carfilzomib at a glance
Medicine class
Proteasome inhibitor and antineoplastic treatment
Licensed use
Previously treated multiple myeloma in adults
Administration
Intravenous infusion given by a specialist cancer team
Important monitoring
Blood counts, blood pressure, heart, kidney and liver function, electrolytes and fluid balance
What is carfilzomib used for?
Licensed uses include:
With daratumumab and dexamethasone for adults with multiple myeloma who have received previous therapy.
With lenalidomide and dexamethasone for adults with multiple myeloma who have received previous therapy.
With dexamethasone for adults with multiple myeloma who have received previous therapy.
How does carfilzomib work?
Proteasomes break down unwanted cellular proteins. Carfilzomib binds selectively and irreversibly to the proteasome, causing proteins to accumulate and promoting the death of susceptible myeloma cells.
How to take carfilzomib
Trained staff prepare and administer carfilzomib as an infusion into a vein. It must not be given as an intravenous push or bolus.
Attend appointments arranged by the cancer team.
Dexamethasone is given beforehand to reduce infusion reactions.
The team will manage hydration and check for fluid overload, particularly when heart problems are possible.
Report symptoms during or after the infusion because reactions can be delayed.
carfilzomib side effects
Common or expected effects
- Tiredness or weakness, including from anaemia
- Low platelets or white blood cells
- Infections, fever or chills
- Nausea, vomiting, diarrhoea or constipation
- Breathlessness or cough
- Headache, dizziness or altered sensation in the hands or feet
- High blood pressure or limb swelling
- Changes in kidney-function or electrolyte blood tests
Get urgent medical advice
- Heart failure, heart attack, cardiac arrest or serious abnormal heart rhythm
- Severe lung toxicity, pulmonary hypertension or respiratory failure
- Acute kidney injury or tumour lysis syndrome
- Severe infusion or allergic reaction
- Major bleeding or venous blood clot
- Severe hypertension
- Liver failure or hepatitis B reactivation
- Thrombotic microangiopathy
- PRES or progressive multifocal leukoencephalopathy
carfilzomib in pregnancy
Human pregnancy data are unavailable, and the mechanism and animal findings indicate potential fetal harm. Carfilzomib should normally be avoided during pregnancy unless a specialist concludes that benefit outweighs risk. Effective contraception is required during treatment and afterwards. Oral contraceptive effectiveness may be reduced; lenalidomide-containing treatment also has strict pregnancy-prevention requirements.
carfilzomib while breastfeeding
Breastfeeding is contraindicated during carfilzomib treatment and afterwards because transfer into milk is unknown and harm to the infant cannot be excluded. Discuss feeding plans with the specialist team.
carfilzomib interactions
The cancer team should review all prescribed, non-prescription and herbal products. Relevant interactions include:
Oral or thrombosis-associated hormonal contraceptives
Contraceptive effectiveness may be reduced, while some hormonal methods may add to clot risk; an alternative effective method is required.
Digoxin or colchicine
Carfilzomib may affect P-glycoprotein transport, so additional caution and clinical monitoring may be needed.
Erythropoiesis-stimulating treatments or hormone replacement therapy
These may add to venous-thrombosis risk, requiring individual assessment.
Common questions about carfilzomib
Answers are fully visible for fast scanning and source review.
Why is carfilzomib given with other medicines?
Its licence is for use with dexamethasone and sometimes daratumumab or lenalidomide. These treatments act in complementary ways against previously treated multiple myeloma.
Is carfilzomib chemotherapy?
It is an antineoplastic treatment, specifically a targeted proteasome inhibitor.
Can carfilzomib affect the heart?
Yes. New or worsening heart failure, heart attack, abnormal rhythms and cardiac arrest have occurred, sometimes without known pre-existing heart disease.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.