Isa-Pd

Say it: EYE-sah P-D

Isatuximab, pomalidomide and dexamethasone

Isa-Pd combines an antibody infusion with two pills for multiple myeloma that has come back after earlier treatments.

Also called: IsaPd, Isa-PD, IPd, Isatuximab-Pd, Isatuximab, pomalidomide, dexamethasone

What it is

Isatuximab is an antibody that sticks to a marker called CD38 on myeloma cells and helps the immune system destroy them. Pomalidomide boosts the immune system and slows myeloma growth, and dexamethasone is a steroid that kills myeloma cells. The goal is to bring the myeloma back under control and keep it there for as long as possible.

Often used for

• Multiple myeloma that came back after at least two earlier treatments, including lenalidomide and a proteasome inhibitor

The medicines in this plan

Isatuximab

An anti-CD38 antibody given through a vein. Weekly in the first cycle (days 1, 8, 15 and 22), then every 2 weeks (days 1 and 15).

Pomalidomide

A capsule taken by mouth once a day on days 1 to 21 of each 28 day cycle, then 7 days off.

Dexamethasone

A steroid taken once a week (days 1, 8, 15 and 22), as a pill or IV on infusion days.

How you get it

Isatuximab is given in an outpatient infusion clinic. The first infusion is slow and can take most of the day; later ones are shorter, often about 1 to 2 hours. Visits are weekly in the first 28 day cycle and every 2 weeks after that. Pomalidomide and dexamethasone are taken at home, and treatment usually continues as long as it is working. Your schedule may be different.

A typical cycle

Cycle 1, days 1, 8, 15 and 22

Pre-medicines, then isatuximab through a vein, plus dexamethasone.

Days 1 to 21

Pomalidomide capsule once a day at home.

Days 22 to 28

Break from pomalidomide. Blood tests before the next cycle.

Cycle 2 and after

Isatuximab on days 1 and 15, dexamethasone weekly, pomalidomide days 1 to 21.

Common side effects and what helps

• Infusion reactions such as chills, cough, stuffy nose, or shortness of breath, mostly with the first dose. You get medicines beforehand and your nurse will watch you closely.
• Low white blood cells and higher infection risk. Wash hands often and avoid people who are sick.
• Colds, sinus infections and bronchitis. Tell your team early about any infection.
• Tiredness. Gentle activity and rest both help.
• Diarrhea or constipation. Drink fluids and ask which medicine to use.
• Low platelets and easy bruising.
• Trouble sleeping, mood swings or high blood sugar on dexamethasone days. Take it in the morning.

Call your care team right away if you have

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Wheezing, throat tightness or trouble breathing during or after an infusion
• Swelling, pain or redness in one leg, or sudden shortness of breath or chest pain (signs of a blood clot)
• A cough with fever, or feeling short of breath
• Bleeding that will not stop, or many new bruises
• A painful rash with blisters on one side of the body (shingles)
• Feeling very weak, dizzy or confused

Good to know

• Isatuximab can make some blood bank tests look positive. Before starting, a blood type and antibody screen is done, and you should tell any hospital or blood bank that you take an anti-CD38 antibody.
• Pomalidomide can cause serious birth defects. It is only available through a safety program (REMS) with pregnancy tests and birth control rules, and condom use for men.
• Pomalidomide raises the risk of blood clots, so most people take aspirin or another blood thinner.
• Blood counts are checked often because low white blood cells are common. Some people need a booster shot.
• You may take an antiviral pill to prevent shingles and get advice on vaccines.

At home

• Take pomalidomide at about the same time each day and swallow it whole. Others should not touch the capsules without gloves.
• Use a calendar to track pill days and infusion days.
• Carry a wallet card or note saying you take isatuximab, in case you need a blood transfusion.
• Keep moving to help prevent blood clots.
• Check your temperature if you feel unwell.

Questions to ask

• Which blood thinner will I take?
• What should I do if I miss a dose of pomalidomide?
• How long will my infusion visits take?
• Which vaccines should I get, and when?
• How will we check whether the treatment is working?

Multiple myeloma

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.