Ixazomib

Say it: ix-AZ-oh-mib · Brand names: Ninlaro

Ixazomib is a pill that kills myeloma cells by blocking the way they clear out old proteins.

What it is

Cells use a structure called the proteasome to break down proteins they no longer need. Myeloma cells make a lot of protein and depend on it. Ixazomib blocks the proteasome, so the waste builds up and the myeloma cells die.

Often used for

• multiple myeloma, together with lenalidomide and dexamethasone, after at least one other treatment

How you get it

Ixazomib is a capsule you take by mouth at home. It is often taken once a week for 3 weeks, then a week off, in a 4-week cycle. Your schedule may be different.

Common side effects and what helps

• Diarrhea. Drink plenty of fluids and use the diarrhea medicine your team suggests.
• Constipation. Drink fluids and eat fiber.
• Nausea or vomiting. Take your anti-nausea medicine as your team tells you.
• Low platelets, which can cause easy bruising or bleeding.
• Numbness, tingling, or burning in your hands or feet.
• Swelling in your legs or feet.
• Back pain or rash. Tell your team if these bother you.

Call your care team right away if you have

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Diarrhea or vomiting that does not stop, or you cannot keep fluids down
• Unusual bleeding or bruising, or black or bloody stools
• Numbness or tingling that makes it hard to walk or hold things
• A rash that spreads, blisters, or peels
• Yellow skin or eyes, or dark urine
• Sudden swelling, weight gain, or shortness of breath

Before you start, tell your team

• If you are pregnant, may become pregnant, or are breastfeeding
• If you have liver or kidney problems
• If you take rifampin, carbamazepine, phenytoin, or St. John's wort
• All the medicines, vitamins, and herbal products you take

Good to know

• You will have blood tests to check your platelets and other blood counts.
• It can cause nerve damage, swelling, skin reactions, and liver problems. Your team will watch for these.
• It can harm an unborn baby. Use birth control during treatment and for a time after, as your team tells you.
• Lenalidomide, which is taken with ixazomib, has its own strict pregnancy safety program.

At home

• Take it on an empty stomach, at least 1 hour before or 2 hours after food.
• Take it on the same day and at about the same time each week. Swallow the capsule whole with water. Do not open, crush, or chew it.
• If you miss a dose or throw up after taking it, ask your care team what to do. Do not take two doses to make up for it.
• Keep the capsules in the original package until it is time to take them. Store at room temperature, away from children and pets.
• If a capsule is broken, avoid touching the powder. Wash your hands with soap and water if you do.

Questions to ask

• What day of the week should I take it?
• How should I time it with my dexamethasone and lenalidomide?
• What should I do for diarrhea?
• How often will my blood be checked?

Part of these treatment plans

• IRd

Side effect guides

• Nausea and vomiting
• Diarrhea
• Constipation
• Low platelets and bleeding
• Neuropathy (numbness and tingling)
• Skin rash (including EGFR-inhibitor rash)
• Pain

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.