| Multiple Myeloma
Ninlaro vs Darzalex
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Ninlaro vs Darzalex with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsDarzalex has a higher rate of injection site reactions vs Ninlaro based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Darzalex but not Ninlaro, including UnitedHealthcare
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Category
Ninlaro
Darzalex
At A Glance
Oral
Once weekly (Days 1, 8, 15 of 28-day cycle)
Proteasome inhibitor
IV infusion
Weekly to every 4 weeks
Anti-CD38 monoclonal antibody
Indications
- Multiple Myeloma
- Multiple Myeloma
Dosing
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.
Multiple Myeloma 16 mg/kg IV; dosing schedule varies by combination regimen: weekly for initial doses (6-9 doses), then every 2-3 weeks, then every 4 weeks until disease progression; pre-medicate with corticosteroids, antipyretics, and antihistamines before each infusion.
Contraindications
—
- History of severe hypersensitivity (e.g., anaphylactic reactions) to daratumumab or any of the formulation components
Adverse Reactions
Most common (>=20%) Thrombocytopenia, neutropenia, diarrhea, constipation, peripheral neuropathy, nausea, peripheral edema, rash, vomiting, bronchitis
Serious Diarrhea, thrombocytopenia, bronchitis
Postmarketing Angioedema, toxic epidermal necrolysis
Most common (>=20%) Upper respiratory infection, neutropenia, infusion-related reactions, thrombocytopenia, diarrhea, constipation, anemia, peripheral sensory neuropathy, fatigue, peripheral edema, nausea, cough, pyrexia, dyspnea, asthenia
Serious Pneumonia, infusion-related reactions (Grade 3-4), neutropenia, thrombocytopenia, febrile neutropenia, sepsis
Postmarketing Anaphylactic reaction, infusion-related reactions (including deaths), pancreatitis, cytomegalovirus, listeriosis
Pharmacology
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.
Anti-CD38 monoclonal antibody; daratumumab is an IgG1k human mAb that binds CD38 on tumor cells and induces apoptosis via Fc-mediated cross-linking and immune-mediated lysis through complement dependent cytotoxicity (CDC), antibody dependent cell mediated cytotoxicity (ADCC), and antibody dependent cellular phagocytosis (ADCP).
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Most Common Insurance
Anthem BCBS
Ninlaro
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Darzalex
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Ninlaro
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Darzalex
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Ninlaro
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Darzalex
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableCancerCare: Multiple Myeloma
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableCancerCare: Acute Lymphoblastic Leukemia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.