Generic Name(s): Carfilzomib

Kyprolis™ is the trade name for the generic drug Carfilzomib. In some cases, health care professionals may use the generic name Carfilzomib when referring to the trade name Kyprolis™.

Drug Type:

Kyprolis™ is a targeted therapy. Kyprolis™ is classified as a Proteasome Inhibitor. (For more detail, see "How this drug works" below).

What Kyprolis™ Is Used For:

• Treatment of multiple myeloma

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Kyprolis™ Is Given:

• As an intravenous/IV (into the vein) infusion.

The amount of Kyprolis™ that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition you have. Your doctor will determine your exact dosage and schedule.

Side Effects:

Important things to remember about the side effects of Kyprolis™:

• Most people will not experience all of the Kyprolis™ side effects listed.
• Kyprolis™ side effects are often predictable in terms of their onset, duration, and severity.
• Kyprolis™ side effects will improve after therapy is complete.
• Kyprolis™ side effects may be quite manageable. There are many options to minimize or prevent the side effects of Kyprolis™.

The following side effects are common (occurring in greater than 30%) for patients taking Kyprolis™:

• Low blood counts. Your white and red blood cells in addition to your platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
• Platelet nadir : about day 8 of cycle

• Fatigue
• Nausea
• Shortness of breath
• Diarrhea
• Fever

These are less common side effects (occurring in about 10-29%) of patients receiving Kyprolis™:

• Upper respiratory infection
• Headache
• Cough
• Swelling
• Increased kidney function tests (creatinine)
• Vomiting
• Constipation
• Back pain
• Difficulty sleeping
• Muscle aches
• Chills
• Muscle spasms
• Numbness and tingling in hands and feet
• Weakness
• Low potassium
• Low magnesium
• High blood pressure
• Arm and leg pain
• Dizziness
• Increased liver enzymes (AST)
• Pneumonia
• Poor appetite
• High blood sugar
• High calcium
• Low phosphorus
• Chest wall pain
• Low Sodium

Not all side effects are listed above. Side effects that are very rare -- occurring in less than about 10 percent of patients -- are not listed here. But you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

• Fever of 100.4º F (38º C) or higher, chills (possible signs of infection)
• Severe Shortness of breath

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

• Diarrhea (4-6 episodes in a 24-hour period).
• Nausea (interferes with ability to eat and unrelieved with prescribed medication).
• Vomiting (vomiting more than 4-5 times in a 24 hour period).
• Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness.
• Shortness of breath, with or without cough and/or fever.

• Skin or the whites of your eyes turn yellow
• Urine turns dark or brown (tea color)
• Decreased appetite
• Pain on the right side of your stomach
• Bleed or bruise more easily than normal
• Itching or rash
• Changes in thinking clearly with logic
• Numbness or tingling in your hands or feet

· Signs of infection. These include: very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, wound that will not heal or anal itching or pain.

• Black or tarry stools, or blood in your stools
• Blood in the urine
• Pain or burning with urination

· Extreme fatigue (unable to carry on self-care activities)

• Very bad swelling

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

• Before starting Kyprolis™ treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
• Do not receive any kind of immunization or vaccination without your doctor’s approval while taking Kyprolis™.
• Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Kyprolis™ may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.).
• For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking Kyprolis™. Barrier methods of contraception, such as condoms, are recommended.
• Do not breast feed while taking Kyprolis™.

Self-Care Tips:

• Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
• You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
• Wash your hands often.
• When working in your yard, wear protective clothing including long pants and gloves.
• Do not handle pet waste.
• Keep all cuts or scratches clean.
• Shower or bath daily and perform frequent mouth care.
• Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
• Ask your doctor or nurse before scheduling dental appointments or procedures.
• Ask your doctor or nurse before you, or someone you live with, has any vaccinations.
• Use an electric razor and a soft toothbrush to minimize bleeding.
• Avoid contact sports or activities that could cause injury.
• To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals. Good mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help.
• For constipation, drinking more liquids, working out, or adding fiber to your diet may help. Talk with your doctor about a stool softener or laxative.
• Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
• Get plenty of rest.
• Maintain good nutrition.
• If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
• For flu-like symptoms, keep warm with blankets and drink plenty of liquids. There are medications that can help reduce the discomfort caused by chills.
• Acetaminophen may help relieve discomfort from fever, headache and/or generalized aches and pains. However, be sure to talk with your doctor before taking it.
• Keep your mouth clean with baking soda and salt rinses. You can mix 1/2 to 1 tsp. of baking soda and/or 1/2 to 1 tsp. salt in 8 ounces of water, and use as a mouthwash, to avoid or decrease the severity of mouth sores.

If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

• You will be checked regularly by your doctor while you are taking Kyprolis™, to monitor side effects and check your response to therapy. Periodic blood work will be obtained to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys, lungs, heart and liver) will also be ordered by your doctor.

· Because drug toxicity is seen, periodic physical examinations and review of your symptoms, which includes a check of your reflexes, is necessary.

How Kyprolis™ Works:

Targeted therapy is the result of about 100 years of research dedicated to understanding the differences between cancer cells and normal cells. To date, cancer treatment has focused primarily on killing rapidly dividing cells because one feature of cancer cells is that divide rapidly. Unfortunately, some of our normal cells divide rapidly too, causing multiple side effects.

Targeted therapy is about identifying other features of cancer cells. Scientists look for specific differences in the cancer cells and the normal cells. This information is used to create a targeted therapy to attack the cancer cells without damaging the normal cells, thus leading to fewer side effects. Each type of targeted therapy works a little bit differently but all interfere with the ability of the cancer cell to grow, divide, repair and/or communicate with other cells.

There are different types of targeted therapies, defined in three broad categories. Some targeted therapies focus on the internal components and function of the cancer cell. The targeted therapies use small molecules that can get into the cell and disrupt the function of the cells, causing them to die. There are several types of targeted therapy that focus on the inner parts of the cells. Other targeted therapies target receptors that are on the outside of the cell. Therapies that target receptors are also known as monoclonal antibodies.

The third broad category of targeted therapies is called anti-angiogenesis inhibitors. These therapies target the blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.

Research continues to identify which cancers may be best treated with targeted therapies and to identify additional targets for more types of cancer.

Kyprolis™ targets and inhibits the proteasome enzyme complex within the cell. Proteasome is part of the cellular machinery and has many functions within the cell, such as it helps to control the level of many of the proteins that help to regulate cell division and cell survival. By interfering with its function this can lead to apoptosis (cell suicide). In the laboratory, it has been shown that cancer cells are more susceptible to the effects of proteasome inhibitors, than normal cells are. In multiple myeloma, Kyprolis™ works by blocking the activation of certain molecules that allow plasma cells to "nest" in the bone marrow.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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