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Chemotherapy and other systemic treatment regimens may change due to COVID-19. Find out more at Systemic Treatment Regimens During COVID-19.

carfilzomib

( kar filz oh mib )
Funding:
New Drug Funding Program
  • Carfilzomib (Doublet Therapy) - In Combination with Dexamethasone for Relapsed Multiple Myeloma
  • Carfilzomib (Triplet Therapy) - In Combination with Lenalidomide and Dexamethasone for Relapsed Multiple Myeloma
Other Name(s): Kyprolis ()
Appearance: Powder for injection after mixing or mixed into larger bag of fluids.

Medication Information Sheet
carfilzomib (kar filz oh mib)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Kyprolis

Appearance:
Powder for injection after mixing or mixed into larger bag of fluids.

What is this medication for?
  • For treating patients with multiple myeloma who have received previous treatments. May be given in combination with oral medication(s).

What should I do before I have this medication?
  • Tell your doctor and pharmacist if you have or had significant medical condition(s), especially if you have or had:

    • liver, lung, kidney or heart problems

    • high blood pressure

    • bleeding problems or blood clots

    • are on a controlled sodium (salt) diet or

    • any allergies

  • Ensure you are not dehydrated. Check with your doctor to see if you need to drink extra fluids before getting this drug.

  • People with cancer have a higher risk of getting other cancers or developing blood clots. Some cancer medications may increase these risks, especially if used for a long period of time. Discuss any concerns about this medication with your health care team.

How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding
     
  • If there is ANY chance that you or your partner may become pregnant, you and your partner together must:
    • Use 2 effective forms of birth control at the same time while taking this drug: Keep using birth control until 90 days after the last dose for male patients; and until 30 days after the last dose for female patients. Discuss with your healthcare team.
       
  • Do not breastfeed while using this drug.
     
  • This medication may affect fertility (ability to get pregnant)
How is this medication given?
  • This drug is given by infusion into a vein.

  • If you miss an appointment to receive carfilzomib, contact your healthcare professional to find out when you should schedule your next dose.

What else do I need to know while on this medication?
  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.
     
  • Make sure your doctor and pharmacist know about all your medicines (prescription, over-the-counter, herbals and supplements), especially if you are taking birth control pills. Check with your doctor or pharmacist before starting or stopping any of them.
     
  • For mild aches and pain:
    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
    • Talk to your health care team first before starting ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), since these may increase your chance of bleeding.
    • If you are already taking aspirin regularly, such as for heart conditions; Do not stop it- talk to your health care team first.
    • If you feel unwell, take your temperature before using any of these drugs. They may hide a fever. Phone your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
       
  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.
     
  • If you feel dizzy, tired or light-headed while taking this medication, avoid driving, operating machinery or activities where you need to be alert
What are the side effects of this medication?

The following side effects have been seen in people using carfilzomib with other chemotherapy drugs, so some of these effects may be caused by chemotherapy.

You may not have all of the side effects below. You may have side effects that are not listed.

Side effects and what to do When to contact doctor?
Common Side Effects (25-49 out of 100 people)

Allergic reaction (maybe severe)

  • The most common symptoms include fever, itchiness, rash, swollen lips, face or tongue, chest and throat tightness.

It may occur during or shortly after the medication is given to you. Let your health care team know right away if this happens to you.

Get emergency medical help right away

Diarrhea (maybe severe)

May happen days to weeks after you get your treatment.

If you have diarrhea :

  • Take anti-diarrhea medication if your health care team prescribed it.
  • Avoid foods or drinks with artificial sweetener (e.g. chewing gum, “diet” drinks), coffee and alcohol.
  • Eat many small meals and snacks instead of 2 or 3 large meals.
  • Drink at least 6 to 8 cups of liquids each day. Talk to your health care team if you can’t drink 6-8 cups of liquids each day when you have diarrhea. You may need special liquids with salt and sugar, called Oral Rehydration Therapy.

​See the Diarrhea pamphlet for more information.

Contact your health care team if no improvement or if severe

High blood pressure

  • Check your blood pressure regularly. Your doctor may prescribe medication to treat high blood pressure.
  • If you have a severe headache, severe dizziness, or if you faint get emergency help right away as it may be a sign your blood pressure is too high or too low.
Contact your health care team if no improvement or if severe

Fatigue (tiredness)

  • Be active and aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days. Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Eat well and stay hydrated by drinking at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired

See our Fatigue pamphlet for more information. 

Contact your health care team if no improvement or if severe

Cough; feeling short of breath

You may have cough and feel short of breath without any signs of infection, such as a sore throat or a stuffed nose.

Rarely this may be severe with chest pain, trouble breathing or coughing up blood.  If this happens get medical help right away.

Contact your health care team if no improvement or if severe

Low platelets in the blood

  • Watch for bleeding (such as unusual nosebleeds or bleeding from the gums) or bruising easily (this is rare).
  • Very rarely, severe symptoms can happen. If you notice black coloured stools (poo), red or pink coloured urine (pee), red or brown coloured mucus when you cough, severe headache/confusion or bleeding that will not stop, you need to talk to your health care team or go to the nearest emergency room right away.

See the Low Platelet Count pamphlet for more information.

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting treatment:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often to prevent infection.
  • Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.


If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Get emergency medical help right away

Trouble falling asleep

  • This may be caused by one of your medications and may improve once your body gets used to the medication or when your treatment ends.
  • Talk to your doctor if this bothers you.
Contact your health care team if no improvement or if severe

Mild swelling in arms and legs; puffiness

To help prevent swelling :

  • Eat a low-salt diet.
  • Avoid tight fitting clothing.

If you have swelling in your legs, keep your feet up when sitting.

Contact your health care team if no improvement or if severe

 

Side effects and what to do When to contact doctor?
Less Common Side Effects (10-24 out of 100 people)

Nausea and vomiting

May occur in hours to days after your treatment. 

If you have nausea or vomiting:

  • Take anti-nausea medication(s) as prescribed to you by your doctor. 
  • Drink clear liquids and have small meals. Get fresh air and rest.
  • Do not eat spicy, fried foods or foods with a strong smell.
  • Limit caffeine (e.g. coffee, tea) and alcohol.
  • Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.

Contact your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours

Headache; mild joint, muscle pain or cramps 

  • Take your pain medication as prescribed by your doctor.
  • You can take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
  • Talk to your doctor or pharmacist first before taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin. These medication may increase bleeding risk.
  • Rest often and try light exercise as it may help.
Contact your health care team if no improvement or if severe

Constipation

To help prevent constipation :

  • Drink more liquids and eat well. Drink at least 6 to 8 cups of liquids each day unless you have been told otherwise.
  • Be Active. Exercise can help to keep you regular.
  • Try to eat more fiber (e.g. fruits with skin, leafy greens and whole grains). If you take opioid pain medication, ask your health care team if eating more fibre is right for you.

To help treat constipation :

  • If you have not had a bowel movement in 2 to 3 days you may need to take a laxative. Ask your health care team what to do.

See the Constipation Pamphlet for more information.

Contact your health care team if no improvement or if severe

Tingling, numb fingers and toes

  • May slowly get better after your treatment ends.
  • Contact your health care team if you have trouble doing up buttons, writing, picking up small objects, have pain or trouble moving.
Contact your health care team if no improvement or if severe

Salt imbalances

It may cause muscle twitching, severe weakness or cramping, confusion and irregular heartbeat.

Get emergency medical help right away

High blood sugar 

  • You may feel thirsty and pee more often.
  • Your doctor may check your blood sugar level. You may be advised to change your diet or take medication to treat high blood sugar.
  • Check your blood sugar regularly if you have diabetes.
Contact your health care team as soon as possible

 

Pains or cramps in the belly

  • If you have constipation or diarrhea it may be causing the pain in your belly.
  • If the pain is severe, gets worse or doesn’t go away, talk to your health care team about other possible causes.

 

Contact your health care team if no improvement or if severe

Abnormal kidney lab tests

  • Signs of a kidney problem include swelling, passing very little or no pee, or new unusual weight gain. If you have these signs, call your health care team or go to your closest emergency department.
  • To prevent bladder or kidney problems, drink lots of water or other liquids. Your doctor may ask you to drink at least 6 to 8 cups (2 L) per day on treatment days, unless you have been told otherwise.
  • Your doctor may check your kidney function regularly.
Contact your health care team if no improvement or if severe

Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:

  • Irregular heartbeat, shortness of breath which worsens with activities, chest pain, fainting spells or swelling in your legs, ankles and belly.

  • Pain, swelling and hardening of the vein in an arm or leg; cough, have trouble breathing, have pain in your chest or cough up blood

  • Severe belly cramps, pain or belly tenderness or vomiting

  • Fever, joint pain, lower back pain, swelling, pee less than usual and have unusual weight gain, muscle twitching, severe weakness or cramping and feel confused

  • Red dots on skin, unusual bruising, bleeding, low platelets, pale skin and/or severe tiredness, passing little or no pee or dark-coloured pee

  • Severe headache, fainting, seizures, confusion and vision loss.


For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.