Kyprolis is a brand-name prescription drug that’s FDA-approved to treat multiple myeloma. It’s used in adults whose past treatments didn’t work to treat the condition.

Depending on how your multiple myeloma has been treated in the past, Kyprolis can be given in one of the following ways:

  • If you’ve received one or more multiple myeloma treatments in the past, Kyprolis can be used on its own.
  • If you’ve received one to three other treatments in the past, Kyprolis can be used with other drugs. Specifically, it can be given in combination with either:
    • both dexamethasone and a cancer drug called lenalidomide (Revlimid)
    • both dexamethasone and a cancer drug called daratumumab (Darzalex)

Multiple myeloma is a type of blood cancer that forms in your white blood cells. To learn more about this condition, see the “Kyprolis for multiple myeloma” section below.

Drug details

Kyprolis contains the drug carfilzomib. It belongs to a class of medications called proteasome inhibitors. It’s a type of cancer drug known as a targeted therapy. This means it targets (works on) specific parts of cancer cells.

You’ll receive Kyprolis as an intravenous (IV) infusion at your healthcare provider’s office or clinic. (An IV infusion is an injection into your vein that’s given over a period of time.)

Effectiveness

For information about the effectiveness of Kyprolis, see the section “Kyprolis for multiple myeloma” below.

Kyprolis contains the drug carfilzomib. It’s available only as a brand-name medication. Kyprolis is not currently available in a generic form. (A generic drug is an exact copy of the active drug in a brand-name medication.)

Kyprolis can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Kyprolis. This list does not include all possible side effects.

For more information on the possible side effects of Kyprolis, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Kyprolis, you can do so through MedWatch.

More common side effects

The more common side effects* of Kyprolis, when it’s used alone, can include:†

  • anemia (low red blood cell level)
  • thrombocytopenia (low platelet level)
  • nausea
  • diarrhea
  • trouble breathing
  • cough
  • tiredness
  • fever
  • headache
  • trouble falling asleep or staying asleep
  • edema (swelling) in your feet, ankles, legs, hands, or arms

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

* In clinical studies, all of these side effects occurred in at least 20% of people using Kyprolis alone. And most of these side effects occurred in at least 10% of people taking Kyprolis with other drugs.
† This is a partial list of the more common side effects from Kyprolis. To learn about other possible side effects, talk with your doctor or pharmacist, or visit Kyprolis’ prescribing information.

Serious side effects

Serious side effects from Kyprolis aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects of Kyprolis, which are discussed further in the “Side effect details” section below, include:

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on several of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Kyprolis. In clinical studies, less than 10% of people who took Kyprolis with dexamethasone had a severe allergic reaction.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Kyprolis. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Infusion reaction

As with most drugs that are given by intravenous (IV) infusion, some people can have an infusion reaction after receiving Kyprolis. With an IV infusion, the drug is injected into your vein over a period of time.

Infusion reactions can be mild or severe. And they can happen up to 24 hours after you’ve received the drug. It’s not known for sure how many people have had an infusion reaction to Kyprolis.

Symptoms of an infusion reaction can include:

  • fever
  • chills
  • muscle pain
  • flushing (warmth and redness in your skin)
  • swelling of your lips, face, or throat
  • vomiting
  • weakness
  • trouble breathing
  • fainting
  • low blood pressure
  • tightness or pain in your chest

If you have symptoms of an infusion reaction after receiving Kyprolis, call your doctor right away. If your symptoms feel life threatening, call 911.

Heart problems

Heart problems have occurred in people of taking Kyprolis. These problems include heart attack and heart failure.

In fact, during clinical studies, 8% of people taking Kyprolis had heart failure. These people were taking Kyprolis in combination with either dexamethasone alone or dexamethasone plus lenalidomide (Revlimid).

Also in the studies, heart attack was reported in less than 10% of people who took Kyprolis with other drugs. And heart attack occurred in less than 20% of people who took Kyprolis alone.

Symptoms of heart failure and heart attack will vary, but they may include:

With heart failure, you may also have sudden weight gain, or swelling in your legs, ankles, or feet.

If you’re 75 years of age or older, you may have a higher risk of heart problems during Kyprolis treatment. You may also have a higher risk of heart problems if you’ve had any issues with your heart in the past.

Talk with your doctor about your risk of having heart problems before you start taking Kyprolis. Your doctor may monitor your blood pressure and fluid intake before you begin Kyprolis treatment to make sure it’s safe for you to use this drug.

If you have any symptoms of heart problems while taking Kyprolis, call your doctor right away. But if your symptoms feel life threatening, call 911. In some cases, your doctor may have you stop taking Kyprolis if you develop heart problems.

Infections

Kyprolis may increase your risk of serious infections, such as lung infections and severe urinary tract infections (UTIs). In fact, during clinical studies, infection was a common side effect of the drug.

In the studies, pneumonia was the most common serious infection that occurred in people taking Kyprolis. Up to 17% of people who took the drug had pneumonia. These people were taking Kyprolis with both dexamethasone and lenalidomide (Revlimid). In comparison, pneumonia occurred in 13% of people who took dexamethasone and lenalidomide without Kyprolis.

Symptoms of an infection will depend on the type of infection you have. But typical symptoms of serious infections can include:

  • fever
  • shivering
  • fast heart rate
  • confusion
  • shortness of breath
  • general pain or discomfort in your body
  • sweating

Rarely, some people taking Kyprolis have developed a rare brain infection called progressive multifocal leukoencephalopathy (PML). This infection is very serious and can sometimes be fatal. During Kyprolis treatment, your doctor will monitor you for PML.

If you have symptoms of an infection while you’re taking Kyprolis, call your doctor. They can check to see if you have an infection. And they’ll recommend whether you need any medical treatment. In some cases, they may also change your dosage of Kyprolis, or they may have you stop using the medication.

Kidney problems

Kidney problems, including kidney failure, have occurred in people taking Kyprolis. In clinical studies, about 9% of people taking the drug, either alone or in combination with other medications, had problems with their kidneys.

Symptoms of kidney problems can include:

  • passing smaller amounts of urine than usual
  • swelling in your legs, ankles, or feet
  • confusion
  • fatigue (lack of energy)
  • nausea
  • pain or pressure in your chest
  • irregular heartbeat
  • seizures

If you have a history of kidney problems, talk with your doctor before taking Kyprolis. Using this drug may worsen your condition.

And if you have any symptoms of kidney problems while you’re taking Kyprolis, call your doctor. They can check to see what’s causing your symptoms, and they’ll recommend whether you need medical treatment.

Tumor lysis syndrome

It’s possible to have tumor lysis syndrome while you’re taking Kyprolis. Tumor lysis syndrome is a metabolic imbalance that’s caused by the rapid death of cancer cells in your body during treatment.

As cancer cells die, they release certain substances into your blood. When these substances aren’t cleared quickly enough by your kidneys, the substances can cause damage to different organs inside your body.

Symptoms of tumor lysis syndrome can include:

  • nausea
  • vomiting
  • loss of appetite
  • muscle cramps or weakness
  • passing smaller amounts of urine than usual
  • fast heart rate

In clinical studies, tumor lysis syndrome occurred in less than 10% of people who took Kyprolis with other drugs. And this condition occurred in less than 20% of people who took Kyprolis alone.

If you have symptoms of tumor lysis syndrome while you’re taking Kyprolis, call your doctor as soon as possible. They can check to see if you have this condition, and they’ll recommend whether you need medical treatment.

Lung damage

Some people using Kyprolis have had damage to their lungs. In clinical studies, 1% to 2% of people taking Kyprolis, either alone or in combination with other drugs, developed lung conditions that damaged their lungs.

The lung conditions seen in people during clinical studies included:

Symptoms of lung disease can include:

If you’ve had any lung diseases in the past, talk with your doctor before starting Kyprolis. You may have a higher risk of developing lung problems while you’re taking this drug.

And if you have any symptoms of lung disease while you’re taking Kyprolis, call your doctor. They can check to see what’s causing your symptoms, and they’ll recommend whether you need medical treatment.

Pulmonary hypertension

A very serious condition called pulmonary hypertension (high blood pressure in your lungs) has occurred in some people taking Kyprolis. Sometimes this condition can lead to complications such as heart failure.

In clinical studies, 1% to 2% of people taking Kyprolis, either alone or in combination with other drugs, had pulmonary hypertension.

Symptoms of pulmonary hypertension can include:

  • trouble breathing
  • being tired
  • feeling dizzy
  • tightness or pain in your chest
  • swelling in your ankles, feet, or legs
  • bluish color of your lips or skin
  • fast heart rate

If you have symptoms of pulmonary hypertension while you’re taking Kyprolis, call your doctor right away. And if your symptoms feel life threatening, call 911.

Hypertension

It’s possible to have hypertension (high blood pressure) while you’re taking Kyprolis. In fact, in clinical studies, 17% of people taking Kyprolis with lenalidomide (Revlimid) and dexamethasone had high blood pressure. In comparison, hypertension occurred in 9% of people taking lenalidomide and dexamethasone without Kyprolis. In another study, 34% of people taking Kyprolis and dexamethasone had high blood pressure.

For some people taking Kyprolis, their blood pressure became dangerously high. This life threatening condition is called hypertensive crisis or hypertensive emergency.

Symptoms of high blood pressure can include:

  • chest pain
  • severe headache
  • blurry vision
  • nausea
  • vomiting
  • trouble breathing
  • seizures

While you’re taking Kyprolis, your doctor will recommend that you monitor your blood pressure. If you have increased blood pressure or any symptoms of increased blood pressure, call your doctor right away. But if your symptoms feel life threatening, call 911.

Venous thrombosis

Venous thrombosis (blood clots in your veins) is a possible side effect of Kyprolis. In clinical studies, 2% of people taking Kyprolis alone had blood clots. Of people taking Kyprolis with lenalidomide (Revlimid) and dexamethasone, 13% had blood clots. And 9% of people taking Kyprolis with just dexamethasone had blood clots. In comparison, blood clots occurred in 6% of people taking lenalidomide and dexamethasone without Kyprolis.

If you’re taking Kyprolis in combination with dexamethasone, dexamethasone and lenalidomide, or dexamethasone and daratumumab, your doctor may recommend that you use thromboprophylaxis. (For thromboprophylaxis, you’ll take a medication that’s used to help prevent blood clots.) This is because your risk of blood clots is higher when Kyprolis is used in combination with these other medications.

Symptoms of blood clots can include:

  • leg cramps
  • swelling in your legs or arms
  • red color or warmth of your skin in the area overlaying a clot
  • chest pain
  • trouble breathing
  • fast heart rate

If you have any symptoms of a blood clot, call your doctor right away. If your symptoms feel life threatening, call 911.

Bleeding problems

Some people taking Kyprolis have had serious bleeding called hemorrhage. With hemorrhage, you may have heavy bleeding in certain areas of your body, such as your nose, lungs, stomach, intestines, and brain. In some cases, bleeding problems may happen as a result of severe thrombocytopenia (very low platelet count). Thrombocytopenia is a possible side effect of Kyprolis.

Symptoms of hemorrhage will vary, depending on where you’re bleeding from. But your symptoms may include:

  • trouble breathing
  • coughing up blood
  • nosebleeds
  • having blood in your stool, urine, or vomit
  • sudden, severe headache
  • loss of consciousness

If you have any abnormal bleeding or symptoms of hemorrhage, call your doctor right away. If your symptoms feel life threatening, call 911.

Liver problems

In some people, Kyprolis can increase the level of liver enzymes. Liver enzymes are certain proteins made by your liver that are measured and used to monitor your liver function. It’s possible that Kyprolis can increase the level of liver enzymes in your body. But the level may also be increased during treatment if you have liver problems, such as liver failure.

In clinical studies, 2% of people taking Kyprolis, either alone or with other drugs, had liver failure.

Symptoms of liver problems can include:

  • jaundice (yellowing of your skin or the whites of your eyes)
  • pain in your upper belly
  • swelling in your belly
  • nausea
  • vomiting
  • feeling tired

If you have symptoms of liver problems, talk with your doctor. They’ll check to see what’s causing your symptoms, and they’ll recommend whether you need medical treatment. And if needed, your doctor may lower your dosage of Kyprolis.

Thrombotic microangiopathy

Rarely, Kyprolis may cause thrombotic microangiopathy. This condition is a serious disease caused by blood clots forming inside your small blood vessels. These blood clots can damage some of your organs, including your kidneys and brain, which can be serious and life threatening.

Symptoms of thrombotic microangiopathy can include:

  • tiredness
  • dizziness
  • trouble breathing
  • bruising or bleeding more often than usual
  • pale skin
  • confusion
  • feeling very tired
  • fever
  • seizures
  • passing smaller amounts of urine than usual
  • blood in your urine
  • swelling in your legs
  • high blood pressure

If you have any symptoms of thrombotic microangiopathy, call your doctor right away. If your symptoms feel life threatening, call 911.

Posterior reversible encephalopathy syndrome

It’s also possible, but rare, to have posterior reversible encephalopathy syndrome (PRES) while you’re taking Kyprolis. With PRES, you have swelling in your brain.

Symptoms of PRES can include:

If you have any symptoms of PRES, call your doctor right away. But if your symptoms feel life threatening, call 911.

Hair loss (not a side effect)

Hair loss hasn’t been reported as a side effect of Kyprolis.

With other cancer treatments, such as chemotherapy (traditional drugs used to treat cancer), hair loss is often a side effect. This is because chemotherapy works by attacking cells in your body that are quickly multiplying (making more cells). Because cancer cells multiply quickly, chemotherapy affects these cells. But chemotherapy can also affect healthy cells in your body that multiply quickly, such as hair cells. This leads to hair loss in people using chemotherapy.

Kyprolis, on the other hand, isn’t considered a chemotherapy drug. Instead, Kyprolis contains the drug carfilzomib. It belongs to a class of drugs called proteasome inhibitors. These drugs target (work on) specific proteins (called proteasomes) rather than affecting your whole body.

If you have concerns about hair loss during Kyprolis treatment, talk with your doctor.

The Kyprolis dosage for multiple myeloma treatment that your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Kyprolis to treat
  • your age
  • other medications that you’re using with Kyprolis
  • other medical conditions you may have
  • certain side effects that you may have during treatment

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Kyprolis comes as a powder inside single-dose vials. It’s mixed with liquid and given to you as an intravenous (IV) infusion by a healthcare provider. With an IV infusion, the drug is injected into your vein over a period of time.

Kyprolis comes in three strengths: 10 mg, 30 mg, and 60 mg.

Dosage for multiple myeloma

The typical dosing schedule for Kyprolis depends on whether it’s given alone or in combination with other drugs. If it’s used with other drugs, Kyprolis can be given with either:

Your doctor will prescribe the combination of drugs and dosage schedule that’s right for you.

In general, Kyprolis dosing is based on a 28-day (4-week) treatment cycle. It’s given once or twice each week for 3 weeks, followed by 1 week without Kyprolis. The number of treatment cycles that your doctor recommends will depend on your unique situation. Typically, Kyprolis is given either until your disease gets worse or you have side effects that are too severe.

What if I miss a dose?

It’s important that you don’t miss doses of Kyprolis. But if you miss an appointment for one of your doses, call your doctor’s office right away. Their medical staff can help you set up another appointment to receive your Kyprolis infusion.

Will I need to use this drug long term?

If Kyprolis helps your condition, you and your doctor can decide whether you should take the drug long-term. But if you have severe side effects from Kyprolis or your condition worsens, your doctor may recommend that you stop taking it.

Administration

Kyprolis is given as an IV infusion by a healthcare provider. With an IV infusion, the drug is injected into your vein over a period of time. Kyprolis infusions generally last about 10 to 30 minutes.

Before administration

Before your healthcare provider gives Kyprolis to you, they’ll make sure you’re ready for the drug. The following list describes some things that will be done to prepare you for the infusion.

  • Hydration. Before getting your dose of Kyprolis, you should be well hydrated. This helps you to avoid certain side effects of the drug. Hydration is especially important for people with a high risk of either tumor lysis syndrome (TLS) or kidney problems. (TLS is a metabolic imbalance that’s caused by cancer cell death during treatment. For more information, see the “Kyprolis side effects” section above.) You should drink plenty of fluids before your Kyprolis infusions. Your doctor will tell you how much to drink based on your body weight. During your first treatment cycle of Kyprolis, you’ll also be given IV fluids before each dose of the drug. Some people with certain heart problems may not be given IV fluids with treatment. Your doctor will recommend how much IV hydration you’ll need with your Kyprolis infusions.
  • Premedication. Before your Kyprolis infusion, you’ll receive a dose of dexamethasone. Whether or not you’re taking Kyprolis with dexamethasone or lenalidomide to treat your multiple myeloma, you’ll still receive this pre-infusion dose of dexamethasone. This pre-infusion treatment helps to lower your risk of an infusion reaction. (With an infusion reaction, your body reacts to a drug that’s given through an IV. For more information, see the “Kyprolis side effects” section above.)
  • Thromboprophylaxis. If you’re taking Kyprolis with dexamethasone alone, lenalidomide (Revlimid) and dexamethasone, or daratumumab (Darzalex) and dexamethasone, you’ll be given thromboprophylaxis before your doses of Kyprolis. (Thromboprophylaxis is a treatment that helps prevent blood clots.) Your doctor will recommend an appropriate drug to use for this purpose.
  • Infection prevention. For some people using Kyprolis, their doctor may recommend that they receive drugs to help prevent herpes zoster infection. This infection is also known as shingles. Your doctor will let you know if you’ll need infection prevention with Kyprolis treatment.
  • Electrolyte monitoring. Your doctor will monitor your electrolyte levels, especially potassium, before and during your treatment with Kyprolis. They’ll do this by checking certain blood tests. Your doctor will recommend how often you’ll need to have these blood tests performed.

As with all medications, the cost of Kyprolis can vary. To find current prices for Kyprolis in your area, check out WellRx.com.

The cost you find on WellRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance coverage and the pharmacy you use.

It’s important to note that Kyprolis is dispensed from a specialty pharmacy and given at medical facilities. Specialty pharmacies are authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Your insurance plan may require you to get prior authorization before approving coverage for Kyprolis. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Kyprolis.

If you’re not sure if you’ll need to get prior authorization for Kyprolis, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Kyprolis, or if you need help understanding your insurance coverage, help is available.

Amgen Inc., the manufacturer of Kyprolis, offers programs that may help lower the cost of the drug. If you have health insurance, you may find financial assistance through the Amgen First Step program. For more information and to find out if you’re eligible for financial support, visit the program website.

If you don’t have health insurance, you may find financial support through the Amgen Safety Net Foundation. For more information about this assistance, visit the program website.

The Food and Drug Administration (FDA) approves prescription drugs such as Kyprolis to treat certain conditions.

Kyprolis is FDA-approved to treat multiple myeloma in adults. It’s used in people whose past treatments didn’t work to treat the condition.

Depending on how your multiple myeloma has been treated in the past, Kyprolis can be used in one of the following ways:

  • If you’ve received one or more multiple myeloma treatments in the past, Kyprolis can be used on its own.
  • If you’ve received one to three other treatments in the past, Kyprolis can be used with other drugs. Specifically, it can be given in combination with either:
    • both dexamethasone and a cancer drug called lenalidomide (Revlimid)
    • both dexamethasone and a cancer drug called daratumumab (Darzalex)

About multiple myeloma

Multiple myeloma is a type of blood cancer that forms in your white blood cells. With this condition, your healthy blood cells are crowded out by cancer cells inside your bone marrow. (Your body makes new blood cells inside your bone marrow.) These cancer cells can lower the ability of your immune system to fight infection. They can also make certain proteins that cause damage inside your body.

Effectiveness for multiple myeloma

In clinical studies, Kyprolis was effective in treating multiple myeloma. In these studies, Kyprolis was given to people with multiple myeloma whose past treatments didn’t work to treat the condition.

Effectiveness of Kyprolis alone

Several clinical studies also looked at treatment with Kyprolis alone in people with multiple myeloma whose past treatments didn’t work. In these studies, between 23% to 50% of people using the drug had their condition improve with treatment.

Effectiveness of Kyprolis with dexamethasone

In a clinical study, people were given either Kyprolis and dexamethasone or bortezomib (Velcade) and dexamethasone. (Velcade is another drug used to treat multiple myeloma.) In this study:

  • in half of the people who took Kyprolis plus dexamethasone, their multiple myeloma didn’t get worse for 18.7 months or longer
  • in half of the people who took bortezomib plus dexamethasone, their multiple myeloma didn’t worsen for 9.4 months or longer

Also in this study, 77% of people who took Kyprolis and dexamethasone had their multiple myeloma improve with treatment. For those who took bortezomib and dexamethasone, 63% had the same result.

Effectiveness of Kyprolis with lenalidomide and dexamethasone

In one clinical study, people were given both lenalidomide (Revlimid) and dexamethasone, either with Kyprolis or with a placebo (treatment with no active drug). In this study:

  • in half of the people who took Kyprolis with lenalidomide plus dexamethasone, their multiple myeloma didn’t get worse for 26.3 months or longer
  • in half of the people who took a placebo plus lenalidomide and dexamethasone, their multiple myeloma didn’t worsen for 17.6 months or longer

Also in the study, 87% of people taking Kyprolis had their multiple myeloma improve with treatment. For those who didn’t take Kyprolis, 67% had the same result.

Effectiveness of Kyprolis with daratumumab and dexamethasone

In another clinical study, some people were given Kyprolis with dexamethasone and daratumumab (Darzalex). Other people were given Kyprolis with just dexamethasone. In this study, improvement in multiple myeloma was seen in:

  • 84% of people who took Kyprolis with daratumumab and dexamethasone
  • 75% of people who took Kyprolis with dexamethasone

Kyprolis can be used alone or with other medications to treat multiple myeloma. Some forms of cancer, such as multiple myeloma, are typically treated with more than drug.

Depending on how your multiple myeloma has been treated in the past, Kyprolis can be used in one of the following ways:

  • on its own if you’ve received one or more multiple myeloma treatments in the past
  • in combination with a steroid called dexamethasone if you’ve received one to three other treatments in the past
  • in combination with both dexamethasone and a cancer drug called lenalidomide (Revlimid) if you’ve received one to three other treatments in the past
  • in combination with both dexamethasone and a cancer drug called daratumumab (Darzalex) if you’ve received one to three other treatments in the past

In addition to dexamethasone and lenalidomide, other drugs are sometimes also used with Kyprolis to help treat multiple myeloma. These drugs include:

  • cyclophosphamide (Cytoxan, Neosar)
  • panobinostat (Farydak)
  • pomalidomide (Pomalyst)

Your doctor will recommend whether you’ll need to use any drugs with Kyprolis to treat your multiple myeloma.

Other drugs are available that can treat multiple myeloma. Some may be better suited for you than others. If you’re interested in finding an alternative to Kyprolis, talk to your doctor to learn more about other medications that may work well for you.

Note: Some of the drugs listed below are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Examples of other drugs that may be used to treat multiple myeloma include:

  • proteasome inhibitors, such as:
    • bortezomib (Velcade)
  • monoclonal antibodies, such as:
    • daratumumab (Darzalex), which is described in more detail below
  • immunomodulating agents, such as:
    • pomalidomide (Pomalyst), which is described in more detail below
  • chemotherapy drugs, such as:
    • cyclophosphamide (Cytoxan, Neosar)
    • vincristine
    • doxorubicin (Adriamycin)
    • liposomal doxorubicin (Doxil)
    • bendamustine (Treanda)
    • melphalan
  • other medications, such as panobinostat (Farydak)

Darzalex (daratumumab)

Darzalex is a brand-name prescription drug that’s approved to treat multiple myeloma. It contains the drug daratumumab. Darzalex is a monoclonal antibody, which means it’s a drug that’s made from immune system cells. It works by attaching to cancer cells and telling your body’s immune system to destroy them.

Darzalex is used to treat multiple myeloma in people with the following situations:

  • People with newly diagnosed multiple myeloma. For this use, Darzalex is either given with bortezomib (Velcade), melphalan (Alkeran), and prednisone; with lenalidomide (Revlimid) and dexamethasone; or with bortezomib (Velcade), thalidomide (Thalomid), and dexamethasone.
  • People who’ve tried at least one other treatment in the past. For this use, Darzalex is given with either lenalidomide (Revlimid) and dexamethasone or bortezomib (Velcade) and dexamethasone.
  • People who’ve tried at least two other treatments in the past. For this use, Darzalex is given with pomalidomide (Pomalyst) and dexamethasone.
  • People who’ve tried at least three other past treatments, which included medications called proteasome inhibitors and immunomodulatory agents. For this use, Darzalex is used alone.
  • People who’ve used, but not improved with, treatment from both a proteasome inhibitor and an immunomodulatory agent. For this use, Darzalex is used alone.

In addition, Darzalex may be used in combination with Kyprolis and dexamethasone to treat multiple myeloma in certain people. For more information, see the “Kyprolis for multiple myeloma” section above.

Pomalyst (pomalidomide)

Pomalyst is a brand-name prescription drug that’s also approved to treat multiple myeloma. It contains the drug pomalidomide. Pomalyst belongs to a class of drugs called immunomodulatory agents. It works by changing (modulating) your body’s immune system. The drug helps your immune system to find and destroy cancer cells.

Pomalyst is approved for use in people with multiple myeloma who’ve tried at least two other treatments in the past. For this use, Pomalyst is given with dexamethasone.

You may wonder how Kyprolis compares to other medications that are prescribed for similar uses. Here we look at how Kyprolis and Velcade are alike and different.

Ingredients

Kyprolis contains the drug carfilzomib, while Velcade contains the drug bortezomib. These drugs both belong to a class of medications called proteasome inhibitors.

Uses

Kyprolis is approved to treat multiple myeloma in adults whose past treatments didn’t work to treat the condition. Depending on how the multiple myeloma has been treated in the past, Kyprolis can be given:

  • on its own
  • in combination with either:
    • a steroid called dexamethasone
    • both dexamethasone and a cancer drug called lenalidomide (Revlimid)
    • both dexamethasone and a cancer drug called daratumumab (Darzalex)

Velcade is also approved to treat multiple myeloma in adults. It can be used in people who’ve never been treated before for multiple myeloma and in people whose past treatments didn’t work.

In addition, Velcade is approved to treat another type of cancer called mantle cell lymphoma.

Drug forms and administration

Kyprolis comes as a powder inside single-dose vials. It’s mixed with liquid and given as an intravenous (IV) infusion by healthcare providers. With an IV infusion, the drug is injected into your vein over a period of time. Kyprolis infusions generally last about 10 to 30 minutes.

Velcade also comes as powder that’s mixed with liquid and given by healthcare providers. However, Velcade can be given by either IV infusion or subcutaneous injection (an injection under your skin).

With either of these drugs, your doctor will recommend the appropriate dosing schedule for you. Your dosing schedule will depend on whether you’re also taking other drugs or if you’ve used certain treatments in the past.

Side effects and risks

Kyprolis and Velcade both belong to a class of drugs called proteasome inhibitors. Therefore, both medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Kyprolis, with Velcade, or with both drugs (when taken individually).

  • Can occur with Kyprolis:
    • trouble breathing
    • cough
    • edema (swelling) in your feet, ankles, legs, hands, or arms
  • Can occur with Velcade:
  • Can occur with both Kyprolis and Velcade:

Serious side effects

These lists contain examples of serious side effects that can occur with Kyprolis, with Velcade, or with both drugs (when taken individually).

  • Can occur with Kyprolis:
    • kidney problems, such as kidney failure
    • infusion reaction (a type of reaction that may occur after having a drug infused into your veins)
    • bleeding problems, which may be caused by severe thrombocytopenia (very low platelet level)
  • Can occur with Velcade:
    • very low blood pressure
    • problems with your stomach and intestines
    • severe peripheral neuropathy (severe weakness, numbness, or pain in your hands and feet)
    • severe neutropenia (very low level of certain white blood cells)
  • Can occur with both Kyprolis and Velcade:
    • severe thrombocytopenia (very low platelet level)
    • tumor lysis syndrome (imbalance in your body that’s caused by cancer cell death)
    • posterior reversible encephalopathy syndrome (swelling in your brain)
    • thrombotic microangiopathy (blood clots in your small blood vessels)
    • severe allergic reaction

Effectiveness

Kyprolis and Velcade are both approved to treat multiple myeloma. Kyprolis is specifically approved for use in people whose past treatments didn’t work for the condition. But Velcade can be used in people who’ve never been treated before for multiple myeloma and in people whose past treatments didn’t work.

The use of Kyprolis and Velcade in treating multiple myeloma has been directly compared in a clinical study. In this study, Kyprolis and Velcade were each used in combination with dexamethasone.

The study showed that:

  • for half of the people who took Kyprolis and dexamethasone, their multiple myeloma didn’t get worse for 18.7 months or longer
  • for half of the people who took Velcade and dexamethasone, their multiple myeloma didn’t worsen for 9.4 months or longer

Costs

Kyprolis and Velcade drug are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Kyprolis and Velcade are each given by healthcare providers. The price you’ll pay for either drug depends on where you receive your treatments and your insurance coverage.

There aren’t any known interactions between alcohol and Kyprolis. However, drinking large amounts of alcohol may cause you to have kidney or liver problems. And having kidney or liver problems can increase your risk of side effects from Kyprolis.

If you drink alcohol, talk with your doctor about the risks of drinking while you’re taking Kyprolis.

Kyprolis can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Kyprolis and other medications

Below is a list of medications that may interact with Kyprolis. This list does not contain all the drugs that may interact with Kyprolis.

Before taking Kyprolis, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Kyprolis and contraception

Certain birth control (contraceptive) medications that contain hormones may increase your risk of blood clots. Kyprolis also increases your risk of developing blood clots. Taking Kyprolis with these contraceptives may further increase your risk of clots.

Examples of birth control medications that may increase your risk of blood clots include:

  • birth control pills, such as:
    • ethinyl estradiol/norgestimate (Ortho Cyclen)
    • ethinyl estradiol/levonorgestrel (Alesse)
    • ethinyl estradiol/norethindrone acetate (Loestrin)
  • birth control skin patch (Xulane)
  • birth control vaginal ring (NuvaRing)
  • hormonal intrauterine devices (Mirena, Skyla, Kyleena)

If you’re using birth control that increases your risk of blood clots, talk with your doctor about using another method of contraception. Your doctor can recommend birth control methods that are safe to use with Kyprolis.

It’s important to note that pregnancy should be avoided while you’re using Kyprolis. See the section “Kyprolis and birth control” below for more information.

Kyprolis is approved to treat a form of cancer called multiple myeloma. With this condition, your healthy blood cells are crowded out by cancer cells inside your body. The cancer cells affect how well your immune system works. And they make certain proteins that cause damage inside your body.

Kyprolis belongs to a class of medications called proteasome inhibitors. It works by attaching to proteasomes in your body. Proteasomes are complex proteins that are responsible for breaking down other proteins.

When Kyprolis binds to proteasomes, it stops them from breaking down proteins in multiple myeloma cells. This ultimately leads to death of the multiple myeloma cells. This is how Kyprolis works to destroy multiple myeloma cancer cells. This action helps to slow the growth or spread of the cancer cells in your body.

How long does it take to work?

To see if your body is responding to cancer treatments, including Kyprolis, doctors usually order different types of tests. These tests may include certain labs or imaging scans.

In clinical studies, it took about 1 to 2 months after people had started Kyprolis for them to have a response to treatment. For some people, however, it took longer to see a response to the drug.

Your doctor will order certain tests to see if Kyprolis is working for you. They’ll recommend a plan to monitor your treatment progress based on your unique situation.

You shouldn’t take Kyprolis if you’re pregnant or planning to become pregnant. In animal studies, Kyprolis caused severe harm to fetuses when pregnant females were given the medication.

To help prevent pregnancy, it’s recommended that both men and women taking Kyprolis use effective birth control. See the next section, “Kyprolis and birth control,” for more information.

If you have questions about the safety of using Kyprolis during pregnancy, talk with your doctor.

It’s recommended that pregnancy be avoided while you’re using Kyprolis. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about options for birth control during Kyprolis treatment.

Recommendations for birth control use in both men and women using Kyprolis are described below.

For women using Kyprolis

If you’re a woman using Kyprolis, you’ll be tested for pregnancy before starting treatment. This is done to make sure that you aren’t pregnant before starting the drug.

If you’re able to become pregnant, you should use an effective form of birth control during Kyprolis treatment. And you should continue to use birth control for at least 6 months after your last dose of the drug.

It’s important to note that certain birth control medications that contain hormones may interact with Kyprolis. See the section above called “Kyprolis interactions” for more information. Talk with your doctor about effective birth control options that are safe to use with Kyprolis.

For men using Kyprolis

If you’re a man using Kyprolis, and you have a female partner who’s able to become pregnant, you should use birth control (such as condoms) during treatment with the drug. And you should continue to use birth control for at least 3 months after your last dose of Kyprolis.

It’s not known for sure if Kyprolis is passed into human breast milk. However, many drugs can be passed into human milk when they’re taken by lactating women.

Because Kyprolis may possibly cause side effects if passed to a child who’s breastfed, women taking the drug shouldn’t breastfeed during treatment. Women should also avoid breastfeeding for at least 2 weeks after their last dose of Kyprolis.

If you have questions about breastfeeding while using Kyprolis, talk with your doctor. They can recommend safe and healthy ways to feed your child.

Here are answers to some frequently asked questions about Kyprolis.

What is the overall survival for people using Kyprolis?

Overall survival describes the length of time from when your disease is first diagnosed or treatment has been started, until death. In clinical studies, overall survival is used to show how well certain treatments work.

In clinical studies of people with multiple myeloma who took Kyprolis, the overall survival was as follows:

  • half of the people taking Kyprolis with dexamethasone lived at least 47.6 months
  • half of the people taking Kyprolis with both dexamethasone and lenalidomide lived at least 48.3 months

If you have questions about the survival length with Kyprolis treatment, talk with your doctor.

Is Kyprolis a chemotherapy drug?

No, Kyprolis isn’t a chemotherapy drug. Typically, chemotherapy refers to traditional drugs used to treat cancer. Chemotherapy works by attacking cells in your body that are quickly multiplying (making more cells). Because cancer cells multiply quickly, chemotherapy affects these cells. But chemotherapy can also affect healthy cells in your body that multiply quickly.

Unlike chemotherapy, Kyprolis is considered a targeted therapy. It belongs to a class of drugs called proteasome inhibitors. Kyprolis targets (works on) specific proteins (called proteasomes) in your body, instead of affecting all your rapidly multiplying cells.

Because targeted therapies affect fewer cells in your body, these drugs can cause different, and sometimes fewer, side effects than chemotherapy drugs cause.

What can I do to prevent side effects while I’m taking Kyprolis?

One thing you can do to prevent side effects from Kyprolis is to stay hydrated. You should drink plenty of fluids before your Kyprolis infusions. Your doctor will tell you how much to drink based on your body weight. It’s a good idea to stay well hydrated over the course of your Kyprolis treatment.

Before you receive Kyprolis infusions, you may also be given certain medications to help prevent side effects. For example, the steroid dexamethasone is given before Kyprolis infusions to help prevent infusion reactions. (With an infusion reaction, your body reacts to a drug that’s given by intravenous [IV] infusion.)

Other medications may also be given to you before your Kyprolis infusions to help prevent other side effects. These side effects include blood clots and herpes zoster infection (also called shingles).

Does Kyprolis cure multiple myeloma?

No, it doesn’t. In fact, at this time, there isn’t a cure for multiple myeloma. However, treatment with Kyprolis may help to slow the worsening of your multiple myeloma.

In addition, treating multiple myeloma helps to reduce symptoms of the condition and improve your quality of life. Treatment may also help you to live longer with the condition.

If you’d like to know more about the benefits of using Kyprolis to treat your multiple myeloma, talk with your doctor.

Can I take this drug if I’ve had a stem cell transplant?

Yes, you may be able to use Kyprolis if you’ve had a stem cell transplant in the past. Your doctor can review your past treatments for multiple myeloma and recommend whether Kyprolis is a good treatment option for you.

Before taking Kyprolis, talk with your doctor about your health history. Kyprolis may not be right for you if you have certain medical conditions. These conditions include:

  • Heart problems. If you have heart disease or other heart problems, taking Kyprolis may worsen your condition. If your heart problems worsen, your doctor may lower your dosage of Kyprolis. Or they may recommend that you stop taking Kyprolis. Talk with your doctor about any heart issues you have before starting this medication.
  • Kidney problems. If you have kidney problems, taking Kyprolis may worsen your condition. If your kidney problems worsen, your doctor may lower your dosage of Kyprolis. Or they may recommend that you stop taking Kyprolis. Talk with your doctor about any history of kidney issues before starting this medication.
  • Liver problems. If youhave liver problems, Kyprolis may worsen your condition. If your liver condition does worsen, your doctor may lower your dosage of Kyprolis. Or they may recommend that you stop taking Kyprolis. Talk with your doctor about any liver problems you have before starting this medication.
  • Bleeding problems. Kyprolis may cause thrombocytopenia (low platelet level) in some people. This condition reduces your body’s ability to stop bleeding. If you already have bleeding problems, taking Kyprolis may worsen your condition. If this happens, your doctor may lower your dosage of Kyprolis. Or they may recommend that you stop taking Kyprolis. Talk with your doctor about any history of bleeding issues before starting this medication.
  • Lung problems. Kyprolis may cause lung damage and trouble breathing in some people. If you already have lung problems, taking Kyprolis may worsen your condition. If this happens, your doctor may recommend that you stop taking Kyprolis. Talk with your doctor about any lung issues before starting this medication.
  • Not being eligible for transplant. If you were recently diagnosed* with multiple myeloma and you aren’t eligible to receive a bone marrow transplant, you should not take Kyprolis with melphalan and prednisone. Using this combination of drugs in people who are not able to have a transplant is not approved because it increases the risk of very serious side effects. Talk with your doctor about whether you are able to receive a bone marrow transplant before starting Kyprolis.
  • Contraceptive use. Kyprolis may cause blood clots in some people using the drug. Taking Kyprolis with certain birth control medications may further increase your risk of blood clots. If you’re taking birth control medications that increase your risk of blood clots, you should talk with your doctor about using another form of contraception during Kyprolis treatment. For more information about this, see the section “Kyprolis interactions” above.
  • Pregnancy. Pregnancy should be avoided if either you or your partner are using Kyprolis. For more information, please see the sections “Kyprolis and pregnancy” and “Kyprolis and birth control” above.
  • Breastfeeding. Breastfeeding should be avoided during Kyprolis treatment. For more information, please see the “Kyprolis and breastfeeding” section above.

Note: For more information about the potential negative effects of Kyprolis, see the “Kyprolis side effects” section above.

* People recently diagnosed with multiple myeloma aren’t typically given Kyprolis.

The following information is provided for clinicians and other healthcare professionals.

Indications

Kyprolis is approved to treat multiple myeloma in adults. It can be used in the following scenarios:

  • in people with relapsed or refractory multiple myeloma who have received one to three lines of therapy, Kyprolis should be used in combination with either:
    • dexamethasone alone
    • dexamethasone plus lenalidomide (Revlimid)
    • dexamethasone plus daratumumab (Darzalex)
  • in people with relapsed or refractory multiple myeloma who have received one or more lines of therapy, Kyprolis can be used alone

Mechanism of action

Kyprolis is a tetrapeptide epoxyketone proteasome inhibitor. It works by irreversibly binding to the 20S proteasome. This binding inhibits proteasome activity that normally recycles proteins within a cell. This inhibition leads to cell apoptosis.

In vitro, Kyprolis was shown to inhibit proliferative activity and promote apoptosis in solid and hematologic tumor cells.

Pharmacokinetics and metabolism

Maximum concentration of Kyprolis is dose-dependent based on its infusion rate. The average steady-state volume of a 20 mg/m2 dose was 28 L. Kyprolis has a half-life of less than 1 hour.

Kyprolis is cleaved by peptidases and undergoes epoxide hydrolysis, with minor metabolism occurring by cytochrome P450 pathways. A total of 25% of the drug is excreted in urine as a metabolite.

Contraindications

There are no reported contraindications.

Storage

Kyprolis vials should be stored in the refrigerator, at a temperature of 36°F to 46°F (2°C to 8°C). The drug should remain in its original packaging to protect it from light. Once reconstituted, Kyprolis is stable for either 24 hours if refrigerated or 4 hours if kept at room temperature.

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 other 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.