| Multiple Myeloma

Kyprolis vs Ninlaro

Side-by-side clinical, coverage, and cost comparison for multiple myeloma.

Deep comparison between: Kyprolis vs Ninlaro with Prescriber.AI

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Safety signalsNinlaro has a higher rate of injection site reactions vs Kyprolis based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Ninlaro but not Kyprolis, including UnitedHealthcare

Category

Kyprolis

Ninlaro

At A Glance

RouteIV infusion

FrequencyOnce or twice weekly

ClassProteasome inhibitor

RouteOral

FrequencyOnce weekly (Days 1, 8, 15 of 28-day cycle)

ClassProteasome inhibitor

Indications

Multiple Myeloma

Multiple Myeloma

Dosing

Multiple Myeloma 20/70 mg/m2 IV once weekly as a 30-minute infusion on Days 1, 8, and 15 of each 28-day cycle (in combination with dexamethasone, daratumumab plus dexamethasone, or daratumumab and hyaluronidase-fihj plus dexamethasone); start at 20 mg/m2 on Cycle 1, Day 1, escalate to 70 mg/m2 on Cycle 1, Day 8 if tolerated.

Multiple Myeloma 20/56 mg/m2 IV twice weekly as a 30-minute infusion on Days 1, 2, 8, 9, 15, and 16 of each 28-day cycle (as monotherapy or in combination with dexamethasone, daratumumab plus dexamethasone, daratumumab and hyaluronidase-fihj plus dexamethasone, or isatuximab plus dexamethasone); start at 20 mg/m2 on Cycle 1, Days 1 and 2, escalate to 56 mg/m2 on Cycle 1, Day 8 if tolerated.

Multiple Myeloma 20/27 mg/m2 IV twice weekly as a 10-minute infusion on Days 1, 2, 8, 9, 15, and 16 (Cycles 1-12) or Days 1, 2, 15, and 16 (Cycle 13+) of each 28-day cycle (as monotherapy or in combination with lenalidomide and dexamethasone); start at 20 mg/m2 on Cycle 1, Days 1 and 2, escalate to 27 mg/m2 on Cycle 1, Day 8 if tolerated.

Multiple Myeloma 4 mg orally once weekly on Days 1, 8, and 15 of a 28-day cycle in combination with lenalidomide 25 mg daily (Days 1-21) and dexamethasone 40 mg (Days 1, 8, 15, 22); reduce starting dose to 3 mg for moderate or severe hepatic impairment, severe renal impairment (CrCl <30 mL/min), or ESRD requiring dialysis.

Contraindications

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Drug Interactions

1089View drug interactions

1162View drug interactions

Adverse Reactions

Most common (>=20%) Anemia, diarrhea, hypertension, fatigue, upper respiratory tract infection, thrombocytopenia, pyrexia, cough, dyspnea, insomnia

Serious Cardiac toxicities, acute renal failure, tumor lysis syndrome, pulmonary toxicity, pulmonary hypertension, venous thrombosis, infusion-related reactions, hemorrhage, hepatic toxicity and failure, thrombotic microangiopathy, posterior reversible encephalopathy syndrome, progressive multifocal leukoencephalopathy

Postmarketing Hemolytic uremic syndrome, hepatitis B virus reactivation, gastrointestinal perforation, pericarditis, cytomegalovirus infection

Most common (>=20%) Thrombocytopenia, neutropenia, diarrhea, constipation, peripheral neuropathy, nausea, peripheral edema, rash, vomiting, bronchitis

Serious Diarrhea, thrombocytopenia, bronchitis

Postmarketing Angioedema, toxic epidermal necrolysis

Pharmacology

Carfilzomib is a tetrapeptide epoxyketone proteasome inhibitor that irreversibly binds to the N-terminal threonine-containing active sites of the 20S proteasome within the 26S proteasome, producing antiproliferative and proapoptotic effects in hematologic and solid tumor cells.

Ixazomib is a reversible proteasome inhibitor that preferentially binds and inhibits the chymotrypsin-like activity of the beta 5 subunit of the 20S proteasome, inducing apoptosis in multiple myeloma cell lines and demonstrating synergistic cytotoxic effects in combination with lenalidomide.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Kyprolis