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Multiple myeloma is a type of blood cancer, responsible for affecting the plasma cells (plasmacyte). Multiple myeloma is also addressed as plasma cell myeloma and simply myeloma. The multiple myeloma medications are often administered through an intravenous (IV) tube placed into a vein using a needle or as a capsule or pill that is swallowed (orally) whole. If you are given oral medicines, be sure to discuss with your health specialist about how to safely store and handle it. The types of medicines used for multiple myeloma (MM) include: Chemotherapy, Immunomodulatory drugs, Targeted therapy,
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ListofMultipleMyelomaMedications • WhatisMultipleMyeloma: • Plasmacellmyelomaalsoknownasmultiplemyeloma,isakindofcancerthatoccursinplasmacells,atypeofwhitebloodcellthatnormallyproducesantibodies. • Multiplemyelomadrugsareexistinginseveraldrugclasses,including: • ProteasomeInhibitors(PIs) • Immunomodulatorydrugs(IMiDs) • AlkylatingAgents • Corticosteroid • HistoneDeacetylaseInhibitors(HDACs) • Bisphosphonates • MonoclonalAntibodies(MAbs). • Abovementionedlistofmultiplemyelomamedicationsisusedasafrontlinerelapsetreatment.Theelaborationisasfollows: • Alkylating Agents: • Melphalan(Alkeran):MelphalanIndicatedforuseinpalliativetreatmentofMultiplemyeloma,approvedforusethroughoutthediseasecourse. • Possiblesideeffectsincludesuppressionofbloodcellcounts,hypersensitivityreactions,infertility,andpulmonarytoxicity. • Cyclophosphamide(Cytoxan):CyclophosphamideindicatedforuseinthetreatmentofMultiplemyelomaaloneorincombinationwithotheragents. • Possiblesideeffectsincludesuppressionofbloodcellcounts,urinarytractandrenaltoxicity,infections,diarrhea,vomiting,nausea,feverandpulmonarytoxicity. • Anthracycline: • Doxorubicin:Doxorubicinhclindicatedforuseincombinationwithbortezomibinpatientswhohavenotpreviouslyreceivedbortezomibandhavereceivedatleastonepriortherapy.
Possiblesideeffectsincludehairloss,vomiting,nausea,mouthsore,eyeproblems,allergicreactions,changeinthecolorofurine,decreasedbloodcellcount,infection,lowerspermcountandinfusionsitereactions.Possiblesideeffectsincludehairloss,vomiting,nausea,mouthsore,eyeproblems,allergicreactions,changeinthecolorofurine,decreasedbloodcellcount,infection,lowerspermcountandinfusionsitereactions. • Corticosteroid: • Dexamethasone(Decadron):DexamethasonehasnospecificFDAapprovalformyeloma,approvedforpalliativemanagementofleukemiasandlymphomas. • Usedinalmosteveryregimenforthefrontlineandrelapsedmultiplemyeloma.Notusedinmaintenancebecauseofsideeffectsfromlongtermused. • Possiblesideeffectsincludeinfection,fluidretention,rash,acne,weightgain,hoarseness,coughing,musclepain,sleeplessnessandelevatedbloodglucose. • Immunomodulatory Drugs (IMiDs): • Thalidomide(Thalomid):Thalidomideapprovedtouseincombinationwithdexamethasoneforthetreatmentofnewlydiagnosedmyeloma,butisusedthroughoutthediseasecourseincludingformaintenancetherapy. • possiblesideeffectsincludedizziness,rash,lowwhitebloodcellcount,drowsinessandembryo-fetaltoxicity. • Lenalidomide(Revlimid):Lenalidomide 25 mgapprovedtousethroughoutthediseasecourse,includingmaintenancetherapy. • Possiblesideeffectsoflenalidomidecouldbeasembryo-fetaltoxicity,lowwhitebloodcellcounts,lowplateletcounts,rash,anemia,fatigue,diarrheaandconstipation. • Pomalidomide(Pomalyst):Pomalidomide 4 mgapprovedinordertouseincombinationwithdexamethasoneforthetreatmentofpatientswithmultiplemyelomawhohaverelapsedafteratleast2priortherapiesincludingRevlimidandaproteasomeinhibitor. • Possiblesideeffectsofpomalidomide2mgor4mgincludelowwhitebloodcellcounts,embryo-fetaltoxicity,lowredbloodcellcounts,lowplateletcounts,dizziness,weakness,fatigue,constipation,confusion,nauseaanddiarrhea. • Proteasome Inhibitors (PIs): • Bortezomib(Velcade):Bortezomibapprovedforuseastreatmentformyelomaandasretreatmentforpatientswhohadpreviouslyrespondedtotreatmentandwhohaverelapsedatleast6monthsaftercompletingpriorVelcadetreatment.Possiblesideeffectsincludenausea,diarrhea,fatigue,thrombocytopenia,morerarelyheadache,lowbloodpressure,insomnia,backpain,feverandmusclecramps.
Carfilzomib(Kyprolis):Carfilzomibindicatedasasingleagentforpatientswithmultiplemyelomawhohavereceivedatleast2priorlinesoftherapyincludingbortezomibandanIMiD.Carfilzomib(Kyprolis):Carfilzomibindicatedasasingleagentforpatientswithmultiplemyelomawhohavereceivedatleast2priorlinesoftherapyincludingbortezomibandanIMiD. • Andincombinationwithlenalidomideanddexforpatientswithrelapsedmultiplemyelomawhohavereceived1-3priorlinesoftherapy. • Possiblesideeffectsincludeinfusionreactions,fatigue,cardiacevents,lowbloodpressure,shortnessofbreath,fever,diarrhea,anemiaandthrombocytopenia. • Monoclonal Antibodies (MAbs): • Daratumumab(Darzalex):DaratumumabindicatedforuseincombinationwithRdorVd,formultiplemyelomapatientswhohavehadatleast1priortherapy. • IncombinationwithVMPfornewlydiagnosednon-transplanteligiblepatients,asmonotherapyforpatientshavehadatleast3priortherapiesincludingaPIandanIMIDandoraredoublerefractorytoaPIandanIMID. • Possiblesideeffectsincludelowbloodcellcounts,backpain,fever,cough,fatigue,nauseaandinfusionreactions. • Histone Deacetylase Inhibitors (HDACs): • Panobinostat(Farydak):Panobinostat medicationisapprovedtousedincombinationwithbortezomibanddex(dexamethasone)forthetreatmentofmultiplemyelomapatientswhohavereceivedatleast2priorregimensincludingbortezomibandanIMiD. • Possiblesideeffectsincludediarrhea,vomiting,nausea,lowbloodcounts,fatigue,infections,hemorrhage,livertoxicityandembryo-fetaltoxicity. • Source:https://theindianpharmanet.wixsite.com/mysite/post/list-of-multiple-myeloma-medications