Kyprolis (carfilzomib) is a prescription brand-name medication. The Food and Drug Administration (FDA) has approved it to treat multiple myeloma. It’s prescribed in adults whose past treatments didn’t work to treat their multiple myeloma. Kyprolis may be used alone or along with other drugs to treat this condition.
Kyprolis comes as a powder that’s mixed into a solution. It’s given as an IV infusion by a healthcare professional.
Kyprolis belongs to a drug class called proteasome inhibitors. There is currently no generic version of Kyprolis.
For information about the dosage of Kyprolis, including its strengths and how to take the drug, keep reading. For a comprehensive look at Kyprolis, see this article.
This article describes typical dosages for Kyprolis provided by the drug’s manufacturer. When taking Kyprolis, always follow the dosage prescribed by your doctor.
Before starting Kyprolis treatment, your doctor will discuss the best dosage and dosage schedule for you. It’s important to follow the dosage guidelines that your doctor recommends, so that the medication can work for you.
Kyprolis form
Kyprolis comes as a powder that’s mixed into a solution. It’s given as an IV infusion by a healthcare professional.
Kyprolis strengths
Kyprolis comes in three strengths: 10 milligrams (mg), 30 mg, and 60 mg.
Typical dosages
Typically, your doctor will start you on a low dosage. Then they’ll adjust it after your first few doses to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect. They will be able to recommend the best administration schedule for you.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosing schedule to fit your needs.
Dosage when given with lenalidomide and dexamethasone
If you are receiving Kyprolis in combination with lenalidomide (Revlimid) and dexamethasone, Kyprolis is typically given on a 28-day (4-week) treatment cycle. In most cases, you will receive a dose on the first two days of each week for 3 weeks. Then you’ll take a week off without receiving Kyprolis before starting your next cycle. You can receive Kyprolis for up to 18 cycles of treatment when it’s given in combination with lenalidomide and dexamethasone.
Your doctor will usually start you on a low dose of Kyprolis – around 20 milligrams per square meter (mg/m2). This will be calculated by your doctor based on your height and weight.
If the first two doses work well for you, your doctor will likely increase your dose to 27 mg/m2. This is the maximum dosage when you are receiving Kyprolis in combination with lenalidomide and dexamethasone.
Below are tables with the recommended doses of Kyprolis when given in combination with lenalidomide and dexamethasone, depending on which treatment cycle you are in:
| Cycle 1 | Cycles 2 to 12 | Cycles 13 through 18 | |
| Week 1 | day 1: 20 mg/m2 day 2: 20 mg/m2 days 3 to 7: no Kyprolis dose* | day 1: 27 mg/m2 day 2: 27 mg/m2 days 3 to 7: no Kyprolis dose* | day 1: 27 mg/m2 day 2: 27 mg/m2 days 3 to 7: no Kyprolis dose* |
| Week 2 | day 8: 27 mg/m2 day 9: 27 mg/m2 days 10 to 14: no Kyprolis dose* | day 8: 27 mg/m2 day 9: 27 mg/m2 days 10 to 14: no Kyprolis dose* | days 8 to 14: no Kyprolis dose* |
| Week 3 | day 15: 27 mg/m2 day 16: 27 mg/m2 days 17 to 21: no Kyprolis dose* | day 15: 27 mg/m2 day 16: 27 mg/m2 days 17 to 21: no Kyprolis dose* | day 15: 27 mg/m2 day 16: 27 mg/m2 days 17 to 21: no Kyprolis dose* |
| Week 4 | days 23 to 28: no Kyprolis dose* | days 23 to 28: no Kyprolis dose* | days 23 to 28: no Kyprolis dose* |
* You’ll likely receive dexamethasone alone at this time. Both dexamethasone and lenalidomide may also be given on a different schedule throughout the cycles.
Each Kyprolis infusion takes about 10 minutes. Your doctor will also recommend the dosage of lenalidomide and dexamethasone to receive in combination with Kyprolis. In some cases, such as if you are having side effects from Kyprolis, your doctor may recommend a dose reduction for you.
Dosage when given with dexamethasone
Kyprolis is typically given based on a cycle of 28 days (4 weeks). If you are receiving Kyprolis and dexamethasone, Kyprolis can be given either once or twice weekly. This will depend on your specific dosing schedule. If you have side effects that are bothersome to you or if your cancer begins to get worse, your doctor may stop your Kyprolis and dexamethasone treatment.
Your doctor can advise you on when you’ll receive dexamethasone and what the dosage would be.
Twice weekly dosing
In some cases, you will receive a dose of Kyprolis on the first two days of each week for the first 3 weeks in a treatment cycle.
When you first start receiving Kyprolis, your doctor will likely start you on a dose of 20 mg/m2. The correct dosage for you will be calculated by your doctor based on your height and weight.
If you are receiving Kyprolis in combination with dexamethasone, your dose will likely increase to a maintenance dose of 56 mg/m2.
Below are tables with the recommended doses for twice weekly dosing of Kyprolis when given in combination with dexamethasone:
| Cycle 1 | Cycles 2 through 18 | |
| Week 1 | day 1: 20 mg/m2 day 2: 20 mg/m2 days 3 to 7: no Kyprolis dose* | day 1: 56 mg/m2 day 2: 56 mg/m2 days 3 to 7: no Kyprolis dose* |
| Week 2 | day 8: 56 mg/m2 day 9: 56 mg/m2 days 10 to 14: no Kyprolis dose* | day 8: 56 mg/m2 day 9: 56 mg/m2 days 10 to 14: no Kyprolis dose* |
| Week 3 | day 15: 56 mg/m2 day 16: 56 mg/m2 days 17 to 21: no Kyprolis dose* | day 15: 56 mg/m2 day 16: 56 mg/m2 days 17 to 21: no Kyprolis dose* |
| Week 4 | days 23 to 28: no Kyprolis dose* | days 23 to 28: no Kyprolis dose* |
* You’ll likely receive dexamethasone alone at this time. Dexamethasone may also be given with infusions of Kyprolis.
If your doctor recommends twice weekly dosing with Kyprolis, each infusion will take about 30 minutes.
Once weekly dosing
You can also receive your dose of Kyprolis once weekly if you receive it in addition to dexamethasone. In this case, dosing of Kyprolis is still broken up into cycles that are 4 weeks each. You will only need a dose of Kyprolis once weekly for the first 3 weeks of each treatment cycle.
You’ll have your first dose of Kyprolis on day 1 of your first treatment cycle. This will be a starting dose of 20 mg/m2. The correct dosage for you will be calculated by your doctor or pharmacist based on your height and weight.
After your first dose, your dose will likely increase to 70 mg/m2.
Below is a table to help determine the typical schedule for once weekly dosing of Kyprolis when it’s given in combination with dexamethasone:
| Cycle 1 | Cycles 2 through 18 | |
| Week 1 | day 1: 20 mg/m2 days 2 to 7: no Kyprolis dose* | day 1: 70 mg/m2 days 2 to 7: no Kyprolis dose* |
| Week 2 | day 8: 70 mg/m2 days 9 to 14: no Kyprolis dose* | day 8: 70 mg/m2 days 9 to 14: no Kyprolis dose* |
| Week 3 | day 15: 70 mg/m2 days 16 to 21: no Kyprolis dose* | day 15: 70 mg/m2 days 16 to 21: no Kyprolis dose* |
| Week 4 | days 22 to 28: no Kyprolis dose* | days 22 to 28: no Kyprolis dose* |
* You’ll likely receive dexamethasone alone at this time. Dexamethasone may also be given with infusions of Kyprolis.
Each Kyprolis infusion takes about 30 minutes. If you have side effects that are bothersome to you or if your cancer begins to get worse, your doctor may stop your Kyprolis and dexamethasone treatment.
Dosage when given with daratumumab and dexamethasone
Kyprolis may be given with daratumumab and dexamethasone. Your doctor can advise you on when you’ll receive these other drugs and what the dosages would be.
You may be able to receive your dose of Kyprolis either once weekly or twice weekly. Your doctor will recommend that you receive your dosages in cycles, which are 4-week periods.
Twice weekly dosing
If your doctor recommends Kyprolis twice weekly, you’ll likely receive a dose on the first two days of each week for the first 3 weeks of each cycle.
The first two doses of your first cycle will be a lower dose of 20 mg/m2 of Kyprolis. Your doctor will calculate the correct dosage of Kyprolis for you based on your height and weight. Then, after your first week of your first cycle, your dosage will likely increase to 56 mg/m2.
Below is a table of the recommended dosing for Kyprolis if you are receiving it twice weekly in combination with daratumumab and dexamethasone.
| Cycle 1 | Cycles 2 through 18 | |
| Week 1 | day 1: 20 mg/m2 day 2: 20 mg/m2 days 3 to 7: no Kyprolis dose* | day 1: 56 mg/m2 day 2: 56 mg/m2 days 3 to 7: no Kyprolis dose* |
| Week 2 | day 8: 56 mg/m2 day 9: 56 mg/m2 days 10 to 14: no Kyprolis dose* | day 8: 56 mg/m2 day 9: 56 mg/m2 days 10 to 14: no Kyprolis dose* |
| Week 3 | day 15: 56 mg/m2 day 16: 56 mg/m2 days 17 to 21: no Kyprolis dose* | day 15: 56 mg/m2 day 16: 56 mg/m2 days 17 to 21: no Kyprolis dose* |
| Week 4 | days 23 to 28: no Kyprolis dose* | days 23 to 28: no Kyprolis dose* |
* You may receive daratumumab and dexamethasone at this time. They may also be given with infusions of Kyprolis. Talk with your doctor to learn more.
Each Kyprolis infusion will take about 30 minutes. If you have side effects that are bothersome to you or if your cancer begins to get worse, your doctor may stop your Kyprolis, daratumumab, and dexamethasone treatment.
Once weekly dosing
Your doctor may also recommend receiving your dose of Kyprolis once weekly for the first 3 weeks of each cycle.
Your first dose will be a smaller dose of 20 mg/m2. Your doctor will help to calculate the best dose for you based on your height and weight. Then, after your first dose, your doctor will likely increase your dose to 70 mg/m2.
Below is a table of the likely doses that your doctor will recommend if you are receiving Kyprolis, daratumumab, and dexamethasone:
| Cycle 1 | Cycles 2 through 18 | |
| Week 1 | day 1: 20 mg/m2 days 2 to 7: no Kyprolis dose* | day 1: 70 mg/m2 days 2 to 7: no Kyprolis dose* |
| Week 2 | day 8: 70 mg/m2 days 9 to 14: no Kyprolis dose* | day 8: 70 mg/m2 days 9 to 14: no Kyprolis dose* |
| Week 3 | day 15: 70 mg/m2 days 16 to 21: no Kyprolis dose* | day 15: 70 mg/m2 days 16 to 21: no Kyprolis dose* |
| Week 4 | days 22 to 28: no Kyprolis dose* | days 22 to 28: no Kyprolis dose* |
* You may receive daratumumab and dexamethasone at this time. They may also be given with infusions of Kyprolis. Talk with your doctor to learn more.
Each Kyprolis infusion takes about 30 minutes to complete. You can usually receive Kyprolis until the medication stops working for you or you have side effects that are bothersome to you.
Dosage when given with daratumumab, hyaluronidase-fihj, and dexamethasone
Kyprolis may be given with daratumumab and hyaluronidase-fihj (Darzalex Faspro), and dexamethasone. The Kyprolis dosage for this is the same as when Kyprolis is given with daratumumab (Darzalex) and dexamethasone. See “Dosage when given with daratumumab and dexamethasone” above for details.
Your doctor can advise you on when you’ll receive daratumumab and hyaluronidase-fihj, and dexamethasone, and what the dosages would be.
Dosage when given alone
In some cases, your doctor may recommend that you receive only Kyprolis, with no other medications to treat your cancer. In this case, they may recommend a 10-minute Kyprolis infusion or a 30-minute Kyprolis infusion. Either way, you will receive a dose of Kyprolis twice a week for the first 3 weeks of each treatment cycle. Each cycle is 4 weeks.
Whether you receive your dose over 10 minutes or 30 minutes will help determine what dose of Kyprolis is prescribed. In either case, you will start your first week of your first treatment cycle with a 20 mg/m2 dose on days 1 and 2. Your doctor will help determine the best dose for you based on your height and weight.
Then, if you are receiving your doses over 10 minutes, you will get a dose of 27 mg/m2.
Below is a table of the recommended dosages of Kyprolis if you are receiving 10-minute infusions:
| Cycle 1 | Cycles 2 to 12 | Cycles 13 through 18 | |
| Week 1 | day 1: 20 mg/m2 day 2: 20 mg/m2 days 3 to 7: no Kyprolis dose | day 1: 27 mg/m2 day 2: 27 mg/m2 days 3 to 7: no Kyprolis dose | day 1: 27 mg/m2 day 2: 27 mg/m2 days 3 to 7: no Kyprolis dose |
| Week 2 | day 8: 27 mg/m2 day 9: 27 mg/m2 days 10 to 14: no Kyprolis dose | day 8: 27 mg/m2 day 9: 27 mg/m2 days 10 to 14: no Kyprolis dose | days 8 to 14: no Kyprolis dose |
| Week 3 | day 15: 27 mg/m2 day 16: 27 mg/m2 days 17 to 21: no Kyprolis dose | day 15: 27 mg/m2 day 16: 27 mg/m2 days 17 to 21: no Kyprolis dose | day 15: 27 mg/m2 day 16: 27 mg/m2 days 17 to 21: no Kyprolis dose |
| Week 4 | days 23 to 28: no Kyprolis dose | days 23 to 28: no Kyprolis dose | days 23 to 28: no Kyprolis dose |
If you receive a dose of Kyprolis over 30 minutes, you’ll likely have a dose of 56 mg/m2 after your first week of treatment. You can continue this treatment through cycle 12. Then, after cycle 12, you’ll need a dose of Kyprolis on days 1, 2, 15, and 16.
Below is an example of typical recommended dosages if you are receiving Kyprolis alone over a 30-minute infusion:
| Cycle 1 | Cycles 2 to 12 | Cycles 13 through 18 | |
| Week 1 | day 1: 20 mg/m2 day 2: 20 mg/m2 days 3 to 7: no Kyprolis dose | day 1: 56 mg/m2 day 2: 56 mg/m2 days 3 to 7: no Kyprolis dose | day 1: 56 mg/m2 day 2: 56 mg/m2 days 3 to 7: no Kyprolis dose |
| Week 2 | day 8: 56 mg/m2 day 9: 56 mg/m2 days 10 to 14: no Kyprolis dose | day 8: 56 mg/m2 day 9: 56 mg/m2 days 10 to 14: no Kyprolis dose | days 8 to 14: no Kyprolis dose |
| Week 3 | day 15: 56 mg/m2 day 16: 56 mg/m2 days 17 to 21: no Kyprolis dose | day 15: 56 mg/m2 day 16: 56 mg/m2 days 17 to 21: no Kyprolis dose | day 15: 56 mg/m2 day 16: 56 mg/m2 days 17 to 21: no Kyprolis dose |
| Week 4 | days 23 to 28: no Kyprolis dose | days 23 to 28: no Kyprolis dose | days 23 to 28: no Kyprolis dose |
If you have side effects that are bothersome to you or if your cancer begins to get worse, your doctor may stop your Kyprolis treatment.
Long-term treatment
In most cases, Kyprolis is meant to be a long-term treatment. If you have side effects that are bothersome to you or if your cancer begins to get worse, your doctor may stop your Kyprolis treatment.
If you and your doctor determine that Kyprolis is safe and effective for you, they may recommend that you receive it long term.
However, if you are receiving Kyprolis in combination with lenalidomide and dexamethasone, your doctor will likely recommend that you receive Kyprolis for a maximum of 18 cycles.
The Kyprolis dosage your doctor prescribes will depend on several factors. These include:
- your height and weight
- other medications that you receive in combination with Kyprolis
- the side effects you have from receiving Kyprolis
Other medical conditions you have can also affect your Kyprolis dosage.
Dosage adjustments
Throughout your treatment, your doctor will continue to check your dosage of Kyprolis to be sure that it’s the best dosage for you. Your dosage is based on your body weight. So if you have a large change in your body weight, your doctor may recommend changing your dose.
If you have kidney or liver disease, your doctor may recommend a different dosage of Kyprolis for you. This is because your body may not be able to process the medication as quickly, and it can build up in your body. This may also increase your risk of side effects.
Your doctor may also adjust your dosage of Kyprolis if you experience side effects from the medication. Your doctor will monitor your blood tests during treatment with Kyprolis to see if the drug is causing serious side effects. Your doctor may decrease your dose of Kyprolis if you do develop side effects, such as:
- low neutrophil count (neutrophils are a type of white blood cell)
- febrile neutropenia (a low neutrophil count and a fever)
- low platelet levels (platelets are a type of blood cell that helps your blood clot)
- renal (kidney) problems, such as kidney failure
Be sure to discuss any other medical conditions that you have with your doctor before starting Kyprolis treatment. They will be able to help determine the best dose for you. Your doctor will also monitor you throughout your treatment.
Kyprolis comes as a powder that’s mixed into a solution. It’s given as an IV infusion by a healthcare professional. You will receive your dose at your doctor’s office or an infusion suite, or in a hospital. The drug needs to be mixed by a pharmacist, doctor, or another healthcare professional before it’s given to you.
Often, before treatment, your doctor may recommend that you receive fluids, which are usually given intravenously. This is to help decrease your risk of side effects, such as kidney problems. Kidneys are responsible for filtering all of the liquid in your body and excreting the medication from your body in urine. It’s important that you are hydrated to ensure your kidneys can function correctly.
You may also receive premedications before your dose of Kyprolis. For example, in most cases, dexamethasone is given before treatment or as a part of treatment to help prevent side effects.
Your healthcare professional will then give your dose of Kyprolis. Depending on your dose, your infusion may last 10 minutes or up to 30 minutes.
If you miss your appointment for your dose of Kyprolis, call your doctor’s office. They can help you schedule your next dose after your missed appointment.
To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.
If you received more than the recommended amount of Kyprolis
Call your doctor right away if you believe you’ve received too much Kyprolis. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
The dosages in this article are typical dosages provided by the drug manufacturer. If your doctor recommends Kyprolis for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes for you.
As with any drug, never change your dosage of Kyprolis without your doctor’s recommendation. If you have questions about the dosage of Kyprolis that’s right for you, talk with your doctor.
Besides learning about dosage, you may want other information about Kyprolis. These additional articles might be helpful to you:
- More about Kyprolis. For information about other aspects of Kyprolis, refer to this article.
- Drug comparison. To find out how Kyprolis compares with Velcade, read this article.
- Details about multiple myeloma. For details on multiple myeloma, see our cancer hub, as well as our list of cancer and oncology articles.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
