Carfilzomib – Uses, Dosage, Side Effects, Interaction

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 64 min read
Patient Tools

Read, save, and share this guide

Use these quick tools to make this medical article easier to read, print, save, or share with a family member.

Patient Mode

Understand this article easily

Switch between simple English and easy Bangla patient notes. This is for education and does not replace a doctor consultation.

Carfilzomib is an irreversible proteasome inhibitor and antineoplastic agent that is used in the treatment of refractory multiple myeloma. Carfilzomib is associated with a low rate of serum enzyme elevations during treatment and has been implicated in rare instances of clinically apparent, acute liver injury...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

Carfilzomib is an irreversible proteasome inhibitor and antineoplastic agent that is used in the treatment of refractory multiple myeloma. Carfilzomib is associated with a low rate of serum enzyme elevations during treatment and has been implicated in rare instances of clinically apparent, acute liver injury some of which have been fatal. Carfilzomib is an injectable antineoplastic agent (IV only). Chemically, it is a modified tetrapeptide...

Key Takeaways

  • This article explains Mechanism of Action in simple medical language.
  • This article explains Indications in simple medical language.
  • This article explains Contraindications in simple medical language.
  • This article explains Dosage in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
Reviewed content workflowUse writer and reviewer profiles for stronger trust.
Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

2

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

3

Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

Before reading

RX Patient Tools

Use these quick guides before reading the article, or return to them when you need help preparing questions for a doctor.

Start here Choose the right pathway for symptoms, reports, medicines, or urgent warning signs. Disease article roadmap Read this topic step by step: meaning, symptoms, warning signs, diagnosis, treatment, prevention, and follow-up. Treatment planner Prepare questions about treatment choices, benefits, risks, side effects, and follow-up. Family & caregiver guide Organize symptoms, reports, medicines, questions, and follow-up safely. Nutrition & diet guide Prepare food, hydration, supplement, and medicine-timing questions safely. Prevention guide Organize risk factors, protective habits, screening, and warning signs. Recovery guide Prepare a safe plan for activity, rehabilitation, warning signs, and follow-up.
Definition

Carfilzomib is an irreversible proteasome inhibitor and antineoplastic agent that is used in the treatment of refractory multiple myeloma. Carfilzomib is associated with a low rate of serum enzyme elevations during treatment and has been implicated in rare instances of clinically apparent, acute liver injury some of which have been fatal. Carfilzomib is an injectable antineoplastic agent (IV only). Chemically, it is a modified tetrapeptide epoxide and an analog of epoxomicin. It is also a selective proteasome inhibitor. FDA approved carfilzomib in July 2012 for the treatment of adults with relapsed or refractory multiple myeloma as monotherapy or combination therapy.[rx]

Carfilzomib is an epoxomicin derivate with potential antineoplastic activity. Carfilzomib irreversibly binds to and inhibits the chymotrypsin-like activity of the 20S catalytic core subunit of the proteasome, a protease complex responsible for degrading a large variety of cellular proteins. Inhibition of proteasome-mediated proteolysis results in an accumulation of polyubiquitinated proteins, which may lead to cell cycle arrest, induction of apoptosis, and inhibition of tumor growth.

Carfilzomib is a synthetic tetrapeptide consisting of morpholine-4-acetyl, L-2-amino-4-phenylbutazone, L-leucyl, and L-phenylalanyl residues joined in sequence with the C-terminus connected to the amino group of (2S)-2-amino-4-methyl-1-[(2R)-2-methyloxiran-2-yl]-1-oxopentan-1-one via an amide linkage. Used for the treatment of patients with multiple myeloma It has a role as an antineoplastic agent and a proteasome inhibitor. It is a tetrapeptide, a member of morpholines, and an epoxide.

Mechanism of Action

Carfilzomib is made up of four modified peptides and acts as a proteasome inhibitor. Carfilzomib irreversibly and selectively binds to N-terminal threonine-containing active sites of the 20S proteasome, the proteolytic core particle within the 26S proteasome. This 20S core has 3 catalytic active sites: the chymotrypsin, trypsin, and caspase-like sites. Inhibition of the chymotrypsin-like site by carfilzomib (β5 and β5i subunits) is the most effective target in decreasing cellular proliferation, ultimately resulting in cell cycle arrest and apoptosis of cancerous cells. At higher doses, carfilzomib will inhibit the trypsin-and capase-like sites.

Intravenous carfilzomib administration resulted in suppression of proteasome chymotrypsin-like activity when measured in blood 1 hour after the first dose. On Day 1 of Cycle 1, proteasome inhibition in peripheral blood mononuclear cells (PBMCs) ranged from 79% to 89% at 15 mg/m2, and from 82% to 83% at 20 mg/m2. In addition, carfilzomib administration resulted in inhibition of the LMP2 and MECL1 subunits of the immunoproteasome ranging from 26% to 32% and 41% to 49%, respectively, at 20 mg/m2. Proteasome inhibition was maintained for ≥ 48 hours following the first dose of carfilzomib for each week of dosing. Resistance against carfilzomib has been observed and although the mechanism has not been confirmed, it is thought that up-regulation of P-glycoprotein may be a contributing factor. Furthermore, studies suggest that carfilzomib is more potent than bortezomib.

Indications

  • Carfilzomib is indicated for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three lines of therapy in combination with lenalidomide and dexamethasone, or dexamethasone, or daratumumab and dexamethasone; or daratumumab and hyaluronidase-fihj and dexamethasone. It is also indicated as a single agent for the treatment of patients with relapsed or refractory multiple myeloma who have received one or more lines of therapy.
  • Kyprolis in combination with daratumumab and dexamethasone, with lenalidomide and dexamethasone, or with dexamethasone alone is indicated for the treatment of adult patients with multiple myeloma who have received at least one prior therapy.
  • Carfilzomib is an irreversible proteasome inhibitor and antineoplastic agent that is used in the treatment of refractory multiple myeloma.
  • Carfilzomib is a proteasome inhibitor used either alone or in conjunction with a chemotherapy regimen to treat patients with relapsed or refractory multiple myeloma.
  • Treatment of Multiple Myeloma
  • Treatment of acute lymphoblastic leukemia

Use in Cancer

Carfilzomib is approved to be used alone or with other drugs to treat:

  • Multiple myeloma that has relapsed (come back) or is refractory (does not respond to treatment). It is used:
    • Alone in adults who have received one or more other therapies.
    • With other drugs in adults who have received one to three other therapies. It is used with dexamethasone with or without one of the following drugs:
      • Lenalidomide
      • Daratumumab
      • Daratumumab and hyaluronidase-fihj

Carfilzomib is also being studied in the treatment of other types of cancer.

Contraindications

  • is allergic to levonorgestrel or to any of the ingredients or components of the device
  • is or may be pregnant
  • has a bacterial infection of the heart valves
  • has a genital infection
  • has a poorly functioning immune system
  • has abnormal cells in the cervix
  • has abnormalities of the uterus (e.g., fibroids) that distort the shape of the uterus
  • has acute liver disease or a liver tumor
  • has cancer of the uterus or cervix
  • has current or recurrent pelvic inflammatory disease
  • has had an abortion complicated by an infection within the past 3 months
  • has infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation of the cervix
  • has infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation of the endometrium (lining of the uterus) after pregnancy
  • has leukemia or other cancers affecting the blood
  • has recently had an abnormal growth of cells inside the uterus
  • has unexplained bleeding of the uterus
  • has progestin-dependent cancer, including breast cancer
  • hemolytic uremic syndrome, a condition that affects the kidney and the blood
  • decreased blood platelets
  • low levels of a type of white blood cell called neutrophils
  • high blood pressure
  • a heart attack
  • a low supply of oxygen rich blood to the heart
  • pulmonary hypertension
  • complete stoppage of the heart
  • chronic heart failure
  • obstruction of a blood vessel by a blood clot
  • pneumonia
  • acute respiratory distress syndrome, a type of lung disorder
  • acute kidney failure
  • trouble breathing
  • abnormal liver function tests
  • pregnancy
  • a patient who is producing milk and breastfeeding
  • progressive multifocal leukoencephalopathy, a type of brain infection
  • a type of brain disorder called posterior reversible encephalopathy syndrome

Dosage

Strengths: 60 mg; 30 mg; 10 mg

Multiple Myeloma

BEFORE INITIATING THIS DRUG:

  • Hydrate patients with both oral fluids (30 mL/kg at least 48 hours before Cycle 1, Day 1) and IV fluids (250 to 500 mL prior to each dose in Cycle 1). If needed, give an additional 250 to 500 mL of IV fluids following drug administration.
  • Continue oral and/or IV hydration, as needed, in subsequent cycles.
  • Monitor for volume overload and adjust hydration to individual needs (especially in patients with or at risk for cardiac failure).
  • Monitor serum potassium levels regularly.
  • Premedicate with dexamethasone at the recommended dose for either monotherapy or combination therapy.
  • Administer dexamethasone orally or IV at least 30 minutes but no more than 4 hours prior to all doses during Cycle 1 to reduce infusion reactions.
  • Reinstate dexamethasone if symptoms occur during subsequent cycles.
  • Provide thromboprophylaxis for patients being treated with this drug in combination with other therapies.
  • Consider antiviral prophylaxis to decrease the risk of herpes zoster reactivation.

DOSE CALCULATION:

  • Calculate the dose based on the actual BSA of the patient at baseline.
  • Patients with a BSA greater than 2.2 m2 should receive a dose based upon a BSA of 2.2 m2.
  • Dose adjustments do not need to be made for weight changes of 20% or less.

CARFILZOMIB IN COMBINATION WITH LENALIDOMIDE AND DEXAMETHASONE:
CARFILZOMIB:

  • Cycle 1: 20 mg/m2 IV over 10 minutes on Days 1 and 2; if tolerated, increase to 27 mg/m2 IV over 10 minutes on Days 8, 9, 15, and 16 of the 28-day cycle
  • Cycles 2 through 12: 27 mg/m2 IV over 10 minutes on Days 1, 2, 8, 9, 15, and 16 of each 28-day cycle
  • Cycle 13 and later: 27 mg/m2 IV over 10 minutes on Days 1, 2, 15, and 16 of each 28-day cycle (omit the Day 8 and 9 doses)
  • Discontinue carfilzomib after Cycle 18.

LENALIDOMIDE/DEXAMETHASONE:

  • All cycles: Lenalidomide 25 mg orally on Days 1 through 21 and dexamethasone 40 mg orally or IV on Days 1, 8, 15, and 22 of the 28-day cycles
  • Administer dexamethasone 30 minutes to 4 hours before carfilzomib.
  • Continue lenalidomide and dexamethasone until disease progression or unacceptable toxicity.
  • Refer to the lenalidomide and dexamethasone prescribing information.

CARFILZOMIB IN COMBINATION WITH DEXAMETHASONE:
TWICE WEEKLY 20/56 MG/M2 REGIMEN BY 30-MINUTE INFUSION:
CARFILZOMIB:

  • Cycle 1: 20 mg/m2 IV over 30 minutes on Days 1 and 2; if tolerated, increase to 56 mg/m2 IV over 30 minutes on Days 8, 9, 15, and 16 of the 28-day cycle
  • Cycles 2 and later: 56 mg/m2 IV over 30 minutes on Days 1, 2, 8, 9, 15, and 16 of each 28-day cycle

DEXAMETHASONE:

  • Cycle 1: 20 mg orally or IV Days 1, 2, 8, 9, 15, 16, 22, and 23 of the 28-day cycle
  • Cycle 2 and later: 20 mg orally or IV Days 1, 2, 8, 9, 15, 16, 22, and 23 of each 28-day cycle
  • Administer dexamethasone 30 minutes to 4 hours before carfilzomib.
  • Continue until disease progression or unacceptable toxicity.
  • Refer to the dexamethasone prescribing information.

CARFILZOMIB IN COMBINATION WITH DEXAMETHASONE:
ONCE WEEKLY 20/70 MG/M2 REGIMEN BY 30-MINUTE INFUSION:
CARFILZOMIB:

  • Cycle 1: 20 mg/m2 IV over 30 minutes on Day 1; if tolerated, increase to 70 mg/m2 IV over 30 minutes on Days 8 and 15 of the 28-day cycle
  • Cycles 2 through 9: 70 mg/m2 IV over 30 minutes on Days 1, 8, and 15 of each 28-day cycle

DEXAMETHASONE:

  • Cycles 1 through 9: 40 mg orally or IV Days 1, 8, 15, and 22 of each 28-day cycle
  • Cycles 10 and later: 40 mg orally or IV Days 1, 8, and 15 of each 28-day cycle
  • Administer dexamethasone 30 minutes to 4 hours before carfilzomib.
  • Continue until disease progression or unacceptable toxicity.
  • Refer to the dexamethasone prescribing information.

CARFILZOMIB IN COMBINATION WITH DARATUMUMAB AND DEXAMETHASONE:
TWICE WEEKLY 20/56 MG/M2 REGIMEN BY 30-MINUTE INFUSION:
CARFILZOMIB:

  • Cycle 1: 20 mg/m2 IV over 30 minutes on Days 1 and 2; if tolerated, increase to 56 mg/m2 IV over 30 minutes on Days 8, 9, 15, and 16 of the 28-day cycle
  • Cycles 2 and later: 56 mg/m2 IV over 30 minutes on Days 1, 2, 8, 9, 15, and 16 of each 28-day cycle

DEXAMETHASONE (NOTE: For patients 75 years or older, administer 20 mg of dexamethasone orally or IV weekly after the first week):

  • All Cycles: 20 mg orally or IV on Days 1, 2, 8, 9, 15, and 16 and 40 mg orally or IV on Day 22 of each 28-day cycle

DARATUMUMAB:

  • Cycle 1: 8 mg/kg on Days 1 and 2 and 16 mg/kg on Days 8, 15, and 22 of the 28-day cycle
  • Cycle 2: 16 mg/kg IV on Days 1, 8, 15, and 22 of the 28-day cycle
  • Cycles 3 through 6: 16 mg/kg IV on Days 1 and 15 of each 28-day cycle
  • Cycles 7 and later: 16 mg/kg on Day 1 of each 28-day cycle
  • Administer dexamethasone 30 minutes to 4 hours before carfilzomib.
  • Continue until disease progression or unacceptable toxicity.
  • Refer to the dexamethasone and daratumumab prescribing information.

CARFILZOMIB IN COMBINATION WITH DARATUMUMAB AND DEXAMETHASONE:
ONCE WEEKLY 20/70 MG/M2 REGIMEN BY 30-MINUTE INFUSION:
CARFILZOMIB:

  • Cycle 1: 20 mg/m2 IV over 30 minutes on Day 1 and 70 mg/m2 IV over 30 minutes on Days 8 and 15 of the 28-day cycle
  • Cycle 2 and later: 70 mg/m2 IV over 30 minutes on Days 1, 8, and 15 of each 28-day cycle

DEXAMETHASONE (NOTE: For patients 75 years or older, administer 20 mg of dexamethasone orally or IV weekly after the first week):

  • Cycles 1 and 2: 20 mg orally or IV on Days 1, 2, 8, 9, 15, 16, 22, and 23 of the 28-day cycle
  • Cycles 3 through 6: 20 mg orally or IV on Days 1,2, 15, and 16 and 40 mg orally or IV on Days 8 and 22 of each 28-day cycle
  • Cycle 7 and later: 20 mg orally or IV on Days 1 and 2 and 40 mg orally or IV on Days 8, 15, and 22 of each 28-day cycle

DARATUMUMAB:

  • Cycle 1: 8 mg/kg on Days 1 and 2 and 16 mg/kg on Days 8, 15, and 22 of the 28-day cycle
  • Cycle 2: 16 mg/kg IV on Days 1, 8, 15, and 22 of the 28-day cycle
  • Cycles 3 through 6: 16 mg/kg IV on Days 1 and 15 of the 28-day cycle
  • Cycles 7 and later: 16 mg/kg on Day 1 of each 28-day cycle
  • Administer dexamethasone 30 minutes to 4 hours before carfilzomib.
  • Continue until disease progression or unacceptable toxicity.
  • Refer to the dexamethasone and daratumumab prescribing information.

MONOTHERAPY BY THE 10-MINUTE INFUSION:
20/27 MG/M2 TWICE WEEKLY REGIMEN BY 10-MINUTE INFUSION:

  • Cycle 1: 20 mg/m2 IV over 10 minutes on Days 1 and 2; if tolerated, increase to 27 mg/m2 IV over 10 minutes on Days 8, 9, 15, and 16 of the 28-day cycle
  • Cycles 2 through 12: 27 mg/m2 IV over 10 minutes on Days 1, 2, 8, 9, 15, and 16 of each 28-day cycle
  • Cycles 13 and later: 27 mg/m2 IV over 10 minutes on Days 1, 2, 15, and 16 of each 28-day cycle
  • Premedicate with dexamethasone 4 mg orally or IV 30 minutes to 4 hours before each dose of this drug in Cycle 1, then as needed to prevent infusion reactions.
  • Continue therapy until the disease progresses or has unacceptable toxicity.

MONOTHERAPY BY THE 30-MINUTE INFUSION:
20/56 MG/M2 TWICE WEEKLY REGIMEN BY 30-MINUTE INFUSION:

  • Cycle 1: 20 mg/m2 IV over 30 minutes on Days 1 and 2; if tolerated, increase to 56 mg/m2 IV over 30 minutes on Days 8, 9, 15, and 16 of the 28-day cycle
  • Cycles 2 through 12: 56 mg/m2 IV over 30 minutes on Days 1, 2, 8, 9, 15, and 16 of each 28-day treatment cycle
  • Cycles 13 and later: 56 mg/m2 IV over 30 minutes on Days 1, 2, 15, and 16 of each 28-day treatment cycle
  • Premedicate with dexamethasone 8 mg orally or IV 30 minutes to 4 hours before each dose of this drug in Cycle 1, then as needed to prevent infusion reactions.
  • Continue therapy until the disease progresses or has unacceptable toxicity.
  • For patients with relapsed or refractory multiple myeloma who have received 1 to 3 lines of therapy in combination with lenalidomide and dexamethasone, or dexamethasone, or daratumumab and dexamethasone
  • As a single agent for the treatment of relapsed or refractory multiple myeloma who have received 1 or more lines of therapy

Renal Dose Adjustments

  • Serum creatinine 2 x baseline or greater, OR CrCl less than 15 mL/min, OR CrCl decreased to 50% or less of baseline, OR need for hemodialysis: Withhold dose and monitor renal function (serum creatinine or CrCl).
  • If attributable to this drug, resume when renal function has recovered to within 25% of baseline; start at 1 dose level reduction.
  • If not attributable to this drug, dosing may be resumed at the discretion of the physician.
  • The dose is to be administered after the hemodialysis procedure for patients on hemodialysis.

Liver Dose Adjustments

  • Mild (total jaundice. সহজ বাংলা: জন্ডিসে বাড়তে পারে এমন হলুদ রঞ্জক।" data-rx-term="bilirubin" data-rx-definition="Bilirubin is a yellow pigment that can build up in jaundice. সহজ বাংলা: জন্ডিসে বাড়তে পারে এমন হলুদ রঞ্জক।">bilirubin 1 to 1.5 x upper limit of normal [ULN] and any AST or total bilirubin less than or equal to ULN and AST greater than ULN) or moderate (total bilirubin greater than 1.5 to 3 x ULN and any AST) hepatic impairment: Reduce the dose of by 25%
    Severe hepatic impairment: Data not available

Dose Adjustments

HEMATOLOGIC TOXICITY:

  • Absolute bacterial infection. সহজ বাংলা: ব্যাকটেরিয়ার বিরুদ্ধে লড়াই করা শ্বেত রক্তকণিকা।" data-rx-term="neutrophil" data-rx-definition="Neutrophil is a white blood cell important for fighting bacterial infection. সহজ বাংলা: ব্যাকটেরিয়ার বিরুদ্ধে লড়াই করা শ্বেত রক্তকণিকা।">neutrophil count (ANC) less than 0.5 X 10(9)/L: Withhold dose; if recovered to 0.5 x 10(9)/L or greater, continue at the same dose level. For subsequent drops to less than 0.5 x 10(9) /L, follow the same recommendations as above and consider 1 dose level reduction when restarting therapy.
  • Febrile bacterial infection. সহজ বাংলা: ব্যাকটেরিয়ার বিরুদ্ধে লড়াই করা শ্বেত রক্তকণিকা।" data-rx-term="neutrophil" data-rx-definition="Neutrophil is a white blood cell important for fighting bacterial infection. সহজ বাংলা: ব্যাকটেরিয়ার বিরুদ্ধে লড়াই করা শ্বেত রক্তকণিকা।">neutrophil count, which may increase infection risk. সহজ বাংলা: নিউট্রোফিল কম থাকা, সংক্রমণের ঝুঁকি বাড়তে পারে।" data-rx-term="neutropenia" data-rx-definition="Neutropenia means low neutrophil count, which may increase infection risk. সহজ বাংলা: নিউট্রোফিল কম থাকা, সংক্রমণের ঝুঁকি বাড়তে পারে।">neutropenia (ANC less than 0.5 x 10(9)/L and an oral temperature of more than 38.5C or 2 consecutive readings of more than 38C for 2 hours): Withhold dose; if ANC returns to baseline grade and fever resolve, resume at the same dose level.
  • Platelets less than 10 X 10(9)/L or evidence of bleeding with thrombocytopenia: Withhold dose; if recovered to greater than or equal to 10 x 10(9)/L and/or bleeding is controlled, continue at the same dose level. For subsequent drops to less than 10 x 10(9)/L, follow the same recommendations as above and consider 1 dose level reduction when restarting therapy.

OTHER NONHEMATOLOGIC TOXICITY:

  • All other severe or life-threatening nonhematologic toxicities (Grades 3 and 4): Withhold therapy until resolved or returned to baseline; consider restarting the next scheduled dose at 1 dose level reduction.

DOSE LEVEL REDUCTION GUIDELINES:
CARFILZOMIB AND DEXAMETHASONE OR CARFILZOMIB, DARATUMUMAB, AND DEXAMETHASONE (ONCE WEEKLY):

  • Initial dose: 70 mg/m2
  • First dose reduction: 56 mg/m2
  • Second dose reduction: 45 mg/m2
  • Third dose reduction: 36 mg/m2; if toxicity persists, discontinue therapy

CARFILZOMIB AND DEXAMETHASONE OR KYPROLIS, DARATUMUMAB, AND DEXAMETHASONE OR KYPROLIS MONOTHERAPY (TWICE WEEKLY):

  • Initial dose: 56 mg/m2
  • First dose reduction: 45 mg/m2
  • Second dose reduction: 36 mg/m2
  • Third dose reduction: 27 mg/m2; if toxicity persists, discontinue therapy

CARFILZOMIB, LENALIDOMIDE, AND DEXAMETHASONE OR CARFILZOMIB MONOTHERAPY (TWICE WEEKLY):

  • Initial dose: 27 mg/m2
  • First dose reduction: 20 mg/m2
  • Second dose reduction: 15 mg/m2; if toxicity persists, discontinue therapy

Administration advice:

  • The IV administration line should be flushed with normal saline or 5% dextrose injection immediately before and after drug administration.
  • This drug is available for IV use only.
  • Do not administer this drug as a bolus.
  • Do not mix this drug with or administer it as an infusion with other medicinal products.
  • Infuse over 10 or 30 minutes depending on the dosing regimen.

Monitoring:

  • Cardiovascular: Fluid overload, cardiac complications
  • Hematologic: Blood chemistries, platelet counts, Thrombotic Thrombocytopenic Purpura/Hemolytic Uremic Syndrome
  • Hepatic: Liver function (transaminases, bilirubin)
  • Nervous: Posterior Reversible Encephalopathy Syndrome
  • Oncologic: Tumor Lysis Syndrome
  • Other: Infusion reactions (immediately following or up to 24 hours after treatment administration)
  • Renal: Renal function (serum creatinine)
  • Respiratory: Dyspnea, pulmonary arterial hypertension

Side Effects

The Most Common

  • headache
  • diarrhea
  • constipation
  • muscle spasm
  • pain in the arms or legs; back pain
  • difficulty falling asleep or staying asleep
  • cough
  • dry mouth, dark urine, decreased sweating, dry skin, and other signs of dehydration
  • swelling of the feet of legs
  • pain, tenderness, or redness in one leg
  • shortness of breath or difficulty breathing
  • chest pain
  • pain, burning, numbness, or tingling in the hands or feet
  • nausea
  • unusual tiredness or weakness
  • unusual bleeding or bruising
  • lack of energy
  • loss of appetite
  • pain in the upper right part of the stomach
  • yellowing of the skin or eyes
  • flu-like symptoms
  • bloody or black, tarry stools
  • rash of pinpoint-sized reddish-purple spots, usually on the lower legs
  • blood in the urine
  • decreased urination
  • seizures
  • vision changes or loss of vision
  • confusion, memory loss, dizziness or loss of balance, difficulty talking or walking, changes in vision, decreased strength or weakness on one side of the body

More Common

  • abdominal pain
  • acne (usually less common after 3 months of treatment, and may improve if acne already exists)
  • breast pain, tenderness, or swelling
  • changes in the menstrual pattern, such as:
    • breakthrough bleeding or spotting between periods
    • complete lack of menstrual flow for several months in a row
    • decreased bleeding during periods
    • occasional stopping of menstrual bleeding
    • prolonged bleeding during periods
  • decreased sex drive
  • feeling of fullness or tightness in the abdomen
  • headache
  • nausea
  • weight gain

Rare

  • back pain
  • dizziness
  • expulsion of the device
  • mood changes
  • nervousness
  • persistent or severe lower abdominal pain along with fever or unusual vaginal discharge
  • severe headaches or migraines (headaches may lessen in many users, or they may increase in number or become worse for other users)
  • signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
  • signs of a liver problem (e.g., yellow skin or eyes, dark urine, pale stools, abdominal pain, or itchy skin)
  • skin rash, hives, or itchy skin
  • symptoms of pregnancy (e.g., abdominal pain, nausea, breast tenderness)
  • vaginal discharge
  • vaginal infection with vaginal itching or irritation, or thick, white, or curd-like discharge
  • abdominal or stomach pain (sudden, severe, or continuing)
  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
  • signs of a blood clot in the leg (e.g., sudden unexplained pain in the leg, especially in the calf)
  • signs of a blood clot in the lungs (e.g., sudden or unexplained shortness of breath, chest pain, coughing up of blood)
  • signs of a heart attack (e.g., pain or discomfort in the chest or upper body, shortness of breath, nausea, cold sweats, or lightheadedness)
  • signs of a stroke (e.g., sudden slurring of speech; sudden unexplained weakness, numbness, or pain in the arm or leg; sudden loss of coordination; sudden, severe headache)

Drug Interaction

Pregnancy and Lactation

Pregnancy Category D

Pregnancy

This device should not be used during pregnancy. You should have this device removed if you become pregnant. Any device in the uterus during pregnancy can result in an increased risk of miscarriage or early labour. There is no evidence of birth defects when the device remains in the uterus for the full term. However, there is no conclusive evidence of this because of limited experience.

Lactation

No information is available on the clinical use of carfilzomib during breastfeeding. Because carfilzomib is 97% bound to plasma proteins, the amount in milk is likely to be low. The manufacturer recommends that breastfeeding be discontinued during carfilzomib therapy and for 2 weeks after the last dose.

How should this medicine be used?

Carfilzomib comes as a powder to be mixed with liquid to be injected intravenously (into a vein). Carfilzomib is given by a doctor or nurse in a medical office or clinic usually over a period of 10 or 30 minutes. It may be given 2 days in a row each week for 3 weeks followed by a 12-day rest period or it may be given once a week for 3 weeks followed by a 13-day rest period. The length of treatment will depend on how well your body responds to the medication.

Carfilzomib injection may cause severe or life-threatening reactions for up to 24 hours after you receive a dose of the medication. You will receive certain medications to help prevent a reaction before you receive each dose of carfilzomib. Tell your doctor immediately if you experience any of these symptoms after your treatment: fever, chills, joint or muscle pain, flushing or swelling of the face, swelling or tightening of the throat, vomiting, weakness, shortness of breath, dizziness or fainting, or chest tightness or pain.

Be sure to tell your doctor how you are feeling during your treatment. Your doctor may stop your treatment for a while or decrease your dose of carfilzomib if you experience side effects of the medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood pressure: Levonorgestrel can cause an increase in blood pressure. If you have high blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience an increase in your blood pressure after having this device inserted, contact your doctor.

Breast cancer: Cases of breast cancer have been reported by women using levonorgestrel-releasing IUDs. However, some studies have shown that progestin-only forms of birth control do not appear to increase the risk of breast cancer. Discuss any concerns you have with your doctor.

Depression: Hormones, such as progestins, are known to contribute to mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication, contact your doctor as soon as possible.

Diabetes: Low-dose contraceptives such as this device have very little effect on blood sugar control. However, people with diabetes or those with a family history of diabetes should monitor their blood sugar closely to detect any worsening of blood sugar control.

Ectopic pregnancy: If you have a history of ectopic pregnancy (when a fertilized egg implants itself outside of the uterus), have had surgery on the fallopian tubes, or have had a pelvic infection, you should speak to your doctor or pharmacist before using this device. If you experience lower abdominal pain along with a missed period or unexpected bleeding while using this medication, contact your doctor.

Expulsion of device: Bleeding or pain may indicate that the device has either moved out of position or has been expelled from the uterine cavity. A device that is out of position is less effective and should be removed and replaced by a new device.

Eye problems: Some women may experience a change in vision or contact lens tolerance. If this occurs, contact your eye doctor.

Headache: Levonorgestrel, like other hormones, may cause severe headache or migraine. If you have a history of migraines, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you notice increasing numbers or severity of headaches after the device has been inserted, contact your doctor as soon as possible.

Heart disease: Levonorgestrel may increase the risk of developing blood clots, causing reduced blood flow to organs or the extremities. If you have a history of clotting you may be at increased risk of experiencing blood clot-related problems such as heart attack, stroke, or clots in the deep veins of your leg. Cigarette smoking increases the risk of serious adverse effects on the heart and blood vessels. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience symptoms such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision, or difficulty speaking, contact your doctor immediately.

Heart valve disorders: This medication can increase your risk of getting an infection in your heart valves if you were born with or have acquired a heart valve defect. You may need to take antibiotics before the insertion and removal of this medication to prevent the infection.

Insertion and removal of the device: Some women may experience some pain and bleeding when the device is inserted or removed. The procedure may also cause fainting or a seizure for someone with a seizure disorder.

Liver disease: If you develop signs of a liver problem (yellow skin or eyes, dark urine, pale stools, abdominal pain, or itchy skin), talk to your doctor about whether you should have the device removed.

Menstrual bleeding: Some women may experience some pain and bleeding when the device is inserted or removed. Irregular menstrual bleeding is common for the first few months after the device is inserted. Over time, menstrual bleeding decreases and may stop completely while the device is inserted.

Ovarian cysts: This medication can cause the development of ovarian cysts. Most of these don’t have any symptoms and disappear on their own within 2 to 3 months. However, if you experience pain in the pelvic area, contact your doctor.

Perforation: The chance of the device puncturing the cervix or uterus is very rare (between 1 in 1,000 and 1 in 10,000). If it were to occur, it would most likely be when the device is being inserted. If this happens, the device should be removed as soon as possible.

Removal of the device: If you experience any of the following, check with your doctor to see if you should have your device removed:

  • confirmed or suspected breast or endometrial cancer
  • migraines or severe headaches
  • recurrent inflammation of the lining of the uterus
  • recurrent pelvic infections
  • significantly elevated blood pressure
  • stroke or heart attack

Return to fertility: Your usual level of fertility should return soon after the device is removed. Nearly 90% of women wishing to become pregnant conceive within 24 months after the removal of the device.

Sexually transmitted infections (STIs): This device does not protect against STIs, including HIV/AIDS. For protection against STIs, use latex condoms.

What special precautions should I follow?

Before receiving carfilzomib injection,

  • tell your doctor and pharmacist if you are allergic to carfilzomib, any other medications, or any of the ingredients in carfilzomib injection. Ask your pharmacist for a list of the ingredients.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have or have ever had heart failure, a heart attack, irregular heartbeat, or other heart problems; high blood pressure; a herpes infection (cold sores, shingles, or genital sores); or seizures or any other neurologic disorder. Also, tell your doctor if you have liver or kidney disease or are on dialysis.
  • tell your doctor if you are pregnant or plan to become pregnant, or if you plan to father a child. You or your partner should not become pregnant while you are receiving carfilzomib. If you are female, you must take a pregnancy test before starting treatment and should use birth control to prevent pregnancy during your treatment with carfilzomib and for 6 months after your final dose. If you are a male, you and your partner should use birth control methods to prevent pregnancy during your treatment with carfilzomib and for 3 months after your final dose. If you or your partner become pregnant while receiving this medication, call your doctor. Carfilzomib may harm the fetus.
  • tell your doctor if you are breastfeeding. Do not breastfeed while you are receiving carfilzomib injection and for 2 weeks after your final dose.
  • you should know that carfilzomib may make you drowsy, dizzy, or lightheaded, or cause fainting. Do not drive or operate machinery until you know how this medication affects you.

References

Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Orthopedic / spine specialist, physical medicine doctor, or qualified clinician
Tests to discuss with doctor
  • Neurological examination for leg power, sensation, reflexes, and straight leg raise
  • X-ray only if injury, deformity, long-lasting pain, or doctor suspects bone problem
  • MRI discussion if severe nerve symptoms, weakness, bladder/bowel problem, or persistent symptoms
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
  • Is physiotherapy, posture correction, or activity modification needed?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Carfilzomib – Uses, Dosage, Side Effects, Interaction

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Mechanism of Action Carfilzomib is made up of four modified peptides and acts as a proteasome inhibitor. Carfilzomib irreversibly and selectively binds to N-terminal threonine-containing active sites of the 20S proteasome, the proteolytic core particle within the 26S proteasome. This 20S core has 3 catalytic active sites: the chymotrypsin, trypsin, and caspase-like sites. Inhibition of the chymotrypsin-like site by carfilzomib (β5 and β5i subunits) is the most effective target in decreasing cellular proliferation, ultimately resulting in cell cycle arrest and apoptosis of cancerous cells. At higher doses, carfilzomib will inhibit the trypsin-and capase-like sites. Intravenous carfilzomib administration resulted in suppression of proteasome chymotrypsin-like activity when measured in blood 1 hour after the first dose. On Day 1 of Cycle 1, proteasome inhibition in peripheral blood mononuclear cells (PBMCs) ranged from 79% to 89% at 15 mg/m2, and from 82% to 83% at 20 mg/m2. In addition, carfilzomib administration resulted in inhibition of the LMP2 and MECL1 subunits of the immunoproteasome ranging from 26% to 32% and 41% to 49%, respectively, at 20 mg/m2. Proteasome inhibition was maintained for ≥ 48 hours following the first dose of carfilzomib for each week of dosing. Resistance against carfilzomib has been observed and although the mechanism has not been confirmed, it is thought that up-regulation of P-glycoprotein may be a contributing factor. Furthermore, studies suggest that carfilzomib is more potent than bortezomib. Indications Carfilzomib is indicated for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three lines of therapy in combination with lenalidomide and dexamethasone, or dexamethasone, or daratumumab and dexamethasone; or daratumumab and hyaluronidase-fihj and dexamethasone. It is also indicated as a single agent for the treatment of patients with relapsed or refractory multiple myeloma who have received one or more lines of therapy. Kyprolis in combination with daratumumab and dexamethasone, with lenalidomide and dexamethasone, or with dexamethasone alone is indicated for the treatment of adult patients with multiple myeloma who have received at least one prior therapy. Carfilzomib is an irreversible proteasome inhibitor and antineoplastic agent that is used in the treatment of refractory multiple myeloma. Carfilzomib is a proteasome inhibitor used either alone or in conjunction with a chemotherapy regimen to treat patients with relapsed or refractory multiple myeloma. Treatment of Multiple Myeloma Treatment of acute lymphoblastic leukemia Use in Cancer Carfilzomib is approved to be used alone or with other drugs to treat: Multiple myeloma that has relapsed (come back) or is refractory (does not respond to treatment). It is used: Alone in adults who have received one or more other therapies. With other drugs in adults who have received one to three other therapies. It is used with dexamethasone with or without one of the following drugs: Lenalidomide Daratumumab Daratumumab and hyaluronidase-fihj Carfilzomib is also being studied in the treatment of other types of cancer. Contraindications is allergic to levonorgestrel or to any of the ingredients or components of the device is or may be pregnant has a bacterial infection of the heart valves has a genital infection has a poorly functioning immune system has abnormal cells in the cervix has abnormalities of the uterus (e.g., fibroids) that distort the shape of the uterus has acute liver disease or a liver tumor has cancer of the uterus or cervix has current or recurrent pelvic inflammatory disease has had an abortion complicated by an infection within the past 3 months has inflammation of the cervix has inflammation of the endometrium (lining of the uterus) after pregnancy has leukemia or other cancers affecting the blood has recently had an abnormal growth of cells inside the uterus has unexplained bleeding of the uterus has progestin-dependent cancer, including breast cancer hemolytic uremic syndrome, a condition that affects the kidney and the blood decreased blood platelets low levels of a type of white blood cell called neutrophils high blood pressure a heart attack a low supply of oxygen rich blood to the heart pulmonary hypertension complete stoppage of the heart chronic heart failure obstruction of a blood vessel by a blood clot pneumonia acute respiratory distress syndrome, a type of lung disorder acute kidney failure trouble breathing abnormal liver function tests pregnancy a patient who is producing milk and breastfeeding progressive multifocal leukoencephalopathy, a type of brain infection a type of brain disorder called posterior reversible encephalopathy syndrome Dosage Strengths: 60 mg; 30 mg; 10 mg Multiple Myeloma BEFORE INITIATING THIS DRUG: Hydrate patients with both oral fluids (30 mL/kg at least 48 hours before Cycle 1, Day 1) and IV fluids (250 to 500 mL prior to each dose in Cycle 1). If needed, give an additional 250 to 500 mL of IV fluids following drug administration. Continue oral and/or IV hydration, as needed, in subsequent cycles. Monitor for volume overload and adjust hydration to individual needs (especially in patients with or at risk for cardiac failure). Monitor serum potassium levels regularly. Premedicate with dexamethasone at the recommended dose for either monotherapy or combination therapy. Administer dexamethasone orally or IV at least 30 minutes but no more than 4 hours prior to all doses during Cycle 1 to reduce infusion reactions. Reinstate dexamethasone if symptoms occur during subsequent cycles. Provide thromboprophylaxis for patients being treated with this drug in combination with other therapies. Consider antiviral prophylaxis to decrease the risk of herpes zoster reactivation. DOSE CALCULATION: Calculate the dose based on the actual BSA of the patient at baseline. Patients with a BSA greater than 2.2 m2 should receive a dose based upon a BSA of 2.2 m2. Dose adjustments do not need to be made for weight changes of 20% or less. CARFILZOMIB IN COMBINATION WITH LENALIDOMIDE AND DEXAMETHASONE: CARFILZOMIB: Cycle 1: 20 mg/m2 IV over 10 minutes on Days 1 and 2; if tolerated, increase to 27 mg/m2 IV over 10 minutes on Days 8, 9, 15, and 16 of the 28-day cycle Cycles 2 through 12: 27 mg/m2 IV over 10 minutes on Days 1, 2, 8, 9, 15, and 16 of each 28-day cycle Cycle 13 and later: 27 mg/m2 IV over 10 minutes on Days 1, 2, 15, and 16 of each 28-day cycle (omit the Day 8 and 9 doses) Discontinue carfilzomib after Cycle 18. LENALIDOMIDE/DEXAMETHASONE: All cycles: Lenalidomide 25 mg orally on Days 1 through 21 and dexamethasone 40 mg orally or IV on Days 1, 8, 15, and 22 of the 28-day cycles Administer dexamethasone 30 minutes to 4 hours before carfilzomib. Continue lenalidomide and dexamethasone until disease progression or unacceptable toxicity. Refer to the lenalidomide and dexamethasone prescribing information. CARFILZOMIB IN COMBINATION WITH DEXAMETHASONE: TWICE WEEKLY 20/56 MG/M2 REGIMEN BY 30-MINUTE INFUSION: CARFILZOMIB: Cycle 1: 20 mg/m2 IV over 30 minutes on Days 1 and 2; if tolerated, increase to 56 mg/m2 IV over 30 minutes on Days 8, 9, 15, and 16 of the 28-day cycle Cycles 2 and later: 56 mg/m2 IV over 30 minutes on Days 1, 2, 8, 9, 15, and 16 of each 28-day cycle DEXAMETHASONE: Cycle 1: 20 mg orally or IV Days 1, 2, 8, 9, 15, 16, 22, and 23 of the 28-day cycle Cycle 2 and later: 20 mg orally or IV Days 1, 2, 8, 9, 15, 16, 22, and 23 of each 28-day cycle Administer dexamethasone 30 minutes to 4 hours before carfilzomib. Continue until disease progression or unacceptable toxicity. Refer to the dexamethasone prescribing information. CARFILZOMIB IN COMBINATION WITH DEXAMETHASONE: ONCE WEEKLY 20/70 MG/M2 REGIMEN BY 30-MINUTE INFUSION: CARFILZOMIB: Cycle 1: 20 mg/m2 IV over 30 minutes on Day 1; if tolerated, increase to 70 mg/m2 IV over 30 minutes on Days 8 and 15 of the 28-day cycle Cycles 2 through 9: 70 mg/m2 IV over 30 minutes on Days 1, 8, and 15 of each 28-day cycle DEXAMETHASONE: Cycles 1 through 9: 40 mg orally or IV Days 1, 8, 15, and 22 of each 28-day cycle Cycles 10 and later: 40 mg orally or IV Days 1, 8, and 15 of each 28-day cycle Administer dexamethasone 30 minutes to 4 hours before carfilzomib. Continue until disease progression or unacceptable toxicity. Refer to the dexamethasone prescribing information. CARFILZOMIB IN COMBINATION WITH DARATUMUMAB AND DEXAMETHASONE: TWICE WEEKLY 20/56 MG/M2 REGIMEN BY 30-MINUTE INFUSION: CARFILZOMIB: Cycle 1: 20 mg/m2 IV over 30 minutes on Days 1 and 2; if tolerated, increase to 56 mg/m2 IV over 30 minutes on Days 8, 9, 15, and 16 of the 28-day cycle Cycles 2 and later: 56 mg/m2 IV over 30 minutes on Days 1, 2, 8, 9, 15, and 16 of each 28-day cycle DEXAMETHASONE (NOTE: For patients 75 years or older, administer 20 mg of dexamethasone orally or IV weekly after the first week): All Cycles: 20 mg orally or IV on Days 1, 2, 8, 9, 15, and 16 and 40 mg orally or IV on Day 22 of each 28-day cycle DARATUMUMAB: Cycle 1: 8 mg/kg on Days 1 and 2 and 16 mg/kg on Days 8, 15, and 22 of the 28-day cycle Cycle 2: 16 mg/kg IV on Days 1, 8, 15, and 22 of the 28-day cycle Cycles 3 through 6: 16 mg/kg IV on Days 1 and 15 of each 28-day cycle Cycles 7 and later: 16 mg/kg on Day 1 of each 28-day cycle Administer dexamethasone 30 minutes to 4 hours before carfilzomib. Continue until disease progression or unacceptable toxicity. Refer to the dexamethasone and daratumumab prescribing information. CARFILZOMIB IN COMBINATION WITH DARATUMUMAB AND DEXAMETHASONE: ONCE WEEKLY 20/70 MG/M2 REGIMEN BY 30-MINUTE INFUSION: CARFILZOMIB: Cycle 1: 20 mg/m2 IV over 30 minutes on Day 1 and 70 mg/m2 IV over 30 minutes on Days 8 and 15 of the 28-day cycle Cycle 2 and later: 70 mg/m2 IV over 30 minutes on Days 1, 8, and 15 of each 28-day cycle DEXAMETHASONE (NOTE: For patients 75 years or older, administer 20 mg of dexamethasone orally or IV weekly after the first week): Cycles 1 and 2: 20 mg orally or IV on Days 1, 2, 8, 9, 15, 16, 22, and 23 of the 28-day cycle Cycles 3 through 6: 20 mg orally or IV on Days 1,2, 15, and 16 and 40 mg orally or IV on Days 8 and 22 of each 28-day cycle Cycle 7 and later: 20 mg orally or IV on Days 1 and 2 and 40 mg orally or IV on Days 8, 15, and 22 of each 28-day cycle DARATUMUMAB: Cycle 1: 8 mg/kg on Days 1 and 2 and 16 mg/kg on Days 8, 15, and 22 of the 28-day cycle Cycle 2: 16 mg/kg IV on Days 1, 8, 15, and 22 of the 28-day cycle Cycles 3 through 6: 16 mg/kg IV on Days 1 and 15 of the 28-day cycle Cycles 7 and later: 16 mg/kg on Day 1 of each 28-day cycle Administer dexamethasone 30 minutes to 4 hours before carfilzomib. Continue until disease progression or unacceptable toxicity. Refer to the dexamethasone and daratumumab prescribing information. MONOTHERAPY BY THE 10-MINUTE INFUSION: 20/27 MG/M2 TWICE WEEKLY REGIMEN BY 10-MINUTE INFUSION: Cycle 1: 20 mg/m2 IV over 10 minutes on Days 1 and 2; if tolerated, increase to 27 mg/m2 IV over 10 minutes on Days 8, 9, 15, and 16 of the 28-day cycle Cycles 2 through 12: 27 mg/m2 IV over 10 minutes on Days 1, 2, 8, 9, 15, and 16 of each 28-day cycle Cycles 13 and later: 27 mg/m2 IV over 10 minutes on Days 1, 2, 15, and 16 of each 28-day cycle Premedicate with dexamethasone 4 mg orally or IV 30 minutes to 4 hours before each dose of this drug in Cycle 1, then as needed to prevent infusion reactions. Continue therapy until the disease progresses or has unacceptable toxicity. MONOTHERAPY BY THE 30-MINUTE INFUSION: 20/56 MG/M2 TWICE WEEKLY REGIMEN BY 30-MINUTE INFUSION: Cycle 1: 20 mg/m2 IV over 30 minutes on Days 1 and 2; if tolerated, increase to 56 mg/m2 IV over 30 minutes on Days 8, 9, 15, and 16 of the 28-day cycle Cycles 2 through 12: 56 mg/m2 IV over 30 minutes on Days 1, 2, 8, 9, 15, and 16 of each 28-day treatment cycle Cycles 13 and later: 56 mg/m2 IV over 30 minutes on Days 1, 2, 15, and 16 of each 28-day treatment cycle Premedicate with dexamethasone 8 mg orally or IV 30 minutes to 4 hours before each dose of this drug in Cycle 1, then as needed to prevent infusion reactions. Continue therapy until the disease progresses or has unacceptable toxicity. For patients with relapsed or refractory multiple myeloma who have received 1 to 3 lines of therapy in combination with lenalidomide and dexamethasone, or dexamethasone, or daratumumab and dexamethasone As a single agent for the treatment of relapsed or refractory multiple myeloma who have received 1 or more lines of therapy Renal Dose Adjustments Serum creatinine 2 x baseline or greater, OR CrCl less than 15 mL/min, OR CrCl decreased to 50% or less of baseline, OR need for hemodialysis: Withhold dose and monitor renal function (serum creatinine or CrCl). If attributable to this drug, resume when renal function has recovered to within 25% of baseline; start at 1 dose level reduction. If not attributable to this drug, dosing may be resumed at the discretion of the physician. The dose is to be administered after the hemodialysis procedure for patients on hemodialysis. Liver Dose Adjustments Mild (total bilirubin 1 to 1.5 x upper limit of normal [ULN] and any AST or total bilirubin less than or equal to ULN and AST greater than ULN) or moderate (total bilirubin greater than 1.5 to 3 x ULN and any AST) hepatic impairment: Reduce the dose of by 25% Severe hepatic impairment: Data not available Dose Adjustments HEMATOLOGIC TOXICITY: Absolute neutrophil count (ANC) less than 0.5 X 10(9)/L: Withhold dose; if recovered to 0.5 x 10(9)/L or greater, continue at the same dose level. For subsequent drops to less than 0.5 x 10(9) /L, follow the same recommendations as above and consider 1 dose level reduction when restarting therapy. Febrile neutropenia (ANC less than 0.5 x 10(9)/L and an oral temperature of more than 38.5C or 2 consecutive readings of more than 38C for 2 hours): Withhold dose; if ANC returns to baseline grade and fever resolve, resume at the same dose level. Platelets less than 10 X 10(9)/L or evidence of bleeding with thrombocytopenia: Withhold dose; if recovered to greater than or equal to 10 x 10(9)/L and/or bleeding is controlled, continue at the same dose level. For subsequent drops to less than 10 x 10(9)/L, follow the same recommendations as above and consider 1 dose level reduction when restarting therapy. OTHER NONHEMATOLOGIC TOXICITY: All other severe or life-threatening nonhematologic toxicities (Grades 3 and 4): Withhold therapy until resolved or returned to baseline; consider restarting the next scheduled dose at 1 dose level reduction. DOSE LEVEL REDUCTION GUIDELINES: CARFILZOMIB AND DEXAMETHASONE OR CARFILZOMIB, DARATUMUMAB, AND DEXAMETHASONE (ONCE WEEKLY): Initial dose: 70 mg/m2 First dose reduction: 56 mg/m2 Second dose reduction: 45 mg/m2 Third dose reduction: 36 mg/m2; if toxicity persists, discontinue therapy CARFILZOMIB AND DEXAMETHASONE OR KYPROLIS, DARATUMUMAB, AND DEXAMETHASONE OR KYPROLIS MONOTHERAPY (TWICE WEEKLY): Initial dose: 56 mg/m2 First dose reduction: 45 mg/m2 Second dose reduction: 36 mg/m2 Third dose reduction: 27 mg/m2; if toxicity persists, discontinue therapy CARFILZOMIB, LENALIDOMIDE, AND DEXAMETHASONE OR CARFILZOMIB MONOTHERAPY (TWICE WEEKLY): Initial dose: 27 mg/m2 First dose reduction: 20 mg/m2 Second dose reduction: 15 mg/m2; if toxicity persists, discontinue therapy Administration advice: The IV administration line should be flushed with normal saline or 5% dextrose injection immediately before and after drug administration. This drug is available for IV use only. Do not administer this drug as a bolus. Do not mix this drug with or administer it as an infusion with other medicinal products. Infuse over 10 or 30 minutes depending on the dosing regimen. Monitoring: Cardiovascular: Fluid overload, cardiac complications Hematologic: Blood chemistries, platelet counts, Thrombotic Thrombocytopenic Purpura/Hemolytic Uremic Syndrome Hepatic: Liver function (transaminases, bilirubin) Nervous: Posterior Reversible Encephalopathy Syndrome Oncologic: Tumor Lysis Syndrome Other: Infusion reactions (immediately following or up to 24 hours after treatment administration) Renal: Renal function (serum creatinine) Respiratory: Dyspnea, pulmonary arterial hypertension Side Effects The Most Common headache diarrhea constipation muscle spasm pain in the arms or legs; back pain difficulty falling asleep or staying asleep cough dry mouth, dark urine, decreased sweating, dry skin, and other signs of dehydration swelling of the feet of legs pain, tenderness, or redness in one leg shortness of breath or difficulty breathing chest pain pain, burning, numbness, or tingling in the hands or feet nausea unusual tiredness or weakness unusual bleeding or bruising lack of energy loss of appetite pain in the upper right part of the stomach yellowing of the skin or eyes flu-like symptoms bloody or black, tarry stools rash of pinpoint-sized reddish-purple spots, usually on the lower legs blood in the urine decreased urination seizures vision changes or loss of vision confusion, memory loss, dizziness or loss of balance, difficulty talking or walking, changes in vision, decreased strength or weakness on one side of the body More Common abdominal pain acne (usually less common after 3 months of treatment, and may improve if acne already exists) breast pain, tenderness, or swelling changes in the menstrual pattern, such as: breakthrough bleeding or spotting between periods complete lack of menstrual flow for several months in a row decreased bleeding during periods occasional stopping of menstrual bleeding prolonged bleeding during periods decreased sex drive feeling of fullness or tightness in the abdomen headache nausea weight gain Rare back pain dizziness expulsion of the device mood changes nervousness persistent or severe lower abdominal pain along with fever or unusual vaginal discharge severe headaches or migraines (headaches may lessen in many users, or they may increase in number or become worse for other users) signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide) signs of a liver problem (e.g., yellow skin or eyes, dark urine, pale stools, abdominal pain, or itchy skin) skin rash, hives, or itchy skin symptoms of pregnancy (e.g., abdominal pain, nausea, breast tenderness) vaginal discharge vaginal infection with vaginal itching or irritation, or thick, white, or curd-like discharge abdominal or stomach pain (sudden, severe, or continuing) signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat) signs of a blood clot in the leg (e.g., sudden unexplained pain in the leg, especially in the calf) signs of a blood clot in the lungs (e.g., sudden or unexplained shortness of breath, chest pain, coughing up of blood) signs of a heart attack (e.g., pain or discomfort in the chest or upper body, shortness of breath, nausea, cold sweats, or lightheadedness) signs of a stroke (e.g., sudden slurring of speech; sudden unexplained weakness, numbness, or pain in the arm or leg; sudden loss of coordination; sudden, severe headache) Drug Interaction DRUG INTERACTION Abatacept The risk or severity of adverse effects can be increased when Abatacept is combined with Carfilzomib. Abciximab The risk or severity of bleeding can be increased when Abciximab is combined with Carfilzomib. Abemaciclib The serum concentration of Abemaciclib can be increased when it is combined with Carfilzomib. Abrocitinib The serum concentration of Carfilzomib can be increased when it is combined with Abrocitinib. Acenocoumarol The risk or severity of bleeding can be increased when Acenocoumarol is combined with Carfilzomib. Acetylsalicylic acid The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Carfilzomib. Adalimumab The risk or severity of adverse effects can be increased when Adalimumab is combined with Carfilzomib. Adenovirus The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Carfilzomib. Afatinib The serum concentration of Afatinib can be increased when it is combined with Carfilzomib. Aldesleukin The risk or severity of adverse effects can be increased when Aldesleukin is combined with Carfilzomib. Alefacept The risk or severity of adverse effects can be increased when Alefacept is combined with Carfilzomib. Alemtuzumab The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Carfilzomib. Allogeneic The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Carfilzomib. Allopurinol The risk or severity of adverse effects can be increased when Allopurinol is combined with Carfilzomib. Alteplase The risk or severity of bleeding can be increased when Alteplase is combined with Carfilzomib. Altretamine The risk or severity of adverse effects can be increased when Altretamine is combined with Carfilzomib. Ambrisentan The serum concentration of Ambrisentan can be increased when it is combined with Carfilzomib. Amiodarone The serum concentration of Carfilzomib can be increased when it is combined with Amiodarone. Amsacrine The risk or severity of adverse effects can be increased when Amsacrine is combined with Carfilzomib. Anagrelide The risk or severity of bleeding can be increased when Anagrelide is combined with Carfilzomib. Anakinra The risk or severity of adverse effects can be increased when Anakinra is combined with Carfilzomib. Ancrod The risk or severity of bleeding can be increased when Ancrod is combined with Carfilzomib. Anifrolumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Anifrolumab. Anistreplase The risk or severity of bleeding can be increased when Anistreplase is combined with Carfilzomib. Anthrax immune The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Carfilzomib. Anthrax vaccine The risk or severity of infection can be increased when Anthrax vaccine is combined with Carfilzomib. Antilymphocyte The risk or severity of adverse effects can be increased when Carfilzomib is combined with Antilymphocyte immunoglobulin (horse). Antithrombin Alfa The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Carfilzomib. Antithrombin III human The risk or severity of bleeding can be increased when Antithrombin III human is combined with Carfilzomib. Antithymocyte The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Carfilzomib. Apalutamide The serum concentration of Carfilzomib can be decreased when it is combined with Apalutamide. Apixaban The serum concentration of Apixaban can be increased when it is combined with Carfilzomib. Apremilast The risk or severity of adverse effects can be increased when Apremilast is combined with Carfilzomib. Ardeparin The risk or severity of bleeding can be increased when Ardeparin is combined with Carfilzomib. Argatroban The risk or severity of bleeding can be increased when Argatroban is combined with Carfilzomib. Arsenic trioxide The serum concentration of Carfilzomib can be increased when it is combined with Arsenic trioxide. Articaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Articaine. Asciminib The serum concentration of Carfilzomib can be increased when it is combined with Asciminib. COVID-19 Vaccine The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Carfilzomib. Asunaprevir The serum concentration of Carfilzomib can be increased when it is combined with Asunaprevir. Avanafil The serum concentration of Avanafil can be increased when it is combined with Carfilzomib. Avatrombopag The serum concentration of Avatrombopag can be increased when it is combined with Carfilzomib. Axitinib The serum concentration of Axitinib can be increased when it is combined with Carfilzomib. Azacitidine The risk or severity of adverse effects can be increased when Azacitidine is combined with Carfilzomib. Azathioprine The risk or severity of adverse effects can be increased when Azathioprine is combined with Carfilzomib. Bacillus calmette The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Carfilzomib. BCG-I live antigen The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Carfilzomib. Bacillus calmette The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Carfilzomib. Baricitinib The risk or severity of adverse effects can be increased when Carfilzomib is combined with Baricitinib. Basiliximab The risk or severity of adverse effects can be increased when Basiliximab is combined with Carfilzomib. BCG vaccine The risk or severity of infection can be increased when BCG vaccine is combined with Carfilzomib. Beclomethasone The risk or severity of adverse effects can be increased when Beclomethasone dipropionate is combined with Carfilzomib. Belantamab The serum concentration of Belantamab mafodotin can be increased when it is combined with Carfilzomib. Belatacept The risk or severity of adverse effects can be increased when Belatacept is combined with Carfilzomib. Belimumab The risk or severity of adverse effects can be increased when Belimumab is combined with Carfilzomib. Belinostat The risk or severity of adverse effects can be increased when Belinostat is combined with Carfilzomib. Belumosudil The serum concentration of Carfilzomib can be increased when it is combined with Belumosudil. Bemiparin The risk or severity of bleeding can be increased when Bemiparin is combined with Carfilzomib. Bendamustine The serum concentration of Bendamustine can be increased when it is combined with Carfilzomib. Bendroflumethiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Carfilzomib. Benzocaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Benzocaine. Benzthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Carfilzomib. Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Benzyl alcohol. Berotralstat The serum concentration of Berotralstat can be increased when it is combined with Carfilzomib. Betamethasone The risk or severity of adverse effects can be increased when Betamethasone is combined with Carfilzomib. Betrixaban The serum concentration of Betrixaban can be increased when it is combined with Carfilzomib. Bexarotene The risk or severity of adverse effects can be increased when Bexarotene is combined with Carfilzomib. Bimekizumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Bimekizumab. Binimetinib The serum concentration of Binimetinib can be increased when it is combined with Carfilzomib. Bisoprolol The serum concentration of Bisoprolol can be increased when it is combined with Carfilzomib. Bivalirudin The risk or severity of bleeding can be increased when Bivalirudin is combined with Carfilzomib. Bleomycin The risk or severity of adverse effects can be increased when Bleomycin is combined with Carfilzomib. Blinatumomab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Blinatumomab. Bordetella pertussis The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Carfilzomib. Bortezomib The serum concentration of Bortezomib can be increased when it is combined with Carfilzomib. Bosutinib The serum concentration of Bosutinib can be increased when it is combined with Carfilzomib. Brentuximab vedotin The serum concentration of Brentuximab vedotin can be increased when it is combined with Carfilzomib. Brodalumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Brodalumab. Budesonide The risk or severity of adverse effects can be increased when Budesonide is combined with Carfilzomib. Bupivacaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Bupivacaine. Busulfan The risk or severity of adverse effects can be increased when Busulfan is combined with Carfilzomib. Butacaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Butacaine. Butamben The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Butamben. Cabazitaxel The serum concentration of Cabazitaxel can be increased when it is combined with Carfilzomib. Cabergoline The serum concentration of Cabergoline can be increased when it is combined with Carfilzomib. Canagliflozin The serum concentration of Carfilzomib can be increased when it is combined with Canagliflozin. Canakinumab The risk or severity of adverse effects can be increased when Canakinumab is combined with Carfilzomib. Cangrelor The risk or severity of bleeding can be increased when Cangrelor is combined with Carfilzomib. Capecitabine The risk or severity of adverse effects can be increased when Capecitabine is combined with Carfilzomib. Caplacizumab The risk or severity of bleeding can be increased when Caplacizumab is combined with Carfilzomib. Capmatinib The serum concentration of Carfilzomib can be increased when it is combined with Capmatinib. Capsaicin The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Capsaicin. Carbamazepine The risk or severity of adverse effects can be increased when Carbamazepine is combined with Carfilzomib. Carboplatin The risk or severity of adverse effects can be increased when Carboplatin is combined with Carfilzomib. Carmustine The risk or severity of adverse effects can be increased when Carmustine is combined with Carfilzomib. Carvedilol The serum concentration of Carfilzomib can be increased when it is combined with Carvedilol. Ceritinib The serum concentration of Ceritinib can be increased when it is combined with Carfilzomib. Certolizumab pegol The risk or severity of adverse effects can be increased when Carfilzomib is combined with Certolizumab pegol. Chlorambucil The risk or severity of adverse effects can be increased when Chlorambucil is combined with Carfilzomib. Chloramphenicol The risk or severity of adverse effects can be increased when Chloramphenicol is combined with Carfilzomib. Chlorothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Carfilzomib. Ciclesonide The risk or severity of adverse effects can be increased when Ciclesonide is combined with Carfilzomib. Cilostazol The risk or severity of bleeding can be increased when Cilostazol is combined with Carfilzomib. Cinchocaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Cinchocaine. Cisplatin The risk or severity of adverse effects can be increased when Cisplatin is combined with Carfilzomib. Cladribine The risk or severity of adverse effects can be increased when Cladribine is combined with Carfilzomib. Clarithromycin The serum concentration of Carfilzomib can be increased when it is combined with Clarithromycin. Clobazam The serum concentration of Clobazam can be increased when it is combined with Carfilzomib. Clobetasol The risk or severity of adverse effects can be increased when Clobetasol propionate is combined with Carfilzomib. Clofarabine The risk or severity of adverse effects can be increased when Clofarabine is combined with Carfilzomib. Clofazimine The serum concentration of Carfilzomib can be increased when it is combined with Clofazimine. Clomifene The serum concentration of Clomifene can be increased when it is combined with Carfilzomib. Clopidogrel The risk or severity of bleeding can be increased when Clopidogrel is combined with Carfilzomib. Clostridium The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Carfilzomib. Clozapine The risk or severity of neutropenia can be increased when Carfilzomib is combined with Clozapine. Cobicistat The serum concentration of Carfilzomib can be increased when it is combined with Cobicistat. Cobimetinib The serum concentration of Cobimetinib can be increased when it is combined with Carfilzomib. Cocaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Cocaine. Colchicine The serum concentration of Colchicine can be increased when it is combined with Carfilzomib. Conivaptan The serum concentration of Carfilzomib can be increased when it is combined with Conivaptan. Copanlisib The serum concentration of Copanlisib can be increased when it is combined with Carfilzomib. Corticotropin The risk or severity of adverse effects can be increased when Corticotropin is combined with Carfilzomib. Cortisone acetate The risk or severity of adverse effects can be increased when Cortisone acetate is combined with Carfilzomib. Corynebacterium The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Carfilzomib. Crizotinib The serum concentration of Carfilzomib can be increased when it is combined with Crizotinib. Curcumin The serum concentration of Carfilzomib can be increased when it is combined with Curcumin. Cyanocobalamin The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Carfilzomib. Cyclopenthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Carfilzomib. Cyclophosphamide The risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Carfilzomib. Cyclosporine Carfilzomib may increase the immunosuppressive activities of Cyclosporine. Cyclothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Carfilzomib. Cytarabine The risk or severity of adverse effects can be increased when Cytarabine is combined with Carfilzomib. Dabigatran The risk or severity of bleeding can be increased when Dabigatran is combined with Carfilzomib. Dabigatran etexilate The serum concentration of Dabigatran etexilate can be increased when it is combined with Carfilzomib. Dabrafenib The serum concentration of Dabrafenib can be increased when it is combined with Carfilzomib. Dacarbazine The risk or severity of adverse effects can be increased when Dacarbazine is combined with Carfilzomib. Daclatasvir The serum concentration of Carfilzomib can be increased when it is combined with Daclatasvir. Dacomitinib The serum concentration of Dacomitinib can be increased when it is combined with Carfilzomib. Dactinomycin The serum concentration of Dactinomycin can be increased when it is combined with Carfilzomib. Dalteparin The risk or severity of bleeding can be increased when Dalteparin is combined with Carfilzomib. Danaparoid The risk or severity of bleeding can be increased when Danaparoid is combined with Carfilzomib. Daptomycin The serum concentration of Daptomycin can be increased when it is combined with Carfilzomib. Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Carfilzomib. Darolutamide The serum concentration of Darolutamide can be increased when it is combined with Carfilzomib. Darunavir The serum concentration of Darunavir can be increased when it is combined with Carfilzomib. Dasabuvir The serum concentration of Dasabuvir can be increased when it is combined with Carfilzomib. Dasatinib The serum concentration of Dasatinib can be increased when it is combined with Carfilzomib. Daunorubicin The risk or severity of adverse effects can be increased when Daunorubicin is combined with Carfilzomib. Decitabine The risk or severity of adverse effects can be increased when Decitabine is combined with Carfilzomib. Defibrotide The risk or severity of bleeding can be increased when Defibrotide is combined with Carfilzomib. Deflazacort The risk or severity of adverse effects can be increased when Carfilzomib is combined with Deflazacort. Denosumab The risk or severity of adverse effects can be increased when Denosumab is combined with Carfilzomib. Desirudin The risk or severity of bleeding can be increased when Desirudin is combined with Carfilzomib. Desoximetasone The risk or severity of adverse effects can be increased when Desoximetasone is combined with Carfilzomib. Deucravacitinib The risk or severity of adverse effects can be increased when Carfilzomib is combined with Deucravacitinib. Dexamethasone The risk or severity of adverse effects can be increased when Dexamethasone is combined with Carfilzomib. Dexamethasone acetate The serum concentration of Carfilzomib can be decreased when it is combined with Dexamethasone acetate. Dexrazoxane The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Carfilzomib. Dextran The risk or severity of bleeding can be increased when Dextran is combined with Carfilzomib. Dicoumarol The risk or severity of bleeding can be increased when Dicoumarol is combined with Carfilzomib. Difluocortolone The risk or severity of adverse effects can be increased when Carfilzomib is combined with Difluocortolone. Digitoxin The serum concentration of Digitoxin can be increased when it is combined with Carfilzomib. Digoxin Carfilzomib may decrease the excretion rate of Digoxin which could result in a higher serum level. Dimethyl fumarate The risk or severity of adverse effects can be increased when Carfilzomib is combined with Dimethyl fumarate. Dinutuximab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Dinutuximab. Diosmin The serum concentration of Carfilzomib can be increased when it is combined with Diosmin. Diphenhydramine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Diphenhydramine. Dipyridamole The risk or severity of bleeding can be increased when Dipyridamole is combined with Carfilzomib. Diroximel fumarate The risk or severity of adverse effects can be increased when Carfilzomib is combined with Diroximel fumarate. Docetaxel The risk or severity of adverse effects can be increased when Docetaxel is combined with Carfilzomib. Dolutegravir The serum concentration of Dolutegravir can be increased when it is combined with Carfilzomib. Doxorubicin The serum concentration of Doxorubicin can be increased when it is combined with Carfilzomib. Dronedarone The serum concentration of Carfilzomib can be increased when it is combined with Dronedarone. Drotrecogin alfa The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Carfilzomib. Duvelisib The serum concentration of Duvelisib can be increased when it is combined with Carfilzomib. Dyclonine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Dyclonine. Ebola Zaire The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Carfilzomib. Eculizumab The risk or severity of adverse effects can be increased when Eculizumab is combined with Carfilzomib. Edetic acid The risk or severity of bleeding can be increased when Edetic acid is combined with Carfilzomib. Edoxaban The serum concentration of Edoxaban can be increased when it is combined with Carfilzomib. Efalizumab The risk or severity of adverse effects can be increased when Efalizumab is combined with Carfilzomib. Elagolix The serum concentration of Carfilzomib can be increased when it is combined with Elagolix. Elbasvir The serum concentration of Elbasvir can be increased when it is combined with Carfilzomib. Eliglustat The serum concentration of Carfilzomib can be increased when it is combined with Eliglustat. Emapalumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Emapalumab. Enasidenib The serum concentration of Carfilzomib can be increased when it is combined with Enasidenib. Enfortumab vedotin The serum concentration of Enfortumab vedotin can be increased when it is combined with Carfilzomib. Enoxaparin The risk or severity of bleeding can be increased when Enoxaparin is combined with Carfilzomib. Entrectinib The serum concentration of Carfilzomib can be increased when it is combined with Entrectinib. Epirubicin The risk or severity of adverse effects can be increased when Epirubicin is combined with Carfilzomib. Epoprostenol The risk or severity of bleeding can be increased when Epoprostenol is combined with Carfilzomib. Eptifibatide The risk or severity of bleeding can be increased when Eptifibatide is combined with Carfilzomib. Erdafitinib The serum concentration of Carfilzomib can be increased when it is combined with Erdafitinib. Eribulin The risk or severity of adverse effects can be increased when Eribulin is combined with Carfilzomib. Ertugliflozin The serum concentration of Ertugliflozin can be increased when it is combined with Carfilzomib. Erythromycin The serum concentration of Carfilzomib can be increased when it is combined with Erythromycin. Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Carfilzomib. Estramustine The risk or severity of adverse effects can be increased when Estramustine is combined with Carfilzomib. Etanercept The risk or severity of adverse effects can be increased when Etanercept is combined with Carfilzomib. Everolimus The serum concentration of Everolimus can be increased when it is combined with Carfilzomib. Famtozinameran The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Carfilzomib. Favipiravir The serum concentration of Carfilzomib can be increased when it is combined with Favipiravir. Fedratinib The serum concentration of Carfilzomib can be increased when it is combined with Fedratinib. Fexofenadine The serum concentration of Fexofenadine can be increased when it is combined with Carfilzomib. Filgotinib The serum concentration of Carfilzomib can be increased when it is combined with Filgotinib. Fingolimod Carfilzomib may increase the immunosuppressive activities of Fingolimod. Flibanserin The serum concentration of Carfilzomib can be increased when it is combined with Flibanserin. Floxuridine The risk or severity of adverse effects can be increased when Floxuridine is combined with Carfilzomib. Fluconazole The serum concentration of Carfilzomib can be increased when it is combined with Fluconazole. Flucytosine The risk or severity of adverse effects can be increased when Flucytosine is combined with Carfilzomib. Fludarabine The risk or severity of adverse effects can be increased when Fludarabine is combined with Carfilzomib. Fludrocortisone The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Carfilzomib. Fluindione The risk or severity of bleeding can be increased when Fluindione is combined with Carfilzomib. Flunisolide The risk or severity of adverse effects can be increased when Flunisolide is combined with Carfilzomib. Fluocinolone acetonide The risk or severity of adverse effects can be increased when Fluocinolone acetonide is combined with Carfilzomib. Fluocinonide The risk or severity of adverse effects can be increased when Fluocinonide is combined with Carfilzomib. Fluocortolone The risk or severity of adverse effects can be increased when Carfilzomib is combined with Fluocortolone. Fluorometholone The risk or severity of adverse effects can be increased when Fluorometholone is combined with Carfilzomib. Fluorouracil The risk or severity of adverse effects can be increased when Fluorouracil is combined with Carfilzomib. Flupentixol The risk or severity of myelosuppression can be increased when Flupentixol is combined with Carfilzomib. Fluprednisolone The risk or severity of adverse effects can be increased when Carfilzomib is combined with Fluprednisolone. Fluticasone The risk or severity of adverse effects can be increased when Carfilzomib is combined with Fluticasone. Fluticasone furoate The risk or severity of adverse effects can be increased when Carfilzomib is combined with Fluticasone furoate. Fluticasone propionate The risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Carfilzomib. Fondaparinux The risk or severity of bleeding can be increased when Fondaparinux is combined with Carfilzomib. Fostemsavir The serum concentration of Fostemsavir can be increased when it is combined with Carfilzomib. Futibatinib The serum concentration of Futibatinib can be increased when it is combined with Carfilzomib. Gallium nitrate The risk or severity of adverse effects can be increased when Gallium nitrate is combined with Carfilzomib. Gemcitabine The serum concentration of Gemcitabine can be increased when it is combined with Carfilzomib. Gemtuzumab ozogamicin The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Carfilzomib. Gilteritinib The serum concentration of Gilteritinib can be increased when it is combined with Carfilzomib. Glasdegib The serum concentration of Carfilzomib can be increased when it is combined with Glasdegib. Glatiramer The risk or severity of adverse effects can be increased when Glatiramer is combined with Carfilzomib. Glecaprevir The serum concentration of Carfilzomib can be increased when it is combined with Glecaprevir. Golimumab The risk or severity of adverse effects can be increased when Golimumab is combined with Carfilzomib. Grazoprevir The serum concentration of Grazoprevir can be increased when it is combined with Carfilzomib. Guselkumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Guselkumab. Hydrocortisone acetate The risk or severity of adverse effects can be increased when Carfilzomib is combined with Hydrocortisone acetate. Hydrocortisone butyrate The risk or severity of adverse effects can be increased when Carfilzomib is combined with Hydrocortisone butyrate. Hydrocortisone The risk or severity of adverse effects can be increased when Carfilzomib is combined with Hydrocortisone succinate. Hydroflumethiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Hydroflumethiazide is combined with Carfilzomib. Hydroxychloroquine The risk or severity of adverse effects can be increased when Hydroxychloroquine is combined with Carfilzomib. Hydroxyurea The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Carfilzomib. Ibritumomab tiuxetan The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Carfilzomib. Ibrutinib The risk or severity of adverse effects can be increased when Carfilzomib is combined with Ibrutinib. Icosapent ethyl The risk or severity of bleeding can be increased when Icosapent ethyl is combined with Carfilzomib. Idarubicin The risk or severity of adverse effects can be increased when Idarubicin is combined with Carfilzomib. Idelalisib The risk or severity of adverse effects can be increased when Carfilzomib is combined with Idelalisib. Ifosfamide The risk or severity of adverse effects can be increased when Ifosfamide is combined with Carfilzomib. Iloprost The risk or severity of bleeding can be increased when Iloprost is combined with Carfilzomib. Imatinib The risk or severity of adverse effects can be increased when Imatinib is combined with Carfilzomib. Imipramine The serum concentration of Imipramine can be increased when it is combined with Carfilzomib. Indacaterol The serum concentration of Indacaterol can be increased when it is combined with Carfilzomib. Indomethacin The risk or severity of adverse effects can be increased when Indomethacin is combined with Carfilzomib. Inebilizumab The risk or severity of infection can be increased when Carfilzomib is combined with Inebilizumab. Infliximab The risk or severity of adverse effects can be increased when Infliximab is combined with Carfilzomib. Lenalidomide The risk or severity of adverse effects can be increased when Lenalidomide is combined with Carfilzomib. Lenvatinib The serum concentration of Lenvatinib can be increased when it is combined with Carfilzomib. Lepirudin The risk or severity of bleeding can be increased when Lepirudin is combined with Carfilzomib. Levobupivacaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Levobupivacaine. Levoketoconazole The serum concentration of Carfilzomib can be increased when it is combined with Levoketoconazole. Levothyroxine The serum concentration of Carfilzomib can be decreased when it is combined with Levothyroxine. Lidocaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Lidocaine. Linagliptin The serum concentration of Carfilzomib can be increased when it is combined with Linagliptin. Linezolid The risk or severity of adverse effects can be increased when Linezolid is combined with Carfilzomib. Lipegfilgrastim Carfilzomib may increase the myelosuppressive activities of Lipegfilgrastim. Lomitapide The serum concentration of Carfilzomib can be increased when it is combined with Lomitapide. Lomustine The risk or severity of adverse effects can be increased when Lomustine is combined with Carfilzomib. Lonafarnib The serum concentration of Carfilzomib can be increased when it is combined with Lonafarnib. Loncastuximab tesirine The serum concentration of Loncastuximab tesirine can be increased when it is combined with Carfilzomib. Loperamide The excretion of Loperamide can be decreased when combined with Carfilzomib. Lopinavir The serum concentration of Carfilzomib can be increased when it is combined with Lopinavir. Lorlatinib The serum concentration of Carfilzomib can be decreased when it is combined with Lorlatinib. Loxapine The serum concentration of Carfilzomib can be increased when it is combined with Loxapine. Lumacaftor The serum concentration of Carfilzomib can be decreased when it is combined with Lumacaftor. Lusutrombopag The serum concentration of Lusutrombopag can be increased when it is combined with Carfilzomib. Magnesium The serum concentration of Magnesium can be decreased when it is combined with Carfilzomib. Mannitol The serum concentration of Mannitol can be increased when it is combined with Carfilzomib. Maribavir The serum concentration of Carfilzomib can be increased when it is combined with Maribavir. Measles virus The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Carfilzomib. Mechlorethamine The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Carfilzomib. Mefloquine The serum concentration of Carfilzomib can be increased when it is combined with Mefloquine. Meloxicam The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Meloxicam. Melphalan The risk or severity of adverse effects can be increased when Melphalan is combined with Carfilzomib. Meningococcal The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Carfilzomib. Mepivacaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Mepivacaine. Mepolizumab The risk or severity of adverse effects can be increased when Mepolizumab is combined with Carfilzomib. Meprednisone The risk or severity of adverse effects can be increased when Carfilzomib is combined with Meprednisone. Mercaptopurine The risk or severity of adverse effects can be increased when Mercaptopurine is combined with Carfilzomib. Methimazole The risk or severity of adverse effects can be increased when Methimazole is combined with Carfilzomib. Methotrexate The risk or severity of adverse effects can be increased when Methotrexate is combined with Carfilzomib. Methoxy The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Carfilzomib. Methylene blue The serum concentration of Carfilzomib can be increased when it is combined with Methylene blue. Methylprednisolone The risk or severity of adverse effects can be increased when Methylprednisolone is combined with Carfilzomib. Mifepristone The serum concentration of Carfilzomib can be decreased when it is combined with Mifepristone. Mirabegron The serum concentration of Carfilzomib can be increased when it is combined with Mirabegron. Mitapivat The serum concentration of Carfilzomib can be increased when it is combined with Mitapivat. Mitomycin The risk or severity of adverse effects can be increased when Mitomycin is combined with Carfilzomib. Mitoxantrone The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Carfilzomib. COVID-19 Vaccine The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Carfilzomib. Modified vaccinia ankara The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Carfilzomib. Mometasone furoate The risk or severity of adverse effects can be increased when Carfilzomib is combined with Mometasone furoate. Monomethyl fumarate The risk or severity of adverse effects can be increased when Carfilzomib is combined with Monomethyl fumarate. Morphine The serum concentration of Morphine can be increased when it is combined with Carfilzomib. Mosunetuzumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Mosunetuzumab. Mumps virus The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Carfilzomib. Muromonab The risk or severity of adverse effects can be increased when Muromonab is combined with Carfilzomib. Mycophenolate mofetil The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Carfilzomib. Mycophenolic acid The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Carfilzomib. Nadroparin The risk or severity of bleeding can be increased when Nadroparin is combined with Carfilzomib. Naloxegol The serum concentration of Naloxegol can be increased when it is combined with Carfilzomib. Natalizumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Natalizumab. Nelarabine The risk or severity of adverse effects can be increased when Nelarabine is combined with Carfilzomib. Neratinib The serum concentration of Carfilzomib can be increased when it is combined with Neratinib. Netupitant The serum concentration of Carfilzomib can be increased when it is combined with Netupitant. Nilotinib The serum concentration of Carfilzomib can be increased when it is combined with Nilotinib. Nimesulide The risk or severity of bleeding can be increased when Nimesulide is combined with Carfilzomib. Nintedanib The serum concentration of Nintedanib can be increased when it is combined with Carfilzomib. Norgestimate The serum concentration of Carfilzomib can be increased when it is combined with Norgestimate. Nortriptyline The serum concentration of Nortriptyline can be increased when it is combined with Carfilzomib. Nuvaxovid The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Carfilzomib. Obinutuzumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Obinutuzumab. Ocrelizumab Ocrelizumab may increase the immunosuppressive activities of Carfilzomib. Ofatumumab The risk or severity of adverse effects can be increased when Ofatumumab is combined with Carfilzomib. Olaparib The risk or severity of adverse effects can be increased when Carfilzomib is combined with Olaparib. Omadacycline The serum concentration of Omadacycline can be increased when it is combined with Carfilzomib. Ombitasvir The serum concentration of Ombitasvir can be increased when it is combined with Carfilzomib. Osimertinib The serum concentration of Osimertinib can be increased when it is combined with Carfilzomib. Oxaliplatin The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Carfilzomib. Oxetacaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Oxetacaine. Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Oxybuprocaine. Ozanimod The risk or severity of adverse effects can be increased when Carfilzomib is combined with Ozanimod. Paclitaxel The risk or severity of adverse effects can be increased when Paclitaxel is combined with Carfilzomib. Pacritinib The serum concentration of Carfilzomib can be increased when it is combined with Pacritinib. Palbociclib The serum concentration of Carfilzomib can be increased when it is combined with Palbociclib. Palifermin The therapeutic efficacy of Palifermin can be decreased when used in combination with Carfilzomib. Paliperidone The serum concentration of Carfilzomib can be increased when it is combined with Paliperidone. Panobinostat The serum concentration of Panobinostat can be increased when it is combined with Carfilzomib. Paritaprevir The serum concentration of Paritaprevir can be increased when it is combined with Carfilzomib. Parnaparin The risk or severity of bleeding can be increased when Parnaparin is combined with Carfilzomib. Pazopanib The serum concentration of Pazopanib can be increased when it is combined with Carfilzomib. Pegaspargase The risk or severity of adverse effects can be increased when Pegaspargase is combined with Carfilzomib. Pegcetacoplan The risk or severity of adverse effects can be increased when Carfilzomib is combined with Pegcetacoplan. Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Carfilzomib. Peginterferon alfa-2a The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Carfilzomib. Peginterferon alfa-2b The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Carfilzomib. Peginterferon beta-1a The risk or severity of adverse effects can be increased when Carfilzomib is combined with Peginterferon beta-1a. Pemetrexed The risk or severity of adverse effects can be increased when Pemetrexed is combined with Carfilzomib. Penicillamine The risk or severity of adverse effects can be increased when Penicillamine is combined with Carfilzomib. Pentosan polysulfate The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Carfilzomib. Pentostatin The risk or severity of adverse effects can be increased when Pentostatin is combined with Carfilzomib. Pentoxifylline The risk or severity of bleeding can be increased when Pentoxifylline is combined with Carfilzomib. Pertussis vaccine The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Carfilzomib. Phenindione The risk or severity of bleeding can be increased when Phenindione is combined with Carfilzomib. Phenol The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Phenol. Phenprocoumon The risk or severity of bleeding can be increased when Phenprocoumon is combined with Carfilzomib. Phenylalanine The risk or severity of adverse effects can be increased when Phenylalanine is combined with Carfilzomib. Pibrentasvir The serum concentration of Carfilzomib can be increased when it is combined with Pibrentasvir. Pimecrolimus The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Carfilzomib. Pirfenidone The risk or severity of adverse effects can be increased when Pirfenidone is combined with Carfilzomib. Polythiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Carfilzomib. Pomalidomide The serum concentration of Pomalidomide can be increased when it is combined with Carfilzomib. Ponatinib The serum concentration of Carfilzomib can be increased when it is combined with Ponatinib. Ponesimod The risk or severity of adverse effects can be increased when Carfilzomib is combined with Ponesimod. Posaconazole The serum concentration of Posaconazole can be increased when it is combined with Carfilzomib. Pralatrexate The risk or severity of adverse effects can be increased when Pralatrexate is combined with Carfilzomib. Pralsetinib The serum concentration of Pralsetinib can be increased when it is combined with Carfilzomib. Pramocaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Pramocaine. Prasugrel The risk or severity of bleeding can be increased when Prasugrel is combined with Carfilzomib. Pravastatin The serum concentration of Pravastatin can be increased when it is combined with Carfilzomib. Prednisolone The risk or severity of adverse effects can be increased when Prednisolone is combined with Carfilzomib. Prednisolone phosphate The serum concentration of Carfilzomib can be decreased when it is combined with Prednisolone phosphate. Prednisone The risk or severity of adverse effects can be increased when Prednisone is combined with Carfilzomib. Prilocaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Prilocaine. Procaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Procaine. Procarbazine The risk or severity of adverse effects can be increased when Procarbazine is combined with Carfilzomib. Propafenone The serum concentration of Carfilzomib can be increased when it is combined with Propafenone. Proparacaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Proparacaine. Propoxycaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Propoxycaine. Propylthiouracil The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Carfilzomib. Protein C The risk or severity of bleeding can be increased when Protein C is combined with Carfilzomib. Protein S human The risk or severity of bleeding can be increased when Protein S human is combined with Carfilzomib. Prucalopride The serum concentration of Prucalopride can be increased when it is combined with Carfilzomib. Quinidine The serum concentration of Carfilzomib can be increased when it is combined with Quinidine. Quinine The serum concentration of Carfilzomib can be increased when it is combined with Quinine. Rglobulin, human The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Carfilzomib. Rabies virus The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Carfilzomib. Rabies virus The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Carfilzomib. Raltitrexed The risk or severity of adverse effects can be increased when Raltitrexed is combined with Carfilzomib. Ranolazine The serum concentration of Ranolazine can be increased when it is combined with Carfilzomib. Ravulizumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Ravulizumab. Regorafenib The serum concentration of Regorafenib can be increased when it is combined with Carfilzomib. Relugolix The serum concentration of Relugolix can be increased when it is combined with Carfilzomib. Reserpine The serum concentration of Carfilzomib can be increased when it is combined with Reserpine. Reteplase The risk or severity of bleeding can be increased when Reteplase is combined with Carfilzomib. Revefenacin The serum concentration of Revefenacin can be increased when it is combined with Carfilzomib. Reviparin The risk or severity of bleeding can be increased when Reviparin is combined with Carfilzomib. Rifampicin The serum concentration of Carfilzomib can be decreased when it is combined with Rifampicin. Rifamycin The serum concentration of Carfilzomib can be increased when it is combined with Rifamycin. Rifaximin The serum concentration of Rifaximin can be increased when it is combined with Carfilzomib. Rilonacept The risk or severity of adverse effects can be increased when Rilonacept is combined with Carfilzomib. Rimegepant The serum concentration of Rimegepant can be increased when it is combined with Carfilzomib. Riociguat The serum concentration of Riociguat can be increased when it is combined with Carfilzomib. Ripretinib The serum concentration of Carfilzomib can be increased when it is combined with Ripretinib. Risankizumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Risankizumab. Ritonavir The serum concentration of Carfilzomib can be increased when it is combined with Ritonavir. Rituximab The risk or severity of adverse effects can be increased when Rituximab is combined with Carfilzomib. Rivaroxaban The serum concentration of Rivaroxaban can be increased when it is combined with Carfilzomib. Roflumilast Roflumilast may increase the immunosuppressive activities of Carfilzomib. Rolapitant The serum concentration of Carfilzomib can be increased when it is combined with Rolapitant. Romidepsin The serum concentration of Romidepsin can be increased when it is combined with Carfilzomib. Ropeginterferon The risk or severity of adverse effects can be increased when Carfilzomib is combined with Ropeginterferon alfa-2b. Ropivacaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Ropivacaine. Rotavirus vaccine The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Carfilzomib. Rubella virus vaccine The risk or severity of infection can be increased when Rubella virus vaccine is combined with Carfilzomib. Ruxolitinib The risk or severity of adverse effects can be increased when Ruxolitinib is combined with Carfilzomib. Sapropterin The serum concentration of Carfilzomib can be increased when it is combined with Sapropterin. Saquinavir The serum concentration of Carfilzomib can be increased when it is combined with Saquinavir. Sarecycline The serum concentration of Carfilzomib can be increased when it is combined with Sarecycline. Sarilumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Sarilumab. Satralizumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Satralizumab. Secukinumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Secukinumab. Selexipag The serum concentration of Selexipag can be increased when it is combined with Carfilzomib. Selumetinib The serum concentration of Selumetinib can be increased when it is combined with Carfilzomib. Sildenafil The serum concentration of Carfilzomib can be increased when it is combined with Sildenafil. Silodosin The excretion of Silodosin can be decreased when combined with Carfilzomib. Siltuximab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Siltuximab. Simeprevir The serum concentration of Carfilzomib can be increased when it is combined with Simeprevir. Simvastatin The serum concentration of Carfilzomib can be increased when it is combined with Simvastatin. Siponimod The risk or severity of adverse effects can be increased when Carfilzomib is combined with Siponimod. Sipuleucel-T The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Carfilzomib. Sirolimus The serum concentration of Sirolimus can be increased when it is combined with Carfilzomib. Sitagliptin The serum concentration of Sitagliptin can be increased when it is combined with Carfilzomib. Smallpox The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Carfilzomib. Sodium citrate The risk or severity of bleeding can be increased when Sodium citrate is combined with Carfilzomib. Sofosbuvir The serum concentration of Sofosbuvir can be increased when it is combined with Carfilzomib. Sorafenib The serum concentration of Carfilzomib can be increased when it is combined with Sorafenib. Sotagliflozin The serum concentration of Carfilzomib can be increased when it is combined with Sotagliflozin. Sotorasib The serum concentration of Carfilzomib can be increased when it is combined with Sotorasib. Spesolimab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Spesolimab. St. John's Wort The serum concentration of Carfilzomib can be decreased when it is combined with St. John's Wort. Stiripentol The serum concentration of Carfilzomib can be increased when it is combined with Stiripentol. Streptokinase The risk or severity of bleeding can be increased when Streptokinase is combined with Carfilzomib. Streptozocin The risk or severity of adverse effects can be increased when Streptozocin is combined with Carfilzomib. Sulfamethoxazole The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Carfilzomib. Sulfasalazine The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Carfilzomib. Sulfinpyrazone The risk or severity of bleeding can be increased when Sulfinpyrazone is combined with Carfilzomib. Sulodexide The risk or severity of bleeding can be increased when Sulodexide is combined with Carfilzomib. Sunitinib The risk or severity of adverse effects can be increased when Sunitinib is combined with Carfilzomib. Suvorexant The serum concentration of Carfilzomib can be increased when it is combined with Suvorexant. Tacrolimus Tacrolimus may increase the immunosuppressive activities of Carfilzomib. Talazoparib The serum concentration of Talazoparib can be increased when it is combined with Carfilzomib. Tamoxifen The serum concentration of Carfilzomib can be increased when it is combined with Tamoxifen. Tazemetostat The serum concentration of Tazemetostat can be increased when it is combined with Carfilzomib. Technetium The serum concentration of Technetium Tc-99m sestamibi can be increased when it is combined with Carfilzomib. Tedizolid phosphate The risk or severity of myelosuppression can be increased when Carfilzomib is combined with Tedizolid phosphate. Tegaserod The serum concentration of Tegaserod can be increased when it is combined with Carfilzomib. Telaprevir The serum concentration of Carfilzomib can be increased when it is combined with Telaprevir. Temozolomide The risk or severity of adverse effects can be increased when Temozolomide is combined with Carfilzomib. Temsirolimus The serum concentration of Carfilzomib can be increased when it is combined with Temsirolimus. Tenecteplase The risk or severity of bleeding can be increased when Tenecteplase is combined with Carfilzomib. Teniposide The risk or severity of adverse effects can be increased when Teniposide is combined with Carfilzomib. Tenofovir alafenamide The serum concentration of Tenofovir alafenamide can be increased when it is combined with Carfilzomib. Tenofovir disoproxil The serum concentration of Tenofovir disoproxil can be increased when it is combined with Carfilzomib. Tepotinib The serum concentration of Tepotinib can be increased when it is combined with Carfilzomib. Teprotumumab The risk or severity of adverse effects can be increased when Teprotumumab is combined with Carfilzomib. Teriflunomide The risk or severity of adverse effects can be increased when Teriflunomide is combined with Carfilzomib. Tetracaine The risk or severity of methemoglobinemia can be increased when Carfilzomib is combined with Tetracaine. Tezacaftor The serum concentration of Tezacaftor can be increased when it is combined with Carfilzomib. Thalidomide The risk or severity of adverse effects can be increased when Thalidomide is combined with Carfilzomib. Thiotepa The risk or severity of adverse effects can be increased when Thiotepa is combined with Carfilzomib. Ticagrelor The serum concentration of Carfilzomib can be increased when it is combined with Ticagrelor. Tick-borne The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Carfilzomib. Ticlopidine The risk or severity of bleeding can be increased when Ticlopidine is combined with Carfilzomib. Tinzaparin The risk or severity of bleeding can be increased when Tinzaparin is combined with Carfilzomib. Tioguanine The risk or severity of adverse effects can be increased when Tioguanine is combined with Carfilzomib. Tipranavir The serum concentration of Carfilzomib can be decreased when it is combined with Tipranavir. Tirofiban The risk or severity of bleeding can be increased when Tirofiban is combined with Carfilzomib. Tivozanib The serum concentration of Tivozanib can be increased when it is combined with Carfilzomib. Tixocortol The risk or severity of adverse effects can be increased when Carfilzomib is combined with Tixocortol. Tocilizumab The risk or severity of adverse effects can be increased when Tocilizumab is combined with Carfilzomib. Tofacitinib Carfilzomib may increase the immunosuppressive activities of Tofacitinib. Tolvaptan The serum concentration of Tolvaptan can be increased when it is combined with Carfilzomib. Topotecan The serum concentration of Topotecan can be increased when it is combined with Carfilzomib. Toremifene The serum concentration of Carfilzomib can be increased when it is combined with Toremifene. Tositumomab The risk or severity of adverse effects can be increased when Tositumomab is combined with Carfilzomib. Trabectedin The risk or severity of adverse effects can be increased when Trabectedin is combined with Carfilzomib. Trastuzumab Trastuzumab may increase the neutropenic activities of Carfilzomib. Trastuzumab emtansine The serum concentration of Trastuzumab emtansine can be increased when it is combined with Carfilzomib. Trazodone The serum concentration of Carfilzomib can be decreased when it is combined with Trazodone. Tretinoin The risk or severity of adverse effects can be increased when Tretinoin is combined with Carfilzomib. Triamcinolone The risk or severity of adverse effects can be increased when Triamcinolone is combined with Carfilzomib. Trichlormethiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Carfilzomib. Trifluridine The risk or severity of adverse effects can be increased when Trifluridine is combined with Carfilzomib. Triflusal The risk or severity of bleeding can be increased when Triflusal is combined with Carfilzomib. Trilaciclib The serum concentration of Trilaciclib can be increased when it is combined with Carfilzomib. Trilostane The risk or severity of adverse effects can be increased when Trilostane is combined with Carfilzomib. Trimipramine The serum concentration of Trimipramine can be increased when it is combined with Carfilzomib. Tucatinib The serum concentration of Carfilzomib can be increased when it is combined with Tucatinib. Typhoid vaccine The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Carfilzomib. Typhoid Vaccine Live The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Carfilzomib. Typhoid The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Carfilzomib. Ubrogepant The serum concentration of Ubrogepant can be increased when it is combined with Carfilzomib. Umbralisib The serum concentration of Carfilzomib can be increased when it is combined with Umbralisib. Umeclidinium The serum concentration of Umeclidinium can be increased when it is combined with Carfilzomib. Upadacitinib The risk or severity of adverse effects can be increased when Carfilzomib is combined with Upadacitinib. Urokinase The risk or severity of bleeding can be increased when Urokinase is combined with Carfilzomib. Vandetanib The serum concentration of Carfilzomib can be increased when it is combined with Vandetanib. Vardenafil The serum concentration of Carfilzomib can be increased when it is combined with Vardenafil. Varicella zoster The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Carfilzomib. Varicella zoster vaccine The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Carfilzomib. Vedolizumab The risk or severity of adverse effects can be increased when Carfilzomib is combined with Vedolizumab. Velpatasvir The serum concentration of Carfilzomib can be increased when it is combined with Velpatasvir. Vemurafenib The serum concentration of Carfilzomib can be increased when it is combined with Vemurafenib. Venetoclax The serum concentration of Venetoclax can be increased when it is combined with Carfilzomib. Verapamil The serum concentration of Carfilzomib can be increased when it is combined with Verapamil. Pregnancy and Lactation Pregnancy Category D Pregnancy This device should not be used during pregnancy. You should have this device removed if you become pregnant. Any device in the uterus during pregnancy can result in an increased risk of miscarriage or early labour. There is no evidence of birth defects when the device remains in the uterus for the full term. However, there is no conclusive evidence of this because of limited experience. Lactation No information is available on the clinical use of carfilzomib during breastfeeding. Because carfilzomib is 97% bound to plasma proteins, the amount in milk is likely to be low. The manufacturer recommends that breastfeeding be discontinued during carfilzomib therapy and for 2 weeks after the last dose. How should this medicine be used?

Carfilzomib comes as a powder to be mixed with liquid to be injected intravenously (into a vein). Carfilzomib is given by a doctor or nurse in a medical office or clinic usually over a period of 10 or 30 minutes. It may be given 2 days in a row each week for 3 weeks followed by a 12-day rest period or it may be given once a week for 3 weeks followed by a 13-day rest period. The length of…

References

Add references, clinical guidelines, textbooks, journal articles, or trusted medical sources here. You can edit this area from the RX Article Professional Blocks panel.

More from this topic
  1. Vasodilator Drugs

    Vasodilator drugs relax and widen blood vessels, increasing blood flow. A few examples include ACE inhibitors, ARBs, calcium channel blockers, and nitrates.   DefinitionVasodilators are medicines that dilate...

    June 9, 2025 • Drugs (A - Z)
  2. Methamphetamine Hydrochloride – Uses, Dosage, Side Effects, Interaction

    Methamphetamine Hydrochloride is the hydrochloride salt form of methamphetamine, an amphetamine and sympathomimetic amine with CNS stimulating properties. Methamphetamine hydrochloride acts by facilitating the release of catecholamines, particularly noradrenaline and dopamine, from...

    June 5, 2025 • Drugs (A - Z)
  3. Methamphetamine – Uses, Dosage, Side Effects, Interactions

    Methamphetamine is a member of the class of amphetamines in which the amino group of (S)-amphetamine carries a methyl substituent. It has a role as a neurotoxin, a psychotropic drug,...

    June 5, 2025 • Drugs (A - Z)
  4. Vitamin D3 – Uses, Dosage, Side Effects, Interactions

    DefinitionCholecalciferol is a steroid? hormone produced in the skin when exposed to ultraviolet light or obtained from dietary sources. The active form of cholecalciferol, 1,25-dihydroxycholecalciferol (calcitriol) plays an important role...

    March 10, 2025 • Drugs (A - Z)
  5. Imidazole – Uses, Dosage, Side Effects, Interactions

    DefinitionImidazole is an imidazole tautomer which has the migrating hydrogen at position 1. It is a conjugate base of an imidazolium cation. It is a conjugate acid of an imidazolide. It is...

    October 20, 2023 • Drugs (A - Z)
  6. Carbimazole

    Carbimazole is a member of the class of imidazoles that is methimazole in which the nitrogen-bearing hydrogen is converted into its methoxycarbonyl derivative. A prodrug for methimazole, carbimazole is...

    October 20, 2023 • Drugs (A - Z)
  7. Methylthiouracil – Uses, Dosage, Side Effects, Interactions

    DefinitionA thiourea antithyroid agent that inhibits the synthesis of thyroid? hormone. It is used in the treatment of hyperthyroidism?. Methylthiouracil is an organosulfur compound that is used in...

    October 20, 2023 • Drugs (A - Z)
  8. Propylthiouracil – Uses, Dosage, Side Effects, Interactions

    DefinitionPropylthiouracil is a Thyroid? Hormone Synthesis Inhibitor. The mechanism of action of propylthiouracil is as a Thyroid Hormone Synthesis Inhibitor. 6-propyl-2-thiouracil is a pyrimidine-thione consisting of uracil in which the...

    October 20, 2023 • Drugs (A - Z)
  9. Methimazole

    DefinitionMethimazole ( Metirox 5 and 10 mg) is a member of the class of imidazoles that it imidazole-2-thione in which a methyl group replaces the hydrogen that is attached to...

    October 20, 2023 • Drugs (A - Z)
  10. Mirogabalin – Uses, Dosage, Side Effects, Interactions

    DefinitionMirogabalin has been used in trials studying the treatment of Post-herpetic Neuralgia, Pain? Associated With Fibromyalgia, and Diabetic peripheral neuropathic pain. Mirogabalin is a medication designed...

    August 12, 2023 • Drugs (A - Z)