NINLARO is used in combination with lenalidomide and dexamethasone to treat adults with multiple myeloma who have received at least one prior therapy.
Ixazomib
NINLARO (Ixazomib) is the first and only oral proteasome inhibitor approved for use with lenalidomide and dexamethasone in treating relapsed or refractory multiple myeloma. Its oral formulation allows for convenient at-home dosing, reducing clinic visits and improving patient comfort and adherence. By targeting and blocking proteasomes, NINLARO promotes cancer cell death and has demonstrated effectiveness in prolonging progression-free survival. Its favorable safety profile and ease of use make it a strong choice for ongoing myeloma treatment.
STRENGTH:
NINLARO capsules are available in the following strengths 4 mg, 3 mg, and 2.3 mg
DOSAGE:
Following is the recommended dosage for Ninlaro:
Standard Dosage Schedule:
NINLARO (ixazomib): 4 mg orally once a week on Days 1, 8, and 15 of a 28-day treatment cycle. It should be taken at least 1 hour before or 2 hours after food. Swallow the capsule whole with water; do not crush, chew, or open it. If a dose is missed and the next dose is ≥72 hours away, take the missed dose. If vomiting occurs after taking a dose, do not repeat the dose; resume at the next scheduled dose.
- Lenalidomide: 25 mg orally daily on Days 1 through 21 of each 28-day cycle.
- Dexamethasone: 40 mg orally on Days 1, 8, 15, and 22 of each 28-day cycle.
NINLARO Dose Reductions due to Adverse Reactions
| Recommended starting dose* | First reduction to | Second reduction to | Discontinue |
| 4 mg | 3 mg | 2.3 mg |
Dosage Adjustments:
- Hepatic Impairment: For moderate or severe hepatic impairment, reduce the starting dose of NINLARO to 3 mg
- Renal Impairment: For severe renal impairment or end-stage renal disease requiring dialysis, reduce the starting dose of NINLARO to 3 mg. NINLARO is not dialyzable and can be administered without regard to the timing of dialysis.
ADVERSE REACTIONS:
The following are the adverse reactions observed in NINLARO
- Thrombocytopenia (low platelet count)
- Gastrointestinal issues
- Peripheral neuropathy (numbness, tingling, or pain in hands/feet)
- Fatigue
- Back pain
- Edema (swelling of limbs)
- Hepatotoxicity (liver toxicity)
- Thrombotic microangiopathy
- Severe skin reactions (e.g., Stevens-Johnson syndrome, rarely)
- Tumor lysis syndrome
- Hepatitis B reactivation
STORAGE:
Store NINLARO at room temperature. Do not store above 30°C.
- Thrombocytopenia: Thrombocytopenia has been observed with NINLARO, with the lowest platelet counts typically occurring between Days 14 and 21 of each 28-day treatment cycle, followed by a return to baseline levels by the beginning of the next cycle. Platelet counts should be monitored at least once a month during NINLARO treatment, with more frequent monitoring recommended during the first three treatment cycles.
- Gastrointestinal Toxicities: Diarrhea, constipation, nausea, and vomiting have been reported with NINLARO and may sometimes require the use of antidiarrheal or antiemetic medications, along with supportive care.
- Peripheral Neuropathy: Peripheral neuropathy with NINLARO was mostly mild to moderate (Grade 1–2: 29%), similar to placebo (22%). Grade 3 events occurred in 2% of both groups. Peripheral sensory neuropathy was most common (24% vs. 17%), while motor neuropathy was rare (<1%). Treatment was discontinued due to neuropathy in 4% of NINLARO patients. Monitor for symptoms and adjust dosing if neuropathy worsens.
- Peripheral Edema: Peripheral edema occurred in 27% of patients receiving the NINLARO regimen, compared to 21% with placebo. Most cases were mild to moderate, with Grade 1 reported in 17% (vs. 14% placebo) and Grade 2 in 7% (vs. 6% placebo).
- Cutaneous Reactions: Rash was reported in 27% of patients on the NINLARO regimen, compared to 16% with placebo. Most cases were mild to moderate, with Grade 1 rash in 15% (vs. 9%) and Grade 2 in 9% (vs. 4%).
FAQ
How is NINLARO taken?
NINLARO is taken orally, once a week on the same day each week for three weeks of a 28-day cycle, followed by one week off. It should be taken at least one hour before or two hours after food.
Can pregnant or breastfeeding women take NINLARO?
No. NINLARO may harm an unborn baby. It is not recommended during pregnancy or breastfeeding. Effective contraception is advised during treatment and for at least 90 days after the last dose.
How should NINLARO be stored?
Store NINLARO capsules at room temperature in the original packaging. Do not remove the capsule until ready to take it.
What is NINLARO used for?
NINLARO is used in combination with lenalidomide and dexamethasone to treat adults with multiple myeloma who have received at least one prior therapy.
What are the key criteria for selecting a supplier?
While selecting a supplier, we essentially ensure that the supplier holds a valid Good Distribution Practice (GDP) and possess valid operating license. These credentials confirm that the supplier’s adherence to International standards for the proper distribution of medicinal products.
What is the cost of ninlaro (ixazomib) in India?
The cost of ninlaro (ixazomib) in India varies as it is not locally manufactured and must be imported. Pricing depends on supplier availability, import duties, and international currency fluctuations. For the latest Ixazomib price details, contact 24/7QualityMeds at +91 9967979080.
How to buy ninlaro (ixazomib) online in India?
To buy ninlaro (ixazomib) online in India at a genuine price, reach out to 24/7QualityMeds. We guide patients through the legal import process and ensure safe, timely delivery of medicines from reliable global sources.




