| Multiple Myeloma
Ninlaro vs Revlimid
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Ninlaro vs Revlimid 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 signalsRevlimid has a higher rate of injection site reactions vs Ninlaro based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Revlimid but not Ninlaro, including UnitedHealthcare
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Category
Ninlaro
Revlimid
At A Glance
Oral
Once weekly (Days 1, 8, 15 of 28-day cycle)
Proteasome inhibitor
Oral
Daily on Days 1-21 of repeated 28-day cycles
Immunomodulatory agent targeting cereblon
Indications
- Multiple Myeloma
- Multiple Myeloma
- Myelodysplastic Syndrome with Isolated del(5q)
- Mantle cell lymphoma
- Lymphoma, Follicular
- Marginal Zone B-Cell Lymphoma
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 (combination therapy) 25 mg orally once daily on Days 1-21 of repeated 28-day cycles, in combination with dexamethasone
Multiple Myeloma (maintenance therapy following auto-HSCT) 10 mg orally once daily continuously on Days 1-28 of repeated 28-day cycles
Myelodysplastic Syndrome with Isolated del(5q) 10 mg orally once daily
Mantle cell lymphoma 25 mg orally once daily on Days 1-21 of repeated 28-day cycles
Follicular Lymphoma 20 mg orally once daily on Days 1-21 of repeated 28-day cycles for up to 12 cycles, in combination with a rituximab-product
Marginal Zone B-Cell Lymphoma 20 mg orally once daily on Days 1-21 of repeated 28-day cycles for up to 12 cycles, in combination with a rituximab-product
Contraindications
—
- Pregnancy
- Severe hypersensitivity to lenalidomide including angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis
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%) - Multiple Myeloma combination therapy Diarrhea, anemia, constipation, peripheral edema, neutropenia, fatigue, back pain, nausea, asthenia, insomnia
Most common (>=20%) - Multiple Myeloma maintenance therapy Neutropenia, thrombocytopenia, leukopenia, anemia, upper respiratory tract infection, bronchitis, diarrhea, rash, fatigue
Most common (>=20%) - Myelodysplastic Syndromes Thrombocytopenia, neutropenia, pruritus, rash, diarrhea, constipation, nausea, nasopharyngitis, cough, dyspnea, pharyngitis, epistaxis, fatigue, pyrexia, peripheral edema, asthenia, arthralgia, back pain, muscle cramp
Most common (>=20%) - Mantle Cell Lymphoma Neutropenia, thrombocytopenia, anemia, fatigue, diarrhea, nausea, cough, dyspnea, rash, pruritus
Most common (>=20%) - Follicular and Marginal Zone Lymphoma Neutropenia, fatigue, diarrhea, constipation, nausea, cough
Serious Venous thromboembolism, arterial thromboembolism, infections including pneumonia, second primary malignancies, hepatotoxicity, severe cutaneous reactions, tumor lysis syndrome, tumor flare reactions
Postmarketing Hypothyroidism, hyperthyroidism, hepatic failure, toxic hepatitis, angioedema, anaphylaxis, acute graft-versus-host disease, viral reactivation, progressive multifocal leukoencephalopathy, pneumonitis, Stevens-Johnson Syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms
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.
Lenalidomide is an immunomodulatory agent that mediates cellular activities through binding to cereblon, a component of a cullin ring E3 ubiquitin ligase enzyme complex, leading to degradation of substrate proteins and resulting in direct cytotoxic and immunomodulatory effects.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Ninlaro
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Revlimid
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Ninlaro
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Revlimid
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (8/8) · Qty limit (7/8)
Humana
Ninlaro
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Revlimid
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableCancerCare: Multiple Myeloma
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Revlimid.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.