| Multiple Myeloma
Ninlaro vs Velcade
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Ninlaro vs Velcade 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 signalsVelcade has a higher rate of injection site reactions vs Ninlaro based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Velcade but not Ninlaro, including UnitedHealthcare
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Category
Ninlaro
Velcade
At A Glance
Oral
Once weekly (Days 1, 8, 15 of 28-day cycle)
Proteasome inhibitor
SC or IV injection
Twice weekly
Proteasome inhibitor
Indications
- Multiple Myeloma
- Multiple Myeloma
- Carcinoma in situ of other and unspecified small intestine NOS
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 1.3 mg/m2 SC or IV; previously untreated: twice weekly (Days 1, 4, 8, 11) in cycles 1-4 then once weekly (Days 1, 8, 22, 29) in cycles 5-9 with melphalan and prednisone for 9 six-week cycles; relapsed: twice weekly (Days 1, 4, 8, 11) every 3 weeks as single agent or with dexamethasone.
Carcinoma in situ of other and unspecified small intestine NOS 1.3 mg/m2 IV twice weekly (Days 1, 4, 8, 11) for 2 weeks followed by a 10-day rest period, in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (VcR-CAP) for 6 three-week cycles.
Contraindications
—
- Hypersensitivity (not including local reactions) to bortezomib, boron, or mannitol, including anaphylactic reactions
- Intrathecal administration
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 (>=10%) Nausea, diarrhea, fatigue, peripheral neuropathies, thrombocytopenia, vomiting, constipation, pyrexia, anorexia, anemia, headache, neutropenia, rash, paresthesia, dizziness, weakness
Serious Diarrhea, vomiting, pyrexia, nausea, dehydration, thrombocytopenia, pneumonia, dyspnea, peripheral neuropathies, herpes zoster
Postmarketing Cardiac tamponade, bilateral deafness, optic neuropathy, blindness, ischemic colitis, progressive multifocal leukoencephalopathy, herpes meningoencephalitis, posterior reversible encephalopathy syndrome, Guillain-Barre syndrome, demyelinating polyneuropathy, acute diffuse infiltrative pulmonary disease, Stevens-Johnson syndrome/toxic epidermal necrolysis, acute febrile neutrophilic dermatosis
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.
Bortezomib is a reversible inhibitor of the chymotrypsin-like activity of the 26S proteasome in mammalian cells; inhibition of this pathway disrupts homeostatic proteolysis, affecting multiple signaling cascades and leading to cell death in various cancer cell types including multiple myeloma.
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)
Velcade
- Covered on 5 commercial plans
- PA (9/12) · 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)
Velcade
- 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)
Velcade
- Covered on 0 commercial plans
- PA (2/3) · 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
No savings programs available for Velcade.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.