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Carfilzomib is a proteasome inhibitor and is used for the following:

• Multiple myeloma that’s been previously treated with at least one therapy
• Given by itself; or
• Given with other medications such as lenalidomide (Revlimid), Darzalex (daratumumab), and dexamethasone

Carfilzomib is a proteasome inhibitor. It works by attaching to proteins called proteasomes in multiple myeloma cancer cells. This blocks the proteasomes from properly breaking down other proteins that the cell no longer needs to keep the cell alive. Multiple myeloma cancer cells make more proteins than normal cells. So when Carfilzomib blocks how proteasomes work, the cancer cells can’t function correctly and usually die. As a result, the myeloma cells can’t grow and spread as well.

Carfilzomib is dosed as follows:

• The dose is based on your body surface area (BSA, m2 units), which is calculated using your height and weight measurements. If your BSA is above 2.2 m2, your dose will be calculated using a BSA of 2.2 m2
• Carfilzomib is given as an infusion through the veins (IV), usually once or twice a week. In general, the medication is given between weeks 1 and 3 in every 4-week treatment cycle
• For once-weekly dosing: The usual starting dose is 20 mg/m2 given IV once a week. After the first week, your provider might raise your dose to 70 mg/m2 once a week
• For twice-weekly dosing: The usual starting dose is 20 mg/m2 given IV twice a week. After the first week, your provider might raise your dose to either 27 mg/m2 or 56 mg/m2 twice a week
• Your dose and your treatment schedule will vary depending on whether you’re taking Carfilzomib by itself or together with other medications for your cancer. Your dose might also differ if you have liver problems or have serious side effects from Carfilzomib

Carfilzomib is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you.

Common side effects of Carfilzomib:

• Anemia
• Tiredness
• Low platelet counts
• Nausea
• Trouble breathing
• Fever
• Diarrhea
• Low white blood cell counts
• Headache
• Cough
• Swelling in legs

Serious side effects are rare with Carfilzomib. Contact your healthcare provider immediately if you experience any of the following.

• Serious heart problems: trouble breathing, chest pain, swelling in legs, feeling lightheaded, abnormal heartbeat
• Serious kidney problems: high creatinine levels on blood tests, urinating less often, having less urine, weakness, confusion, nausea
• Tumor lysis syndrome: abnormal heartbeat, muscle cramps, muscle weakness, abnormal electrolyte levels (high potassium, high uric acid, high creatinine, low calcium)
• Serious lung problems: sudden cough, trouble breathing, very quick breathing, clicking or rattling sound when breathing, pain when breathing
• Severely high blood pressure: sudden headache, confusion, chest pain, trouble breathing, blood pressure reading higher than 180/120
• Blood clots: swelling or red and warm skin in one arm or one leg, sudden trouble breathing, sudden chest pain
• Bleeding: nosebleeds, blood in stool or urine, coughing up blood, sudden headache, severe tiredness
• Serious brain and nerve problems: seizures, confusion, vision or speech changes

There are no major drug interactions listed for Carfilzomib. However, always let your physician and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking.

Various FDA-approved generic manufacturers

Based on its mechanism of action and findings in animals, Carfilzomib can cause fetal harm when administered to a pregnant woman. Pregnancy testing on females of reproductive potential should be done prior to initiating Carfilzomib treatment.

• Females who can become pregnant should use effective contraception during treatment with Carfilzomib and for 6 months following the last dose
• Males with female sexual partners who can become pregnant should use effective contraception during treatment with Carfilzomib and for 3 months following the last dose

• Kyprolis