Carfilzomib

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

  1. abdominal pain
  2. acute respiratory distress syndrome (ARDS)
  3. anemia
  4. anemia
  5. angina
  6. anorexia
  7. anorexia
  8. anxiety
  9. arthralgia
  10. asthenia
  11. asthenia
  12. atrial fibrillation
  13. back pain
  14. back pain
  15. bleeding
  16. blurred vision
  17. cardiac arrest
  18. cataracts
  19. chest pain (unspecified)
  20. chest pain (unspecified)
  21. chills
  22. chills
  23. cholestasis
  24. colitis
  25. confusion
  26. constipation
  27. cough
  28. cough
  29. dehydration
  30. delirium
  31. dental pain
  32. diarrhea
  33. diarrhea
  34. dizziness
  35. dizziness
  36. dyspepsia
  37. dysphonia
  38. dyspnea
  39. dyspnea
  40. edema
  41. elevated hepatic enzymes
  42. encephalopathy
  43. epistaxis
  44. erythema
  45. fatigue
  46. fatigue
  47. fever
  48. fever
  49. flushing
  50. GI bleeding
  51. GI perforation
  52. headache
  53. headache
  54. hearing loss
  55. heart failure
  56. hemolytic-uremic syndrome
  57. hepatic failure
  58. hepatitis B exacerbation
  59. hyperbilirubinemia
  60. hypercalcemia
  61. hyperglycemia
  62. hyperglycemia
  63. hyperhidrosis
  64. hyperkalemia
  65. hypertension
  66. hypertension
  67. hypertensive crisis
  68. hyperuricemia
  69. hypoalbuminemia
  70. hypocalcemia
  71. hypocalcemia
  72. hypoesthesia
  73. hypokalemia
  74. hypokalemia
  75. hypomagnesemia
  76. hyponatremia
  77. hypophosphatemia
  78. hypotension
  79. infection
  80. infection
  81. influenza
  82. infusion-related reactions
  83. injection site reaction
  84. insomnia
  85. insomnia
  86. intracranial bleeding
  87. laryngeal edema
  88. lethargy
  89. leukoencephalopathy
  90. leukopenia
  91. lymphopenia
  92. lymphopenia
  93. malaise
  94. muscle cramps
  95. muscle cramps
  96. musculoskeletal pain
  97. myalgia
  98. myocardial infarction
  99. nausea
  100. nausea
  101. nephrotoxicity
  102. neutropenia
  103. neutropenia
  104. palpitations
  105. paresthesias
  106. pericardial effusion
  107. pericarditis
  108. peripheral edema
  109. peripheral edema
  110. peripheral neuropathy
  111. peripheral neuropathy
  112. pharyngitis
  113. pneumonitis
  114. progressive multifocal leukoencephalopathy
  115. pruritus
  116. pulmonary edema
  117. pulmonary embolism
  118. pulmonary hypertension
  119. rash
  120. rash
  121. renal failure (unspecified)
  122. rhinitis
  123. seizures
  124. sinus tachycardia
  125. stroke
  126. syncope
  127. thrombocytopenia
  128. thrombocytopenia
  129. thromboembolism
  130. thrombosis
  131. thrombotic microangiopathy
  132. thrombotic thrombocytopenic purpura (TTP)
  133. tinnitus
  134. tumor lysis syndrome (TLS)
  135. vomiting
  136. vomiting
  137. weakness
  138. 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

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