

Warnings

Carfilzomib can cause serious side effects:

Heart problems: carfilzomib can cause heart problems or worsen pre-existing heart conditions. Death due to cardiac arrest has occurred within one day of carfilzomib administration. Before starting carfilzomib, you should have a full medical work-up (including blood pressure and fluid management). You should be closely monitored during treatment.

Kidney problems: There have been reports of sudden kidney failure in patients receiving carfilzomib. Your kidney function should be closely monitored during treatment.

Tumor lysis syndrome (TLS): Cases of TLS have been reported in patients receiving carfilzomib, including fatalities. You should be closely monitored during treatment for any signs of TLS.

Lung damage: Cases of lung damage have been reported in patients receiving carfilzomib, including fatal cases.

Pulmonary hypertension (high blood pressure in the lungs): There have been reports of pulmonary hypertension in patients receiving carfilzomib.

Lung complications: Shortness of breath was reported in patients receiving carfilzomib. Your lung function should be closely monitored during treatment.

High blood pressure: Cases of high blood pressure, including fatal cases, have been reported in patients receiving carfilzomib. Your blood pressure should be closely monitored during treatment.

Blood clots: There have been reports of blood clots in patients receiving carfilzomib. If you are at high risk for blood clots, your doctor can recommend ways to lower the risk. If you are using carfilzomib in combination with dexamethasone or with lenalidomide plus dexamethasone or with daratumumab and dexamethasone, your doctor should assess and may prescribe another medicine to help lower your risk for blood clots.

If you are using birth control pills or other medical forms of birth control associated with a risk of blood clots, talk to your doctor and consider a different method of birth control during treatment with carfilzomib in combination with dexamethasone, with lenalidomide plus dexamethasone, or with daratumumab and dexamethasone.

Infusion-related reactions: Signs and symptoms of infusion-related reactions included fever, chills, joint pain, muscle pain, facial flushing and/or swelling, swelling of the larynx (voice box), vomiting, weakness, shortness of breath, low blood pressure, fainting, chest tightness, and chest pain. These symptoms can occur immediately following infusion or up to 24 hours after administration of carfilzomib. If you experience any of these symptoms, contact your doctor immediately.

Severe bleeding problems: Fatal or serious cases of bleeding problems have been reported in patients receiving carfilzomib. Your doctor should monitor your signs and symptoms of blood loss.

Very low platelet count: Low platelet levels can cause unusual bruising and bleeding. You should have regular blood tests to check your platelet count during treatment.

Liver problems: Cases of liver failure, including fatal cases, have been reported in patients receiving carfilzomib. Your liver function should be closely monitored during treatment.

Blood problems: Cases of a blood disease called thrombotic microangiopathy, including thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS), including fatal cases, have been reported in patients who received carfilzomib. Your doctor should monitor your signs and symptoms.

Brain problems: A nerve disease called Posterior Reversible Encephalopathy Syndrome (PRES), formerly called Reversible Posterior Leukoencephalopathy Syndrome (RPLS), has been reported in patients receiving carfilzomib. It can cause seizure, headache, lack of energy, confusion, blindness, altered consciousness, and other visual and nerve disturbances, along with high blood pressure. Your doctor should monitor your signs and symptoms.

Cases of a brain infection called Progressive Multifocal Leukoencephalopathy (PML), including fatal cases, have been reported in patients receiving carfilzomib. Your doctor should monitor your signs and symptoms.

Contact your doctor straight away if you experience any of the following while taking carfilzomib:

Shortness of breath

Prolonged, unusual or excessive bleeding

Yellowing of the skin and/or eyes (jaundice)

Headaches, confusion, seizures or loss of sight

Pregnancy

What other drugs will affect Carfilzomib

Tell your healthcare provider about all the medicines you take, including prescriptions an over-the-counter medicine, vitamins, and herbal supplements. Talk to your doctor before starting any new medications during treatment with carfilzomib.

Popular FAQ

Kyprolis (carfilzomib) is a type of chemotherapy drug. It works by inhibiting proteasomes - a complex of proteases (enzymes), which break down proteins in the body. Continue reading

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