Carfilzomib Brand Name– KYPROLIS
What is Carfilzomib
Carfilzomib is a proteasome inhibitor that exhibits antiproliferative and proapoptotic activity in solid and hematologic tumor cells in vitro.
It is indicated for the treatment of relapsed or refractory multiple myeloma as a single-agent following 1 or more lines of therapy and in combination with dexamethasone or lenalidomide plus dexamethasone following 1 to 3 prior lines of therapy.
Thromboprophylaxis is recommended in patients who receive carfilzomib in combination with dexamethasone or lenalidomide plus dexamethasone.
Indications
- multiple myeloma
Side Effects
- abdominal pain
- acute respiratory distress syndrome (ARDS)
- anemia
- anemia
- angina
- anorexia
- anorexia
- anxiety
- arthralgia
- asthenia
- asthenia
- atrial fibrillation
- back pain
- back pain
- bleeding
- blurred vision
- cardiac arrest
- cataracts
- chest pain (unspecified)
- chest pain (unspecified)
- chills
- chills
- cholestasis
- colitis
- confusion
- constipation
- cough
- cough
- dehydration
- delirium
- dental pain
- diarrhea
- diarrhea
- dizziness
- dizziness
- dyspepsia
- dysphonia
- dyspnea
- dyspnea
- edema
- elevated hepatic enzymes
- encephalopathy
- epistaxis
- erythema
- fatigue
- fatigue
- fever
- fever
- flushing
- GI bleeding
- GI perforation
- headache
- headache
- hearing loss
- heart failure
- hemolytic-uremic syndrome
- hepatic failure
- hepatitis B exacerbation
- hyperbilirubinemia
- hypercalcemia
- hyperglycemia
- hyperglycemia
- hyperhidrosis
- hyperkalemia
- hypertension
- hypertension
- hypertensive crisis
- hyperuricemia
- hypoalbuminemia
- hypocalcemia
- hypocalcemia
- hypoesthesia
- hypokalemia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hypophosphatemia
- hypotension
- infection
- infection
- influenza
- infusion-related reactions
- injection site reaction
- insomnia
- insomnia
- intracranial bleeding
- laryngeal edema
- lethargy
- leukoencephalopathy
- leukopenia
- lymphopenia
- lymphopenia
- malaise
- muscle cramps
- muscle cramps
- musculoskeletal pain
- myalgia
- myocardial infarction
- nausea
- nausea
- nephrotoxicity
- neutropenia
- neutropenia
- palpitations
- paresthesias
- pericardial effusion
- pericarditis
- peripheral edema
- peripheral edema
- peripheral neuropathy
- peripheral neuropathy
- pharyngitis
- pneumonitis
- progressive multifocal leukoencephalopathy
- pruritus
- pulmonary edema
- pulmonary embolism
- pulmonary hypertension
- rash
- rash
- renal failure (unspecified)
- rhinitis
- seizures
- sinus tachycardia
- stroke
- syncope
- thrombocytopenia
- thrombocytopenia
- thromboembolism
- thrombosis
- thrombotic microangiopathy
- thrombotic thrombocytopenic purpura (TTP)
- tinnitus
- tumor lysis syndrome (TLS)
- vomiting
- vomiting
- weakness
- wheezing
Monitoring Parameters
- CBC with differential
- LFTs
- platelet count
- pregnancy testing
- serum creatinine
- serum electrolytes
- serum uric acid
Contraindications
- angina
- bleeding
- breast-feeding
- cardiac arrest
- cardiac arrhythmias
- cardiomyopathy
- contraception requirements
- edema
- encephalopathy
- geriatric
- GI bleeding
- heart failure
- hemolytic-uremic syndrome
- hepatic disease
- hepatotoxicity
- hypertension
- immunosuppression
- infusion-related reactions
- intracranial bleeding
- male-mediated teratogenicity
- myocardial infarction
- neutropenia
- pneumonitis
- pregnancy
- pregnancy testing
- progressive multifocal leukoencephalopathy
- pulmonary bleeding
- pulmonary disease
- pulmonary edema
- pulmonary hypertension
- renal failure
- renal impairment
- reproductive risk
- respiratory distress syndrome
- thrombocytopenia
- thromboembolic disease
- thrombotic thrombocytopenic purpura (TTP)
- tumor lysis syndrome (TLS)
Interactions
- Clozapine
Clozapine: (Major) It is unclear if concurrent use of other drugs known to cause neutropenia (e.g., antineoplastic agents) increases the risk or severity of clozapine-induced neutropenia. Because there is no strong rationale for avoiding clozapine in patients treated with these drugs, consider increased absolute neutrophil count (ANC) monitoring and consult the treating oncologist
