Ninlaro (ixazomib) is a brand-name prescription medication. It’s approved by the Food and Drug Administration (FDA) to treat multiple myeloma in adults.
Ninlaro is typically used as a long-term treatment in combination with certain other cancer drugs.
Here are some fast facts about Ninlaro:
- Active ingredient: ixazomib
- Drug class: proteasome inhibitor, which is a type of targeted cancer therapy
- Drug form: oral capsule
Like other drugs, Ninlaro can cause side effects. Read on to learn about potential common, mild, and serious side effects. For a general overview of Ninlaro, including details about its uses, see this article.
Ninlaro can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
These are just a few of the more common side effects reported by people who took Ninlaro in clinical trials:
- peripheral neuropathy (nerve damage that leads to weakness, numbness, or pain in the arms, hands, legs, or feet)
- problems with digestion, such as nausea, diarrhea, vomiting, and constipation
- low level of platelets (a type of blood cell that helps your blood clot)
- back pain
- peripheral edema (swelling in your arms, hands, legs, or feet)*
* For more information about this side effect, see “Side effect specifics” below.
Mild side effects can occur with Ninlaro use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Ninlaro’s prescribing information.
Mild side effects that have been reported with Ninlaro include:
- mild problems with digestion, such as nausea, diarrhea, vomiting, and constipation
- upper respiratory infection, such as the common cold
- eye problems, such as dry eyes, blurry vision, and pink eye
- back pain
These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Ninlaro and want to tell the FDA about it, visit MedWatch.
Ninlaro may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Ninlaro’s prescribing information.
If you develop serious side effects while taking Ninlaro, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported and their symptoms include:
- Low level of platelets (a type of blood cell that helps your blood clot). Symptoms can include:
- unusual bleeding, such as nosebleeds that happen without a known cause
- bruising
- Peripheral neuropathy (a type of nerve damage). Symptoms can include:
- weakness, numbness, or pain in the arms, hands, legs, or feet
- loss of balance or coordination
- Shingles. Symptoms can include:
- painful skin rash, generally on the back, chest, abdomen, or waist
- Thrombotic microangiopathy (a condition that causes blood clots in the body’s small blood vessels). Symptoms can include:
- anemia (low level of red blood cells)
- Liver problems, such as fatty liver disease. Symptoms can include:
- pain in the upper right abdomen
- loss of appetite, which may lead to weight loss
- Severe problems with digestion, such as nausea, diarrhea, vomiting, and constipation.
- Rash.*
- Peripheral edema.*
- Low level of white blood cells.*
- Allergic reaction.*†
* For more information about this side effect, see “Side effect specifics” below.
† An allergic reaction is possible after taking Ninlaro. However, this side effect wasn’t reported in clinical trials.
Learn more about some of the side effects that Ninlaro may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Ninlaro.
Rash
Rash may occur with Ninlaro. Mild rash was a common side effect in clinical trials of the drug.
However, in rare cases, Ninlaro may cause a more severe, painful skin rash. And this could be a symptom of a more serious skin condition.
While taking Ninlaro, watch for signs of the serious skin conditions below:
- shingles, which typically causes a painful rash on the back, chest, abdomen, or waist
- Sweet’s syndrome, which typically causes a painful rash on the face, neck, back, or arms
- Stevens-Johnson syndrome, which is a life threatening condition that causes a painful rash in combination with blistering and peeling
What you can do
If you have a bothersome rash with Ninlaro, talk with your doctor. They may lower your dosage of Ninlaro or the other drugs you’re taking it with. Or they may switch you to a different treatment for your condition.
However, you should call 911 or your local emergency number right away if you have a severe, painful skin rash. This could be a sign of a more serious skin condition that should be treated right away.
Peripheral edema
Ninlaro may cause peripheral edema (swelling). This was a more common side effect in clinical trials of the drug.
Peripheral edema causes symptoms such as:
- swelling in your arms, hands, legs, or feet
- weight gain
- pain or stiffness around the affected area
What you can do
If you have peripheral edema while taking Ninlaro, talk with your doctor. They may adjust your dosage of Ninlaro or the other drugs you’re taking it with.
Your doctor may also give you treatments to reduce your swelling, such as diuretics. (A diuretic is a type of drug that helps your body get rid of water.)
Low level of white blood cells
Taking Ninlaro can cause a low level of white blood cells. This side effect was common in clinical trials of the drug.
This condition doesn’t typically cause any symptoms. However, your doctor can check your white blood cell levels with a lab test.
Having a low level of white blood cells can increase your risk of infection. Infections that were reported in clinical trials of Ninlaro include upper respiratory infections and shingles.
Keep in mind that multiple myeloma, which Ninlaro is used to treat, can also cause a low level of white blood cells.
What you can do
Your doctor will likely check your white blood cells levels before you start taking Ninlaro and periodically during treatment. If you have a low level of white blood cells while taking Ninlaro, your doctor may temporarily stop the drug.
Once your white blood cell level returns to normal, your doctor may have you start Ninlaro again. However, they may give you a lower dosage of the drug than you were previously taking.
Allergic reaction
As with most drugs, Ninlaro can cause an allergic reaction in some people. However, this side effect wasn’t reported in clinical trials.
Symptoms can be mild or serious and can include:
- skin rash
- itching
- flushing
- swelling under your skin, typically in your lips, eyelids, feet, or hands
- swelling of your mouth, tongue, or throat, which can make it hard to breathe
What you can do
For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Ninlaro. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Be sure to talk with your doctor about your health history before you take Ninlaro. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:
Kidney problems. Before taking Ninlaro, tell your doctor if you have kidney problems. They may prescribe a lower dosage of Ninlaro for you.
Liver problems. Taking Ninlaro may cause new or worsened liver problems. If you have liver problems, tell your doctor before starting treatment with the drug. They can recommend if it’s safe to take Ninlaro. If they determine Ninlaro is safe for you, your doctor may prescribe a lower dosage of the drug.
Allergic reaction. If you’ve had an allergic reaction to Ninlaro or any of its ingredients, your doctor will likely not prescribe Ninlaro. Ask your doctor what other medications may be better options for you.
Alcohol with Ninlaro
There is no known interaction between Ninlaro and alcohol.
However, drinking alcohol while taking Ninlaro may worsen certain side effects of the drug. Examples include digestive problems such as nausea, diarrhea, and vomiting.
If you drink alcohol, talk with your doctor before taking Ninlaro. They can discuss what amount of alcohol, if any, is safe for you to consume while taking the drug.
Pregnancy and breastfeeding while taking Ninlaro
Below are details about taking Ninlaro while pregnant or breastfeeding.
Pregnancy and Ninlaro
It may not be safe to take Ninlaro while pregnant. The way Ninlaro works in the body is expected to cause problems with fetal development (commonly known as birth defects).
Because of this risk, your doctor will likely recommend that you do not take Ninlaro during pregnancy. Before prescribing the drug, your doctor will give you a pregnancy test to make sure you aren’t pregnant.
If you or your partner are able to become pregnant, doctors recommend using effective nonhormonal birth control while taking Ninlaro. You’ll continue using birth control for at least 90 days after your last dose of the drug.
If you become pregnant while taking Ninlaro, tell your doctor right away.
Breastfeeding and Ninlaro
It isn’t known if Ninlaro passes into breast milk. It also isn’t known if Ninlaro may cause side effects in a breastfed child.
Your doctor will likely recommend that you do not take Ninlaro while breastfeeding. And to be safe, it’s best to avoid breastfeeding until at least 90 days after your last dose of the drug.
Both mild and serious side effects may happen with Ninlaro. If you have bothersome side effects with the drug, talk with your doctor. They can recommend ways to ease your symptoms. Or they may recommend a drug other than Ninlaro for you.
If you’d like to learn more about Ninlaro, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.
Besides talking with your doctor, you can do some research on your own. These articles might help:
- More information about Ninlaro. For details about other aspects of Ninlaro, refer to this article.
- Drug comparison. Read how Ninlaro compares with Velcade.
- A look at your condition. For details about multiple myeloma, our cancer hub may be helpful.
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.