Carfilez 30

Indications

Carfilzomib is an anticancer medicine used to treat adults with multiple myeloma (a cancer of plasma cells in the bone marrow) that has come back or has not responded after at least one previous treatment. It is given together with other medicines such as Dexamethasone, Lenalidomide, or Daratumumab.

How It Works

Cells use structures called proteasomes to break down proteins they no longer need. Carfilzomib permanently blocks the proteasome, so unwanted and damaged proteins build up inside myeloma cells. Myeloma cells are especially sensitive to this, and they stop growing and die.

Dosage and Administration

Carfilzomib is given only in hospital or a cancer day-care unit by a doctor or nurse, as an infusion into a vein over a set time on specific days of each treatment cycle. The dose is based on body surface area and is set by the cancer specialist. Fluids may be given before and after the infusion, and Dexamethasone is often given beforehand to reduce infusion reactions.

Interactions

• Hormonal contraceptives: carfilzomib combined with Dexamethasone and Lenalidomide increases the risk of blood clots; the doctor will advise a suitable contraceptive method.
• Medicines that raise the risk of clots or bleeding, or that harm the heart or kidneys, need careful review.
• Tell the doctor about all medicines, vaccines and supplements.

Contraindications

• Allergy to carfilzomib or any ingredient.
• Breastfeeding.

Side Effects

Common effects include tiredness, low blood counts (anaemia, low platelets, low white cells), shortness of breath, fever, diarrhoea, nausea, cough, high blood pressure, swelling of the legs, back pain, muscle cramps, headache and infections such as pneumonia.

Get urgent medical help for chest pain, severe breathlessness or swelling (possible heart failure), fever or chills (infection), unusual bleeding or bruising, sudden very high blood pressure with headache or confusion, seizures or vision changes, a painful swollen leg, reduced urine output, or a reaction during or after the infusion such as wheezing, flushing or fainting.

Pregnancy and Lactation

Carfilzomib may harm an unborn baby. Women and men must use effective contraception during treatment and for several months afterwards, as advised by the doctor. Do not breastfeed during treatment and for a period after the last dose.

Precautions and Warnings

• Heart, kidney and liver function, blood pressure and blood counts are checked regularly.
• Drink enough fluid as advised to protect the kidneys, but report sudden weight gain or swelling.
• Blood clot prevention may be prescribed.
• Tell the doctor about hepatitis B infection, which may reactivate.

Overdose

Overdose may cause severe chills, low blood pressure, kidney failure and low blood counts. Treatment is supportive in hospital.

Therapeutic Class

Antineoplastic, proteasome inhibitor.

Storage

Store unopened vials in a refrigerator at 2 to 8°C in the original carton to protect from light. Do not freeze. Hospital use: prepare and store as directed on the pack.