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Ixazomib Citrate – Uses, Dosage, Side Effects, Interaction

Ixazomib Citrate - Uses, Dosage, Side Effects, Interaction

Mechanism of Action

Ixazomib is an N-capped dipeptidyl leucine boronic acid that reversibly inhibits the CT-L proteolytic (β5) site of the 20S proteasome. At higher concentrations, ixazomib also seems to inhibit the proteolytic β1 and β2 subunits and induce the accumulation of ubiquitinated proteins. In vitro studies have shown ixazomib to induce apoptosis in multiple myeloma cells sensitive or resistant to other conventional therapies. In mouse xenograft models, ixazomib induced tumor growth inhibition.

At therapeutic concentrations, ixazomib selectively and reversibly inhibits the protein proteasome subunit beta type-5 (PSMB5)[rx] with a dissociation half-life of 18 minutes. This mechanism is the same as that of bortezomib, which has a much longer dissociation half-life of 110 minutes; the related drug carfilzomib, by contrast, blocks PSMB5 irreversibly. Proteasome subunits beta type-1 and type-2 are only inhibited at high concentrations reached in cell culture models.[rx]

PSMB5 is part of the 20S proteasome complex and has an enzymatic activity similar to chymotrypsin. It induces apoptosis, a type of programmed cell death, in various cancer cell lines. A synergistic effect of ixazomib and lenalidomide has been found in a large number of myeloma cell lines. Ixazomib a second-generation proteasome inhibitor (PI) and the first oral PI approved by the FDA in November 2015 for multiple myeloma treatment in combination with 2 other therapies (lenalidomide and dexamethasone) for patients who have received at least 1 prior therapy.

Indications

  • Ixazomib is indicated in combination with lenalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior therapy. It is used in combination with dexamethasone and lenalidomide in patients who have had one prior treatment, allowing patients to be on a fully oral regimen, which has been proven to have a progression-free survival benefit.
  • Treatment of lymphoid malignancies (excluding multiple myeloma)
  • Ixazomib is a small-molecule proteasome inhibitor that is used in combination with other antineoplastic agents to treat refractory multiple myeloma
  • Treatment of systemic light chain amyloidosis.
  • Ixazomib is a monoclonal antibody used with other medications to treat multiple myeloma in patients who have received one other therapy already.

Use in Cancer

Ixazomib citrate is approved to be used with lenalidomide and dexamethasone to treat:

  • Multiple myeloma in patients who have already received at least one other type of treatment.

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

Contraindications

  • decreased blood platelets
  • low levels of a type of white blood cell called neutrophils
  • a painful condition that affects the nerves in the legs and arms called peripheral neuropathy
  • liver problems
  • fluid retention in the legs, feet, arms or hands
  • abnormal liver function tests
  • pregnancy
  • a patient who is producing milk and breastfeeding
  • chronic kidney disease stage 4 (severe)
  • chronic kidney disease stage 5 (failure)
  • kidney disease with likely reduction in kidney function
  • Child-Pugh class B liver impairment
  • Child-Pugh class C liver impairment

Dosage

Strengths: 2.3 mg; 3 mg; 4 mg

Multiple Myeloma

  • 4 mg orally once a week on Days 1, 8, and 15 of a 28-day cycle
  • This drug is only given in combination with lenalidomide and dexamethasone.
  • For additional information regarding lenalidomide and dexamethasone, refer to their prescribing information.
  • Antiviral prophylaxis should be considered to decrease the risk of herpes zoster reactivation.
  • Prior to initiating a new cycle of therapy:
  • The absolute neutrophil count should be at least 1,000/mm3, the Platelet count should be at least 75,000/mm3, and Nonhematologic toxicities should, at physician discretion, generally be recovered to patient baseline condition or Grade 1 or lower
  • Treatment should be continued until the disease progresses or has unacceptable toxicity.
  • In combination with lenalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior therapy

Dose Adjustments

DOSE REDUCTIONS DUE TO ADVERSE REACTIONS:

  • Recommended starting dose: 4 mg
  • First reduction recommendation: 3 mg
  • Second reduction recommendation: 2.3 mg
  • Discontinue therapy

DOSE MODIFICATION GUIDELINES FOR THIS DRUG IN COMBINATION WITH LENALIDOMIDE AND DEXAMETHASONE:
THROMBOCYTOPENIA:
Platelet count less than 30,000/mm3:

  • Withhold this drug and lenalidomide until the platelet count is at least 30,000/mm3.
  • Following recovery, resume lenalidomide at the next lower dose according to its prescribing information and resume this drug at its most recent dose.
  • If the platelet count falls to less than 30,000/mm3 again, withhold this drug and lenalidomide until the platelet count is at least 30,000/mm3.
  • Following recovery, resume this drug at the next lower dose and resume lenalidomide at its most recent dose.

NEUTROPENIA:
Absolute neutrophil count less than 500/mm3:

  • Withhold this drug and lenalidomide until the absolute neutrophil count is at least 500/mm3. Consider adding granulocyte colony-stimulating factor (G-CSF) as per clinical guidelines.
  • Following recovery, resume lenalidomide at the next lower dose according to its prescribing information and resume this drug at its most recent dose.
  • If the absolute neutrophil count falls to less than 500/mm3 again, withhold this drug and lenalidomide until the absolute neutrophil count is at least 500/mm3.
  • Following recovery, resume this drug at the next lower dose and resume lenalidomide at its most recent dose.

NONHEMATOLOGIC TOXICITIES RECOMMENDED DOSE MODIFICATIONS:
Grade 2 or 3 rash:

  • Withhold lenalidomide until the rash recovers to Grade 1 or lower.
  • Following recovery, resume lenalidomide at the next lower dose according to its prescribing information.
  • If a Grade 2 or 3 rash occurs again, withhold this drug and lenalidomide until the rash recovers to Grade 1 or lower.
  • Following recovery, resume this drug at the next lower dose and resume lenalidomide at its most recent dose.

Grade 4 rash:

  • Discontinue therapy.

PERIPHERAL NEUROPATHY RECOMMENDED DOSE MODIFICATIONS:
Grade 1 peripheral neuropathy with pain or Grade 2 peripheral neuropathy:

  • Withhold this drug until peripheral neuropathy recovers to Grade 1 or lower without pain or the patient’s baseline.
  • Following recovery, resume this drug at its most recent dose.

Grade 2 peripheral neuropathy with pain or Grade 3 peripheral neuropathy:

  • Withhold this drug. Toxicities should, at the physician’s discretion, generally recover to the patient’s baseline condition or Grade 1 or lower prior to resuming this drug.
  • Following recovery, resume this drug at the next lower dose.

Grade 4 peripheral neuropathy:

  • Discontinue therapy.

OTHER NONHEMATOLOGIC TOXICITIES RECOMMENDED DOSE MODIFICATIONS:
Other Grade 3 or 4 nonhematological toxicities:

  • Withhold this drug. Toxicities should, at the physician’s discretion, generally recover to the patient’s baseline condition or Grade 1 or lower prior to resuming this drug.
  • If attributable to this drug, resume this drug at the next lower dose following recovery.

Patients take ixazomib by mouth; based on the drug approval study, it should be taken weekly on days 1, 8, and 15 of a 28-day cycle. The recommended dose is 4 mg, and for patients with moderate or severe hepatic impairment, renal impairment, or need dialysis, this dose is reduced to 3 mg. Ixazomib comes in three different capsule doses, which are 4 mg, 3 mg, and 2.3 mg.

It is also important to keep in mind that ixazomib should be given with dexamethasone and lenalidomide, which have their specific dosing schedules within a cycle. Both ixazomib and dexamethasone are given on days 1, 8, and 15; hence it is important to separate them since ixazomib should not be taken with food, whereas dexamethasone should be.

Administration advice:

  • Capsules should not be opened or crushed.
  • This drug is cytotoxic and direct contact with the capsule contents should be avoided.
  • If contact occurs with the skin, wash thoroughly with soap and water.
  • If contact occurs with the eyes, flush thoroughly with water.
  • Any unused medicinal product or waste material should be disposed of in accordance with local requirements.
  • The patient should be advised to read the approved patient labeling.
  • If a dose is delayed or missed, the dose should be taken only if the next scheduled dose is 72 hours away or more.
  • A missed dose should not be taken within 72 hours of the next scheduled dose.
  • A double dose should not be taken to make up for the missed dose.
  • If vomiting occurs after taking a dose, the patient should not repeat the dose. The patient should resume dosing at the time of the next scheduled dose.
  • Patients should be advised to take this drug exactly as prescribed.
  • Patients should be advised to take this drug at least 1 hour before or at least 2 hours after food.
  • Patients should be advised that this drug and dexamethasone should not be taken at the same time, because dexamethasone should be taken with food.
  • Patients should swallow the capsule whole with water. The capsule should not be crushed, chewed or opened.
  • Patients should be advised that direct contact with the capsule contents should be avoided.
  • Patients should be advised to wash thoroughly with soap and water If contact occurs with the skin and to flush thoroughly with water If contact occurs with the eyes.

Side Effects

The Most Common

  • diarrhea
  • constipation
  • nausea
  • new or worsening rash
  • back pain
  • unusual swelling of your arms or legs
  • weight gain due to swelling
  • blurred vision
  • dry eyes
  • pink eye
  • nausea
  • extreme tiredness
  • loss of appetite
  • flu-like symptoms
  • unusual bleeding or bruising
  • yellowing of your skin or eyes
  • pain in the upper right part of your stomach
  • burning, tingling, numbness, pain, or weakness in arms or legs
  • bloody or black, tarry stool

More common

  • Black, tarry stools
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • burning, numbness, tingling, or painful sensations
  • chills
  • cough
  • dark urine
  • diarrhea
  • dizziness
  • fever
  • headache
  • itching or rash
  • light-colored stools
  • loss of appetite
  • lower back or side pain
  • nausea
  • numbness, tingling, or pain in the hands or feet
  • painful or difficult urination
  • pale skin
  • rapid weight gain
  • rash with flat lesions or small raised lesions on the skin
  • redness or discoloration of the skin
  • sore throat
  • stomach pain
  • tingling of the hands or feet
  • ulcers, sores, or white spots in the mouth
  • unpleasant breath odor
  • unsteadiness or awkwardness
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusual weight gain or loss
  • vomiting of blood
  • weakness in the arms, hands, legs, or feet
  • yellow eyes or skin

Rare

  • Bleeding gums
  • blood in the urine or stools
  • pinpoint red spots on the skin
  • Blistering, peeling, or loosening of the skin
  • bloody nose
  • heavier menstrual periods
  • joint or muscle pain
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • Back pain
  • blurred vision
  • body aches or pain
  • burning, dry, or itching eyes
  • difficulty having a bowel movement (stool)
  • discharge, excessive tearing
  • ear congestion
  • loss of voice
  • nasal congestion
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • sneezing

Drug Interaction

Pregnancy and Lactation

AU TGA pregnancy category: C
US FDA pregnancy category: Not assigned.

Pregnancy

This drug can cause fetal harm when administered to a pregnant woman. Females of reproductive potential should be advised to avoid becoming pregnant while being treated with this drug. Male and female patients of reproductive potential should use effective contraceptive measures during and for 90 days following therapy with this drug. Females using oral hormonal contraceptives should additionally use a barrier method of contraception. Based on animals and the drug mechanism of action, this drug can cause fetal harm.

Lactation

No information is available on the clinical use of ixazomib during breastfeeding. Because its half-life is about 9.5 days, it is likely to accumulate in the infant. It is also given in combination with leflunomide and dexamethasone, which may increase the risk to the infant. The manufacturer recommends that breastfeeding be discontinued during ixazomib therapy and for 90 days after the last dose.

Why is this medication prescribed?

Ixazomib is used in combination with lenalidomide (Revlimid) and dexamethasone to treat multiple myeloma (cancer of the plasma cells in the bone marrow) that has worsened after treatment with other chemotherapy medications. Ixazomib is in a class of medications called proteasome inhibitors. It works by helping to kill cancer cells.

How should this medicine be used?

Ixazomib comes as a capsule to take by mouth. It is usually taken with water on an empty stomach, at least 1 hour before or 2 hours after eating. It is taken on days 1,8, and 15 of a 28 day treatment cycle. Take ixazomib at around the same time on every day that you take it. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ixazomib exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Do not take ixazomib and dexamethasone at the same time because you should take dexamethasone with food.

Swallow the capsules whole; do not split, chew, or crush them.

Be careful when handling ixazomib capsules. Do not allow your skin, eyes, mouth, or nose to come into contact with broken or crushed ixazomib capsules. If such contact occurs, wash your skin well with soap and water or rinse your eyes well with plain water.

If you vomit after taking ixazomib, do not repeat the dose. Take your next dose of ixazomib on the next scheduled day that you are supposed to take it.

Your doctor may need to temporarily or permanently stop your treatment or decrease your dose of ixazomib, or of the other medications that you are taking, depending on the side effects that you experience. Be sure to talk to your doctor about how you are feeling during your treatment. Do not stop taking ixazomib without talking to your doctor. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking ixazomib,

  • tell your doctor and pharmacist if you are allergic to ixazomib, any other medications, or any of the ingredients in ixazomib capsules. Ask your pharmacist for a list of the ingredients.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements you are taking or plan to take. Be sure to mention any of the following: carbamazepine (Epitol, Equetro, Carbatrol, Tegretol, Teril), efavirenz (Sustiva, in Atripla), nevirapine (Viramune), phenobarbital, pioglitazone (Actos, in Actoplus, Duetact, Oseni), phenytoin (Dilantin, Phenytek), rifabutin (Mycobutin), and rifampin (Rifadin, Rimactane, in Rifamate, Rifater). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor what herbal products you are taking, especially St. John’s wort.
  • tell your doctor if you have or have ever had liver or kidney disease.
  • tell your doctor if you are pregnant or plan to become pregnant, or plan to father a child. You should not become pregnant while you are taking ixazomib. Use effective birth control during your treatment with ixazomib and for 90 days after your final dose. If you are a male and your partner can become pregnant, you should use effective birth control during your treatment and for 90 days after your final dose. Talk to your doctor about birth control methods that will work for you. If you or your partner become pregnant while taking ixazomib, call your doctor immediately. Ixazomib can harm the fetus.
  • tell your doctor if you are breastfeeding. You should not breastfeed while you are taking ixazomib.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is within 72 hours (3 days) of your next scheduled dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Frequently Asked Questions

Mechanism of ActionIxazomib is an N-capped dipeptidyl leucine boronic acid that reversibly inhibits the CT-L proteolytic (β5) site of the 20S proteasome. At higher concentrations, ixazomib also seems to inhibit the proteolytic β1 and β2 subunits and induce the accumulation of ubiquitinated proteins. In vitro studies have shown ixazomib to induce apoptosis in multiple myeloma cells sensitive or resistant to other conventional therapies. In mouse xenograft models, ixazomib induced tumor growth inhibition.At therapeutic concentrations, ixazomib selectively and reversibly inhibits the protein proteasome subunit beta type-5 (PSMB5)[rx] with a dissociation half-life of 18 minutes. This mechanism is the same as that of bortezomib, which has a much longer dissociation half-life of 110 minutes; the related drug carfilzomib, by contrast, blocks PSMB5 irreversibly. Proteasome subunits beta type-1 and type-2 are only inhibited at high concentrations reached in cell culture models.[rx]PSMB5 is part of the 20S proteasome complex and has an enzymatic activity similar to chymotrypsin. It induces apoptosis, a type of programmed cell death, in various cancer cell lines. A synergistic effect of ixazomib and lenalidomide has been found in a large number of myeloma cell lines. Ixazomib a second-generation proteasome inhibitor (PI) and the first oral PI approved by the FDA in November 2015 for multiple myeloma treatment in combination with 2 other therapies (lenalidomide and dexamethasone) for patients who have received at least 1 prior therapy.IndicationsIxazomib is indicated in combination with lenalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior therapy. It is used in combination with dexamethasone and lenalidomide in patients who have had one prior treatment, allowing patients to be on a fully oral regimen, which has been proven to have a progression-free survival benefit.[rx][rx] Treatment of lymphoid malignancies (excluding multiple myeloma) Ixazomib is a small-molecule proteasome inhibitor that is used in combination with other antineoplastic agents to treat refractory multiple myeloma Treatment of systemic light chain amyloidosis. Ixazomib is a monoclonal antibody used with other medications to treat multiple myeloma in patients who have received one other therapy already.Use in Cancer Ixazomib citrate is approved to be used with lenalidomide and dexamethasone to treat:Multiple myeloma in patients who have already received at least one other type of treatment.Ixazomib citrate is also being studied in the treatment of other types of cancer.Contraindicationsdecreased blood platelets low levels of a type of white blood cell called neutrophils a painful condition that affects the nerves in the legs and arms called peripheral neuropathy liver problems fluid retention in the legs, feet, arms or hands abnormal liver function tests pregnancy a patient who is producing milk and breastfeeding chronic kidney disease stage 4 (severe) chronic kidney disease stage 5 (failure) kidney disease with likely reduction in kidney function Child-Pugh class B liver impairment Child-Pugh class C liver impairmentDosage Strengths: 2.3 mg; 3 mg; 4 mg Multiple Myeloma4 mg orally once a week on Days 1, 8, and 15 of a 28-day cycle This drug is only given in combination with lenalidomide and dexamethasone. For additional information regarding lenalidomide and dexamethasone, refer to their prescribing information. Antiviral prophylaxis should be considered to decrease the risk of herpes zoster reactivation. Prior to initiating a new cycle of therapy: The absolute neutrophil count should be at least 1,000/mm3, the Platelet count should be at least 75,000/mm3, and Nonhematologic toxicities should, at physician discretion, generally be recovered to patient baseline condition or Grade 1 or lower Treatment should be continued until the disease progresses or has unacceptable toxicity. In combination with lenalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior therapyDose Adjustments DOSE REDUCTIONS DUE TO ADVERSE REACTIONS:Recommended starting dose: 4 mg First reduction recommendation: 3 mg Second reduction recommendation: 2.3 mg Discontinue therapyDOSE MODIFICATION GUIDELINES FOR THIS DRUG IN COMBINATION WITH LENALIDOMIDE AND DEXAMETHASONE: THROMBOCYTOPENIA: Platelet count less than 30,000/mm3:Withhold this drug and lenalidomide until the platelet count is at least 30,000/mm3. Following recovery, resume lenalidomide at the next lower dose according to its prescribing information and resume this drug at its most recent dose. If the platelet count falls to less than 30,000/mm3 again, withhold this drug and lenalidomide until the platelet count is at least 30,000/mm3. Following recovery, resume this drug at the next lower dose and resume lenalidomide at its most recent dose.NEUTROPENIA: Absolute neutrophil count less than 500/mm3:Withhold this drug and lenalidomide until the absolute neutrophil count is at least 500/mm3. Consider adding granulocyte colony-stimulating factor (G-CSF) as per clinical guidelines. Following recovery, resume lenalidomide at the next lower dose according to its prescribing information and resume this drug at its most recent dose. If the absolute neutrophil count falls to less than 500/mm3 again, withhold this drug and lenalidomide until the absolute neutrophil count is at least 500/mm3. Following recovery, resume this drug at the next lower dose and resume lenalidomide at its most recent dose.NONHEMATOLOGIC TOXICITIES RECOMMENDED DOSE MODIFICATIONS: Grade 2 or 3 rash:Withhold lenalidomide until the rash recovers to Grade 1 or lower. Following recovery, resume lenalidomide at the next lower dose according to its prescribing information. If a Grade 2 or 3 rash occurs again, withhold this drug and lenalidomide until the rash recovers to Grade 1 or lower. Following recovery, resume this drug at the next lower dose and resume lenalidomide at its most recent dose.Grade 4 rash:Discontinue therapy.PERIPHERAL NEUROPATHY RECOMMENDED DOSE MODIFICATIONS: Grade 1 peripheral neuropathy with pain or Grade 2 peripheral neuropathy:Withhold this drug until peripheral neuropathy recovers to Grade 1 or lower without pain or the patient's baseline. Following recovery, resume this drug at its most recent dose.Grade 2 peripheral neuropathy with pain or Grade 3 peripheral neuropathy:Withhold this drug. Toxicities should, at the physician's discretion, generally recover to the patient's baseline condition or Grade 1 or lower prior to resuming this drug. Following recovery, resume this drug at the next lower dose.Grade 4 peripheral neuropathy:Discontinue therapy.OTHER NONHEMATOLOGIC TOXICITIES RECOMMENDED DOSE MODIFICATIONS: Other Grade 3 or 4 nonhematological toxicities:Withhold this drug. Toxicities should, at the physician's discretion, generally recover to the patient's baseline condition or Grade 1 or lower prior to resuming this drug. If attributable to this drug, resume this drug at the next lower dose following recovery.Patients take ixazomib by mouth; based on the drug approval study, it should be taken weekly on days 1, 8, and 15 of a 28-day cycle.[rx] The recommended dose is 4 mg, and for patients with moderate or severe hepatic impairment, renal impairment, or need dialysis, this dose is reduced to 3 mg. Ixazomib comes in three different capsule doses, which are 4 mg, 3 mg, and 2.3 mg.[rx]It is also important to keep in mind that ixazomib should be given with dexamethasone and lenalidomide, which have their specific dosing schedules within a cycle. Both ixazomib and dexamethasone are given on days 1, 8, and 15; hence it is important to separate them since ixazomib should not be taken with food, whereas dexamethasone should be.[rx][rx] Administration advice:Capsules should not be opened or crushed. This drug is cytotoxic and direct contact with the capsule contents should be avoided. If contact occurs with the skin, wash thoroughly with soap and water. If contact occurs with the eyes, flush thoroughly with water. Any unused medicinal product or waste material should be disposed of in accordance with local requirements. The patient should be advised to read the approved patient labeling. If a dose is delayed or missed, the dose should be taken only if the next scheduled dose is 72 hours away or more. A missed dose should not be taken within 72 hours of the next scheduled dose. A double dose should not be taken to make up for the missed dose. If vomiting occurs after taking a dose, the patient should not repeat the dose. The patient should resume dosing at the time of the next scheduled dose. Patients should be advised to take this drug exactly as prescribed. Patients should be advised to take this drug at least 1 hour before or at least 2 hours after food. Patients should be advised that this drug and dexamethasone should not be taken at the same time, because dexamethasone should be taken with food. Patients should swallow the capsule whole with water. The capsule should not be crushed, chewed or opened. Patients should be advised that direct contact with the capsule contents should be avoided. Patients should be advised to wash thoroughly with soap and water If contact occurs with the skin and to flush thoroughly with water If contact occurs with the eyes.Side Effects The Most Commondiarrhea constipation nausea new or worsening rash back pain unusual swelling of your arms or legs weight gain due to swelling blurred vision dry eyes pink eye nausea extreme tiredness loss of appetite flu-like symptoms unusual bleeding or bruising yellowing of your skin or eyes pain in the upper right part of your stomach burning, tingling, numbness, pain, or weakness in arms or legs bloody or black, tarry stoolMore commonBlack, tarry stools bloating or swelling of the face, arms, hands, lower legs, or feet burning, numbness, tingling, or painful sensations chills cough dark urine diarrhea dizziness fever headache itching or rash light-colored stools loss of appetite lower back or side pain nausea numbness, tingling, or pain in the hands or feet painful or difficult urination pale skin rapid weight gain rash with flat lesions or small raised lesions on the skin redness or discoloration of the skin sore throat stomach pain tingling of the hands or feet ulcers, sores, or white spots in the mouth unpleasant breath odor unsteadiness or awkwardness unusual bleeding or bruising unusual tiredness or weakness unusual weight gain or loss vomiting of blood weakness in the arms, hands, legs, or feet yellow eyes or skinRareBleeding gums blood in the urine or stools pinpoint red spots on the skin Blistering, peeling, or loosening of the skin bloody nose heavier menstrual periods joint or muscle pain red skin lesions, often with a purple center red, irritated eyes Back pain blurred vision body aches or pain burning, dry, or itching eyes difficulty having a bowel movement (stool) discharge, excessive tearing ear congestion loss of voice nasal congestion redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid sneezingDrug InteractionDRUG INTERACTIONAbacavir Abacavir may decrease the excretion rate of Ixazomib which could result in a higher serum level.Abametapir The serum concentration of Ixazomib can be increased when it is combined with Abametapir.Abatacept The metabolism of Ixazomib can be increased when combined with Abatacept.Acalabrutinib The metabolism of Ixazomib can be decreased when combined with Acalabrutinib.Aceclofenac Aceclofenac may decrease the excretion rate of Ixazomib which could result in a higher serum level.Acemetacin Acemetacin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Acetaminophen The metabolism of Ixazomib can be increased when combined with Acetaminophen.Acetazolamide The metabolism of Ixazomib can be decreased when combined with Acetazolamide.Acetylsalicylic acid Acetylsalicylic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Aclidinium Aclidinium may decrease the excretion rate of Ixazomib which could result in a higher serum level.Acrivastine Acrivastine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Acyclovir Acyclovir may decrease the excretion rate of Ixazomib which could result in a higher serum level.Adalimumab The metabolism of Ixazomib can be increased when combined with Adalimumab.Adefovir dipivoxil Adefovir dipivoxil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Albendazole The metabolism of Ixazomib can be decreased when combined with Albendazole.Albutrepenona Ixazomib may decrease the excretion rate of Albutrepenonacog alfa which could result in a higher serum level.Alclofenac Alclofenac may decrease the excretion rate of Ixazomib which could result in a higher serum level.Aldesleukin The metabolism of Ixazomib can be decreased when combined with Aldesleukin.Allopurinol Allopurinol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Almasilate Ixazomib may decrease the excretion rate of Almasilate which could result in a higher serum level.Almotriptan Almotriptan may decrease the excretion rate of Ixazomib which could result in a higher serum level.Alogliptin Alogliptin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Alpelisib The metabolism of Ixazomib can be increased when combined with Alpelisib.Alprazolam Alprazolam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Amantadine Amantadine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Amikacin Ixazomib may decrease the excretion rate of Amikacin which could result in a higher serum level.Amiloride Amiloride may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Aminoglutethimide The metabolism of Ixazomib can be increased when combined with Aminoglutethimide.Aminophenazone Aminophenazone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Amiodarone The metabolism of Ixazomib can be decreased when combined with Amiodarone.Amitriptyline Amitriptyline may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ammonium chloride Ammonium chloride may decrease the excretion rate of Ixazomib which could result in a higher serum level.Amobarbital The metabolism of Ixazomib can be increased when combined with Amobarbital.Amoxicillin Amoxicillin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Amphetamine Amphetamine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Amphotericin B Amphotericin B may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ampicillin Ampicillin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Amprenavir The metabolism of Ixazomib can be decreased when combined with Amprenavir.Amrinone Amrinone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Anakinra The metabolism of Ixazomib can be increased when combined with Anakinra.Ancestim Ancestim may decrease the excretion rate of Ixazomib which could result in a higher serum level.Antihemophilic Antihemophilic factor (recombinant), PEGylated may decrease the excretion rate of Ixazomib which could result in a higher serum level.Antipyrine Antipyrine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Antithrombin III Ixazomib may decrease the excretion rate of Antithrombin III human which could result in a higher serum level.Antrafenine Antrafenine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Apalutamide The metabolism of Ixazomib can be increased when combined with Apalutamide.Apremilast The metabolism of Ixazomib can be increased when combined with Apremilast.Aprepitant The metabolism of Ixazomib can be decreased when combined with Aprepitant.Arformoterol Arformoterol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Armodafinil The metabolism of Ixazomib can be increased when combined with Armodafinil.Arsenic trioxide Arsenic trioxide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Articaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Articaine.Asciminib The serum concentration of Ixazomib can be increased when it is combined with Asciminib.Astemizole The metabolism of Ixazomib can be decreased when combined with Astemizole.Asunaprevir The metabolism of Ixazomib can be increased when combined with Asunaprevir.Atazanavir The metabolism of Ixazomib can be decreased when combined with Atazanavir.Atomoxetine Atomoxetine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Auranofin Auranofin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Aurothioglucose Aurothioglucose may decrease the excretion rate of Ixazomib which could result in a higher serum level.Avacopan The metabolism of Ixazomib can be decreased when combined with Avacopan.Avanafil The serum concentration of Avanafil can be increased when it is combined with Ixazomib.Azacitidine Azacitidine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Azathioprine Azathioprine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Azelaic acid Azelaic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Azithromycin The metabolism of Ixazomib can be decreased when combined with Azithromycin.Aztreonam Aztreonam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Bacitracin Bacitracin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Baclofen Baclofen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Balsalazide Balsalazide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Baricitinib Ixazomib may decrease the excretion rate of Baricitinib which could result in a higher serum level.Beclomethasone d The metabolism of Ixazomib can be increased when combined with Beclomethasone dipropionate.Belzutifan The serum concentration of Ixazomib can be decreased when it is combined with Belzutifan.Bendroflumethi Bendroflumethiazide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Benorilate Benorilate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Benoxaprofen Benoxaprofen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Benserazide Ixazomib may decrease the excretion rate of Benserazide which could result in a higher serum level.Benzatropine Benzatropine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Benznidazole Ixazomib may decrease the excretion rate of Benznidazole which could result in a higher serum level.Benzocaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Benzocaine.Benzthiazide Benzthiazide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Benzydamine Benzydamine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Benzyl alcohol.Bepotastine Bepotastine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Berotralstat The serum concentration of Ixazomib can be increased when it is combined with Berotralstat.Betamethasone The metabolism of Ixazomib can be increased when combined with Betamethasone.Betamethasone The metabolism of Ixazomib can be increased when combined with Betamethasone phosphate.Bexarotene The metabolism of Ixazomib can be increased when combined with Bexarotene.Bicalutamide The metabolism of Ixazomib can be decreased when combined with Bicalutamide.Bicisate Ixazomib may decrease the excretion rate of Bicisate which could result in a higher serum level.Bifonazole The metabolism of Ixazomib can be decreased when combined with Bifonazole.Bimekizumab The metabolism of Ixazomib can be increased when combined with Bimekizumab.Bismuth sub Ixazomib may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.Bisoprolol Bisoprolol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Bisoxatin Bisoxatin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Bleomycin Bleomycin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Boceprevir The metabolism of Ixazomib can be decreased when combined with Boceprevir.Bosentan The metabolism of Ixazomib can be increased when combined with Bosentan.Bosutinib The metabolism of Ixazomib can be decreased when combined with Bosutinib.Brentuximab ve The metabolism of Ixazomib can be decreased when combined with Brentuximab vedotin.Brivaracetam Brivaracetam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Bromazepam Bromazepam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Bromotheophy Bromotheophylline may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Budesonide The metabolism of Ixazomib can be increased when combined with Budesonide.Bumadizone Bumadizone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Bumetanide Bumetanide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Bupivacaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Bupivacaine.Buprenorphine The metabolism of Ixazomib can be decreased when combined with Buprenorphine.Bupropion Bupropion may decrease the excretion rate of Ixazomib which could result in a higher serum level.Buspirone Buspirone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Butabarbital Butabarbital may decrease the excretion rate of Ixazomib which could result in a higher serum level.Butacaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Butacaine.Butalbital The metabolism of Ixazomib can be increased when combined with Butalbital.Butamben The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Butamben.Calcitriol The metabolism of Ixazomib can be increased when combined with Calcitriol.Canagliflozin Canagliflozin may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Canakinumab The metabolism of Ixazomib can be increased when combined with Canakinumab.Candicidin The metabolism of Ixazomib can be decreased when combined with Candicidin.Cannabidiol The metabolism of Ixazomib can be decreased when combined with Cannabidiol.Canrenoic acid Canrenoic acid may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Capecitabine Capecitabine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Capreomycin Ixazomib may decrease the excretion rate of Capreomycin which could result in a higher serum level.Capsaicin The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Capsaicin.Carbamazepine The metabolism of Ixazomib can be increased when combined with Carbamazepine.Carbidopa Carbidopa may decrease the excretion rate of Ixazomib which could result in a higher serum level.Carboplatin Carboplatin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Carmustine Carmustine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Carprofen Carprofen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefaclor Cefaclor may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefadroxil Cefadroxil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefalotin Cefalotin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefamandole Cefamandole may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefapirin Cefapirin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefazolin Cefazolin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefdinir Cefdinir may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefditoren Cefditoren may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefepime Cefepime may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefmenoxime Cefmenoxime may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefmetazole Cefmetazole may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefonicid Cefonicid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefoperazone Cefoperazone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ceforanide Ceforanide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefotaxime Cefotaxime may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefotetan Cefotetan may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefotiam Cefotiam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefoxitin Cefoxitin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefpiramide Cefpiramide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefpirome Cefpirome may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefpodoxime Cefpodoxime may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefprozil Cefprozil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefradine The metabolism of Ixazomib can be increased when combined with Cefradine.Ceftaroline fosamil Ceftaroline fosamil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ceftazidime Ceftazidime may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ceftibuten Ceftibuten may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ceftizoxime Ceftizoxime may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ceftobiprole Ceftobiprole may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ceftolozane Ceftolozane may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ceftriaxone Ceftriaxone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cefuroxime Cefuroxime may decrease the excretion rate of Ixazomib which could result in a higher serum level.Celecoxib Celecoxib may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cenobamate The serum concentration of Ixazomib can be decreased when it is combined with Cenobamate.Cephalexin The metabolism of Ixazomib can be decreased when combined with Cephalexin.Cephaloglycin Cephaloglycin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ceritinib The metabolism of Ixazomib can be decreased when combined with Ceritinib.Cerivastatin The metabolism of Ixazomib can be increased when combined with Cerivastatin.Certolizumab pegol The metabolism of Ixazomib can be increased when combined with Certolizumab pegol.Cetirizine Cetirizine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cevimeline Cevimeline may decrease the excretion rate of Ixazomib which could result in a higher serum level.Chloral hydrate Chloral hydrate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Chloramphenicol The metabolism of Ixazomib can be decreased when combined with Chloramphenicol.Chloroprocaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Chloroprocaine.Chloroquine Chloroquine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Chlorothiazide Chlorothiazide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Chloroxylenol Ixazomib may decrease the excretion rate of Chloroxylenol which could result in a higher serum level.Chlorpromazine The metabolism of Ixazomib can be increased when combined with Chlorpromazine.Chlorpropamide Chlorpropamide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Chlorthalidone Chlorthalidone may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Chlorzoxazone Chlorzoxazone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Choline C 11 Choline C 11 may decrease the excretion rate of Ixazomib which could result in a higher serum level.Choline magnesium Choline magnesium trisalicylate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Choline salicylate Ixazomib may decrease the excretion rate of Choline salicylate which could result in a higher serum level.Chondroitin sulfate Chondroitin sulfate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Chromic chloride Chromic chloride may decrease the excretion rate of Ixazomib which could result in a higher serum level.Chromic nitrate Ixazomib may decrease the excretion rate of Chromic nitrate which could result in a higher serum level.Chromium Ixazomib may decrease the excretion rate of Chromium which could result in a higher serum level.Chromium gluco Ixazomib may decrease the excretion rate of Chromium gluconate which could result in a higher serum level.Chromium nicotin Ixazomib may decrease the excretion rate of Chromium nicotinate which could result in a higher serum level.Chromous sulfate Ixazomib may decrease the excretion rate of Chromous sulfate which could result in a higher serum level.Cidofovir Cidofovir may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cilostazol Cilostazol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cimetidine The metabolism of Ixazomib can be decreased when combined with Cimetidine.Cinchocaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Cinchocaine.Ciprofloxacin The metabolism of Ixazomib can be decreased when combined with Ciprofloxacin.Cisapride The metabolism of Ixazomib can be decreased when combined with Cisapride.Cisplatin Ixazomib may decrease the excretion rate of Cisplatin which could result in a higher serum level.Citalopram The metabolism of Ixazomib can be decreased when combined with Citalopram.Clarithromycin The metabolism of Ixazomib can be decreased when combined with Clarithromycin.Clevidipine The metabolism of Ixazomib can be increased when combined with Clevidipine.Clobazam The metabolism of Ixazomib can be increased when combined with Clobazam.Clobetasol propio The metabolism of Ixazomib can be increased when combined with Clobetasol propionate.Clofarabine Clofarabine may decreClofazimine The metabolism of Ixazomib can be decreased when combined with Clofazimine.Clofibrate The metabolism of Ixazomib can be increased when combined with Clofibrate.Clomipramine Clomipramine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Clonazepam Clonazepam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Clorazepic acid Clorazepic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Clove oil Ixazomib may decrease the excretion rate of Clove oil which could result in a higher serum level.Clozapine The metabolism of Ixazomib can be increased when combined with Clozapine.Cobicistat The metabolism of Ixazomib can be decreased when combined with Cobicistat.Cobimetinib The metabolism of Ixazomib can be decreased when combined with Cobimetinib.Cocaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Cocaine.Colchicine Colchicine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Colistimethate Colistimethate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Colistin Ixazomib may decrease the excretion rate of Colistin which could result in a higher serum level.Conivaptan The metabolism of Ixazomib can be decreased when combined with Conivaptan.Conjugated Conjugated estrogens may decrease the excretion rate of Ixazomib which could result in a higher serum level.Corifollitropin alfa Corifollitropin alfa may decrease the excretion rate of Ixazomib which could result in a higher serum level.Corticotropin The metabolism of Ixazomib can be increased when combined with Corticotropin.Cortisone acetate The metabolism of Ixazomib can be increased when combined with Cortisone acetate.Crizotinib The metabolism of Ixazomib can be decreased when combined with Crizotinib.Curcumin The metabolism of Ixazomib can be decreased when combined with Curcumin.Cyanocobalamin Cyanocobalamin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Cyclopenthiazide Cyclopenthiazide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Cyclophosphamide The metabolism of Ixazomib can be increased when combined with Cyclophosphamide.Cyclosporine The metabolism of Ixazomib can be decreased when combined with Cyclosporine.Cyclothiazide Cyclothiazide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Cyproterone acetate The metabolism of Ixazomib can be decreased when combined with Cyproterone acetate.Dabigatran etexilate Dabigatran etexilate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dabrafenib The serum concentration of Ixazomib can be decreased when it is combined with Dabrafenib.Dacarbazine Dacarbazine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dacomitinib The metabolism of Ixazomib can be decreased when combined with Dacomitinib.Dalfampridine Dalfampridine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dalfopristin The metabolism of Ixazomib can be decreased when combined with Dalfopristin.Danazol The metabolism of Ixazomib can be decreased when combined with Danazol.Dapagliflozin Dapagliflozin may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Daptomycin Daptomycin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Ixazomib.Darunavir The serum concentration of Ixazomib can be increased when it is combined with Darunavir.Dasatinib The metabolism of Ixazomib can be decreased when combined with Dasatinib.Daunorubicin The metabolism of Ixazomib can be decreased when combined with Daunorubicin.Deferasirox The metabolism of Ixazomib can be increased when combined with Deferasirox.Deferiprone Deferiprone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Deflazacort The metabolism of Ixazomib can be increased when combined with Deflazacort.Delafloxacin Ixazomib may decrease the excretion rate of Delafloxacin which could result in a higher serum level.Delavirdine The metabolism of Ixazomib can be decreased when combined with Delavirdine.Desipramine The metabolism of Ixazomib can be decreased when combined with Desipramine.Desmopressin Desmopressin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Desvenlafaxine The metabolism of Ixazomib can be decreased when combined with Desvenlafaxine.Deutetrabenazine Ixazomib may decrease the excretion rate of Deutetrabenazine which could result in a higher serum level.Dexamethasone The metabolism of Ixazomib can be increased when combined with Dexamethasone.Dexamethasone The metabolism of Ixazomib can be increased when combined with Dexamethasone acetate.Dexibuprofen Dexibuprofen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dexketoprofen Dexketoprofen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dexmedetomidine Dexmedetomidine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dexpanthenol Dexpanthenol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dexrazoxane Dexrazoxane may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dextran Dextran may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dextropropox The metabolism of Ixazomib can be decreased when combined with Dextropropoxyphene.Diatrizoate Diatrizoate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Diazepam Diazepam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dichlorobenzyl a Ixazomib may decrease the excretion rate of Dichlorobenzyl alcohol which could result in a higher serum level.Diclofenac Diclofenac may decrease the excretion rate of Ixazomib which could result in a higher serum level.Diclofenamide Diclofenamide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Dicloxacillin The metabolism of Ixazomib can be increased when combined with Dicloxacillin.Dicyclomine Dicyclomine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Didanosine Didanosine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dienogest Dienogest may decrease the excretion rate of Ixazomib which could result in a higher serum level.Diethylstilbestrol The metabolism of Ixazomib can be decreased when combined with Diethylstilbestrol.Diflunisal Diflunisal may decrease the excretion rate of Ixazomib which could result in a higher serum level.Difluocortolone The metabolism of Ixazomib can be increased when combined with Difluocortolone.Digoxin Ixazomib may decrease the excretion rate of Digoxin which could result in a higher serum level.Dihydroergocornine The metabolism of Ixazomib can be decreased when combined with Dihydroergocornine.Dihydroergocristine The metabolism of Ixazomib can be decreased when combined with Dihydroergocristine.Dihydroergotamine The metabolism of Ixazomib can be decreased when combined with Dihydroergotamine.Dihydrostreptomycin Dihydrostreptomycin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Diltiazem The metabolism of Ixazomib can be decreased when combined with Diltiazem.Dimercaprol Dimercaprol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dimethyl sulfoxide The metabolism of Ixazomib can be decreased when combined with Dimethyl sulfoxide.Diosmin The metabolism of Ixazomib can be decreased when combined with Diosmin.Diphenhydramine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Diphenhydramine.Disopyramide Disopyramide may decrease the excretion rate of Ixazomib which could result in a higher serum level.DL-Methylephedrine Ixazomib may decrease the excretion rate of DL-Methylephedrine which could result in a higher serum level.Dobutamine Dobutamine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Docetaxel The metabolism of Ixazomib can be decreased when combined with Docetaxel.Dopamine Dopamine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Doripenem Doripenem may decrease the excretion rate of Ixazomib which could result in a higher serum level.Doxacurium Doxacurium may decrease the excretion rate of Ixazomib which could result in a higher serum level.Doxazosin The metabolism of Ixazomib can be decreased when combined with Doxazosin.Doxepin Doxepin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Doxorubicin The metabolism of Ixazomib can be decreased when combined with Doxorubicin.Doxycycline Doxycycline may decrease the excretion rate of Ixazomib which could result in a higher serum level.Dronedarone The serum concentration of Ixazomib can be increased when it is combined with Dronedarone.Drospirenone The metabolism of Ixazomib can be decreased when combined with Drospirenone.Droxidopa Droxidopa may decrease the excretion rate of Ixazomib which could result in a higher serum level.Duloxetine Duloxetine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Duvelisib The metabolism of Ixazomib can be decreased when combined with Duvelisib.Dyclonine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Dyclonine.Dyphylline Dyphylline may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ebastine The metabolism of Ixazomib can be decreased when combined with Ebastine.Echinacea The metabolism of Ixazomib can be increased when combined with Echinacea.Edoxaban Edoxaban may decrease the excretion rate of Ixazomib which could result in a higher serum level.Edrophonium Edrophonium may decrease the excretion rate of Ixazomib which could result in a higher serum level.Efavirenz The metabolism of Ixazomib can be decreased when combined with Efavirenz.Elexacaftor The metabolism of Ixazomib can be decreased when combined with Elexacaftor.Elvitegravir The metabolism of Ixazomib can be decreased when combined with Elvitegravir.Emapalumab The metabolism of Ixazomib can be increased when combined with Emapalumab.Enalaprilat Enalaprilat may decrease the excretion rate of Ixazomib which could result in a higher serum level.Enasidenib The metabolism of Ixazomib can be increased when combined with Enasidenib.Enzalutamide The serum concentration of Ixazomib can be decreased when it is combined with Enzalutamide.Epinephrine The metabolism of Ixazomib can be decreased when combined with Epinephrine.Eplerenone Eplerenone may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Epoprostenol Epoprostenol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ergotamine The metabolism of Ixazomib can be decreased when combined with Ergotamine.Erlotinib The metabolism of Ixazomib can be decreased when combined with Erlotinib.Ertapenem Ertapenem may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ertugliflozin Ertugliflozin may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Erythromycin The metabolism of Ixazomib can be decreased when combined with Erythromycin.Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Ixazomib.Esketamine The metabolism of Ixazomib can be increased when combined with Esketamine.Eslicarbazepine The metabolism of Ixazomib can be increased when combined with Eslicarbazepine.Eslicarbazepine The metabolism of Ixazomib can be increased when combined with Eslicarbazepine acetate.Estazolam Estazolam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Estetrol The metabolism of Ixazomib can be decreased when combined with Estetrol.Estradiol Estradiol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Estradiol acetate The metabolism of Ixazomib can be increased when combined with Estradiol acetate.Estradiol benzoate The metabolism of Ixazomib can be increased when combined with Estradiol benzoate.Estradiol cypionate The metabolism of Ixazomib can be increased when combined with Estradiol cypionate.Estradiol dienanthate The metabolism of Ixazomib can be increased when combined with Estradiol dienanthate.Estradiol valerate The metabolism of Ixazomib can be increased when combined with Estradiol valerate.Estrone sulfate Estrone sulfate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Eszopiclone Eszopiclone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Etacrynic acid Etacrynic acid may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Etafedrine Ixazomib may decrease the excretion rate of Etafedrine which could result in a higher serum level.Etanercept The metabolism of Ixazomib can be increased when combined with Etanercept.Ethambutol The metabolism of Ixazomib can be decreased when combined with Ethambutol.Ethanol The metabolism of Ixazomib can be increased when combined with Ethanol.Ethyl chloride The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Ethyl chloride.Etidocaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Etidocaine.Etodolac Etodolac may decrease the excretion rate of Ixazomib which could result in a higher serum level.Etomidate Etomidate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Etonogestrel Etonogestrel may decrease the excretion rate of Ixazomib which could result in a higher serum level.Etoricoxib The metabolism of Ixazomib can be decreased when combined with Etoricoxib.Etravirine The metabolism of Ixazomib can be increased when combined with Etravirine.Eucalyptus oil Ixazomib may decrease the excretion rate of Eucalyptus oil which could result in a higher serum level.Ezogabine Ezogabine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Felbamate The metabolism of Ixazomib can be increased when combined with Felbamate.Fenbufen Fenbufen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Fenofibrate The metabolism of Ixazomib can be decreased when combined with Fenofibrate.Fenofibric acid Ixazomib may decrease the excretion rate of Fenofibric acid which could result in a higher serum level.Fenoldopam Fenoldopam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Fenoprofen Fenoprofen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Fentanyl Fentanyl may decrease the excretion rate of Ixazomib which could result in a higher serum level.Fesoterodine Fesoterodine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Fexinidazole The metabolism of Ixazomib can be decreased when combined with Fexinidazole.Finerenone Finerenone may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Flavoxate Flavoxate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Floctafenine Floctafenine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Florbetaben (18F) Florbetaben (18F) may decrease the excretion rate of Ixazomib which could result in a higher serum level.Florbetapir (18F) Florbetapir (18F) may decrease the excretion rate of Ixazomib which could result in a higher serum level.Floxuridine Floxuridine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Flucloxacillin The metabolism of Ixazomib can be increased when combined with Flucloxacillin.Fluconazole The metabolism of Ixazomib can be decreased when combined with Fluconazole.Flucytosine Flucytosine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Fludeoxyglucose Fludeoxyglucose (18F) may decrease the excretion rate of Ixazomib which could result in a higher serum level.Flumazenil Flumazenil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Flunisolide The metabolism of Ixazomib can be increased when combined with Flunisolide.Fluocinolone a The metabolism of Ixazomib can be increased when combined with Fluocinolone acetonide.Fluocinonide The metabolism of Ixazomib can be increased when combined with Fluocinonide.Fluocortolone The metabolism of Ixazomib can be increased when combined with Fluocortolone.Fluoxetine The metabolism of Ixazomib can be decreased when combined with Fluoxetine.Flurazepam Flurazepam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Flurbiprofen Flurbiprofen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Flutamide Flutamide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Fluticasone The metabolism of Ixazomib can be increased when combined with Fluticasone.Fluticasone p The metabolism of Ixazomib can be decreased when combined with Fluticasone propionate.Fluvoxamine The metabolism of Ixazomib can be decreased when combined with Fluvoxamine.Folic acid Folic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Fomepizole Fomepizole may decrease the excretion rate of Ixazomib which could result in a higher serum level.Fondaparinux Fondaparinux may decrease the excretion rate of Ixazomib which could result in a higher serum level.Formestane The metabolism of Ixazomib can be increased when combined with Formestane.Fosamprenavir The metabolism of Ixazomib can be decreased when combined with Fosamprenavir.Fosaprepitant The metabolism of Ixazomib can be increased when combined with Fosaprepitant.Foscarnet Foscarnet may decrease the excretion rate of Ixazomib which could result in a higher serum level.Fosfomycin Fosfomycin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Fosinopril Fosinopril may decrease the excretion rate of Ixazomib which could result in a higher serum level.Fosnetupitant The metabolism of Ixazomib can be decreased when combined with Fosnetupitant.Fosphenytoin The metabolism of Ixazomib can be increased when combined with Fosphenytoin.Fostamatinib The metabolism of Ixazomib can be decreased when combined with Fostamatinib.Framycetin Framycetin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Furosemide Furosemide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Fusidic acid The metabolism of Ixazomib can be decreased when combined with Fusidic acid.Gabapentin enac Gabapentin enacarbil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Gadobenic acid Gadobenic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Gadodiamide Gadodiamide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Gadofosveset trisodium Gadofosveset trisodium may decrease the excretion rate of Ixazomib which could result in a higher serum level.Gadopentetic acid Gadopentetic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Gadoteric acid Gadoteric acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Gadoteridol Gadoteridol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ganciclovir Ganciclovir may decrease the excretion rate of Ixazomib which could result in a higher serum level.Gemcitabine Gemcitabine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Gemfibrozil Gemfibrozil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Gentamicin Ixazomib may decrease the excretion rate of Gentamicin which could result in a higher serum level.Gilteritinib The metabolism of Ixazomib can be decreased when combined with Gilteritinib.Gimeracil Gimeracil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ginkgo biloba The metabolism of Ixazomib can be decreased when combined with Ginkgo biloba.Givosiran Givosiran may decrease the excretion rate of Ixazomib which could result in a higher serum level.Glecaprevir The metabolism of Ixazomib can be decreased when combined with Glecaprevir.Glipizide Glipizide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Glyburide The metabolism of Ixazomib can be decreased when combined with Glyburide.Glycerol phenyl The metabolism of Ixazomib can be increased when combined with Glycerol phenylbutyrate.Golimumab The metabolism of Ixazomib can be increased when combined with Golimumab.Golodirsen Ixazomib may decrease the excretion rate of Golodirsen which could result in a higher serum level.Goserelin Goserelin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Griseofulvin The metabolism of Ixazomib can be increased when combined with Griseofulvin.Guanethidine Guanethidine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Guanfacine Guanfacine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Haloperidol The serum concentration of Haloperidol can be increased when it is combined with Ixazomib.Hydralazine The metabolism of Ixazomib can be decreased when combined with Hydralazine.Hydrochlorothiazide Hydrochlorothiazide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Hydrocortamate The metabolism of Ixazomib can be increased when combined with Hydrocortamate.Hydrocortisone The metabolism of Ixazomib can be increased when combined with Hydrocortisone.Hydrocortisone a The metabolism of Ixazomib can be increased when combined with Hydrocortisone acetate.Hydrocortisone The metabolism of Ixazomib can be increased when combined with Hydrocortisone butyrate.Hydrocortisone The metabolism of Ixazomib can be increased when combined with Hydrocortisone succinate.Hydroflumethiazide Hydroflumethiazide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Hydromorphone Hydromorphone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Hydroxocobalamin Hydroxocobalamin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Hydroxyethyl Starch Hydroxyethyl Starch may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ibuprofen Ibuprofen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ibutilide Ibutilide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Icatibant Icatibant may decrease the excretion rate of Ixazomib which could result in a higher serum level.Icosapent Icosapent may decrease the excretion rate of Ixazomib which could result in a higher serum level.Idarucizumab Idarucizumab may decrease the excretion rate of Ixazomib which could result in a higher serum level.Idebenone Idebenone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Idelalisib The metabolism of Ixazomib can be decreased when combined with Idelalisib.Ifosfamide The metabolism of Ixazomib can be increased when combined with Ifosfamide.Imatinib The serum concentration of Ixazomib can be increased when it is combined with Imatinib.Imipramine Imipramine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Indapamide Indapamide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Indigotindisulfonic Ixazomib may decrease the excretion rate of Indigotindisulfonic acid which could result in a higher serum level.Indinavir The metabolism of Ixazomib can be decreased when combined with Indinavir.Indomethacin Indomethacin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Infigratinib The metabolism of Ixazomib can be decreased when combined with Infigratinib.Infliximab The metabolism of Ixazomib can be increased when combined with Infliximab.Inosine pranobex Ixazomib may decrease the excretion rate of Inosine pranobex which could result in a higher serum level.Inositol Ixazomib may decrease the excretion rate of Inositol which could result in a higher serum level.Inotersen Inotersen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Iobenguane sulfa Iobenguane sulfate I-123 may decrease the excretion rate of Ixazomib which could result in a higher serum level.Iodixanol Iodixanol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ioflupane I-123 Ioflupane I-123 may decrease the excretion rate of Ixazomib which could result in a higher serum level.Iopromide Iopromide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Iothalamic acid Iothalamic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ioversol Ioversol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ioxilan Ioxilan may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ipecac Ixazomib may decrease the excretion rate of Ipecac which could result in a higher serum level.Ipilimumab Ipilimumab may decrease the excretion rate of Ixazomib which could result in a higher serum level.Irbesartan The metabolism of Ixazomib can be decreased when combined with Irbesartan.Isavuconazole The metabolism of Ixazomib can be increased when combined with Isavuconazole.Isavuconazonium The metabolism of Ixazomib can be increased when combined with Isavuconazonium.Isoniazid The metabolism of Ixazomib can be decreased when combined with Isoniazid.Isosorbide Isosorbide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Isosorbide mon Isosorbide mononitrate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Isosulfan blue Isosulfan blue may decrease the excretion rate of Ixazomib which could result in a higher serum level.Isotretinoin Isotretinoin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Isoxicam Isoxicam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Isradipine The metabolism of Ixazomib can be decreased when combined with Isradipine.Itraconazole The metabolism of Ixazomib can be decreased when combined with Itraconazole.Ivacaftor The metabolism of Ixazomib can be decreased when combined with Ivacaftor.Ivosidenib The metabolism of Ixazomib can be increased when combined with Ivosidenib.Kanamycin Ixazomib may decrease the excretion rate of Kanamycin which could result in a higher serum level.Ketamine Ketamine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ketazolam The metabolism of Ixazomib can be decreased when combined with Ketazolam.Ketoconazole The metabolism of Ixazomib can be decreased when combined with Ketoconazole.Ketoprofen Ketoprofen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ketorolac Ketorolac may decrease the excretion rate of Ixazomib which could result in a higher serum level.Labetalol Labetalol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lacosamide The metabolism of Ixazomib can be decreased when combined with Lacosamide.Lamivudine Lamivudine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lamotrigine Lamotrigine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lanreotide The metabolism of Ixazomib can be decreased when combined with Lanreotide.Lapatinib The metabolism of Ixazomib can be decreased when combined with Lapatinib.Latamoxef Latamoxef may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ledipasvir Ledipasvir may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lefamulin The serum concentration of Ixazomib can be increased when it is combined with Lefamulin.Lenalidomide Lenalidomide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lesinurad The metabolism of Ixazomib can be increased when combined with Lesinurad.Letermovir The metabolism of Ixazomib can be decreased when combined with Letermovir.Leuprolide Leuprolide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Levobupivacaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Levobupivacaine.Levocarnitine Levocarnitine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Levocetirizine Levocetirizine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Levofloxacin Levofloxacin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Levoketoconazole The metabolism of Ixazomib can be decreased when combined with Levoketoconazole.Levomilnacipran Levomilnacipran may decrease the excretion rate of Ixazomib which could result in a higher serum level.Levosalbutamol Ixazomib may decrease the excretion rate of Levosalbutamol which could result in a higher serum level.Lidocaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Lidocaine.Linagliptin The metabolism of Ixazomib can be decreased when combined with Linagliptin.Liothyronine Liothyronine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lisinopril Lisinopril may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lithium carbonate Ixazomib may decrease the excretion rate of Lithium carbonate which could result in a higher serum level.Lithium citrate Lithium citrate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lixisenatide Lixisenatide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lofexidine Lofexidine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lomitapide The metabolism of Ixazomib can be decreased when combined with Lomitapide.Lonafarnib The metabolism of Ixazomib can be decreased when combined with Lonafarnib.Lopinavir The metabolism of Ixazomib can be decreased when combined with Lopinavir.Loracarbef Loracarbef may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lorazepam Lorazepam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lorcaserin Lorcaserin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lorlatinib The metabolism of Ixazomib can be increased when combined with Lorlatinib.Lornoxicam Lornoxicam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lorpiprazole Lorpiprazole may decrease the excretion rate of Ixazomib which could result in a higher serum level.Losartan The metabolism of Ixazomib can be decreased when combined with Losartan.Lovastatin The metabolism of Ixazomib can be decreased when combined with Lovastatin.Loxoprofen Loxoprofen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lubiprostone Lubiprostone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Lumacaftor The metabolism of Ixazomib can be increased when combined with Lumacaftor.Lumiracoxib Lumiracoxib may decrease the excretion rate of Ixazomib which could result in a higher serum level.Macitentan Macitentan may decrease the excretion rate of Ixazomib which could result in a higher serum level.Magnesium carbo Magnesium carbonate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Magnesium chloride Magnesium chloride may decrease the excretion rate of Ixazomib which could result in a higher serum level.Magnesium hyd Magnesium hydroxide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Magnesium tris Magnesium trisilicate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Mangafodipir Mangafodipir may decrease the excretion rate of Ixazomib which could result in a higher serum level.Manidipine The metabolism of Ixazomib can be decreased when combined with Manidipine.Mannitol Mannitol may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Maprotiline Maprotiline may decrease the excretion rate of Ixazomib which could result in a higher serum level.Mavacamten The serum concentration of Ixazomib can be decreased when it is combined with Mavacamten.Mecamylamine Mecamylamine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Meclofenamic acid Meclofenamic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Medroxyprogester The metabolism of Ixazomib can be increased when combined with Medroxyprogesterone acetate.Mefenamic acid Mefenamic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Megestrol acetate Megestrol acetate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Meloxicam The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Meloxicam.Memantine Memantine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Meperidine The metabolism of Ixazomib can be decreased when combined with Meperidine.Mepivacaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Mepivacaine.Meprednisone The metabolism of Ixazomib can be increased when combined with Meprednisone.Meropenem Meropenem may decrease the excretion rate of Ixazomib which could result in a higher serum level.Mesalazine Mesalazine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Metamfetamine Metamfetamine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Metamizole Metamizole may decrease the excretion rate of Ixazomib which could result in a higher serum level.Metaxalone Metaxalone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Metformin Metformin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Methadone The metabolism of Ixazomib can be decreased when combined with Methadone.Methazolamide Methazolamide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Methimazole The metabolism of Ixazomib can be decreased when combined with Methimazole.Methotrexate Methotrexate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Methoxsalen Methoxsalen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Methoxy The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Ixazomib.Methyldopa Methyldopa may decrease the excretion rate of Ixazomib which could result in a higher serum level.Methylene blue The metabolism of Ixazomib can be decreased when combined with Methylene blue.Methylergometrine The metabolism of Ixazomib can be decreased when combined with Methylergometrine.Methylnaltrexone Methylnaltrexone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Methylphenobarbital The metabolism of Ixazomib can be increased when combined with Methylphenobarbital.Methylprednisolone The metabolism of Ixazomib can be increased when combined with Methylprednisolone.Methylprednisone The metabolism of Ixazomib can be decreased when combined with Methylprednisone.Methyltestosterone Methyltestosterone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Methysergide The metabolism of Ixazomib can be decreased when combined with Methysergide.Meticrane Meticrane may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Metoclopramide Metoclopramide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Metolazone Metolazone may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Metoprolol Metoprolol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Metreleptin The metabolism of Ixazomib can be increased when combined with Metreleptin.Metronidazole The metabolism of Ixazomib can be decreased when combined with Metronidazole.Metyrapone The metabolism of Ixazomib can be increased when combined with Metyrapone.Miconazole The metabolism of Ixazomib can be decreased when combined with Miconazole.Midazolam The metabolism of Ixazomib can be decreased when combined with Midazolam.Midostaurin The metabolism of Ixazomib can be decreased when combined with Midostaurin.Mifepristone The metabolism of Ixazomib can be increased when combined with Mifepristone.Migalastat Migalastat may decrease the excretion rate of Ixazomib which could result in a higher serum level.Milnacipran The metabolism of Ixazomib can be decreased when combined with Milnacipran.Milrinone Milrinone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Miocamycin The metabolism of Ixazomib can be decreased when combined with Miocamycin.Mirabegron Mirabegron may decrease the excretion rate of Ixazomib which could result in a higher serum level.Mirtazapine The metabolism of Ixazomib can be decreased when combined with Mirtazapine.Mitapivat The metabolism of Ixazomib can be increased when combined with Mitapivat.Mitotane The metabolism of Ixazomib can be increased when combined with Mitotane.Mobocertinib The serum concentration of Ixazomib can be decreased when it is combined with Mobocertinib.Modafinil The metabolism of Ixazomib can be increased when combined with Modafinil.Mometasone fur The metabolism of Ixazomib can be increased when combined with Mometasone furoate.Mosunetuzumab The metabolism of Ixazomib can be decreased when combined with Mosunetuzumab.Moxisylyte Moxisylyte may decrease the excretion rate of Ixazomib which could result in a higher serum level.Muzolimine Muzolimine may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Mycophenolate Mycophenolate mofetil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Mycophenolic acid Mycophenolic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.N-acetyltyrosine Ixazomib may decrease the excretion rate of N-acetyltyrosine which could result in a higher serum level.Nabumetone Nabumetone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Nadolol Nadolol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Nafcillin The metabolism of Ixazomib can be increased when combined with Nafcillin.Naldemedine Ixazomib may decrease the excretion rate of Naldemedine which could result in a higher serum level.Nalmefene Nalmefene may decrease the excretion rate of Ixazomib which could result in a higher serum level.Naloxone Naloxone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Naproxen Naproxen may decrease the excretion rate of Ixazomib which could result in a higher serum level.Nateglinide Nateglinide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Nedaplatin Ixazomib may decrease the excretion rate of Nedaplatin which could result in a higher serum level.Nedocromil Nedocromil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Nefazodone The metabolism of Ixazomib can be decreased when combined with Nefazodone.Nelfinavir The metabolism of Ixazomib can be decreased when combined with Nelfinavir.Neomycin Ixazomib may decrease the excretion rate of Neomycin which could result in a higher serum level.Netilmicin Ixazomib may decrease the excretion rate of Netilmicin which could result in a higher serum level.Netupitant The metabolism of Ixazomib can be decreased when combined with Netupitant.Niacin The metabolism of Ixazomib can be decreased when combined with Niacin.Nicardipine The metabolism of Ixazomib can be decreased when combined with Nicardipine.Nicorandil Nicorandil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Nifedipine Nifedipine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Nilotinib The metabolism of Ixazomib can be decreased when combined with Nilotinib.Nilutamide Nilutamide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Nilvadipine The metabolism of Ixazomib can be decreased when combined with Nilvadipine.Nimesulide Nimesulide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Nintedanib The metabolism of Ixazomib can be decreased when combined with Nintedanib.Nisoldipine Nisoldipine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Nitric Oxide Nitric Oxide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Nitrofurantoin Nitrofurantoin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Nitroprusside Nitroprusside may decrease the excretion rate of Ixazomib which could result in a higher serum level.Norethisterone The metabolism of Ixazomib can be decreased when combined with Norethisterone.Norgestimate The metabolism of Ixazomib can be increased when combined with Norgestimate.Noscapine The metabolism of Ixazomib can be decreased when combined with Noscapine.Octinoxate Octinoxate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Octreotide The serum concentration of Ixazomib can be increased when it is combined with Octreotide.Olaparib The metabolism of Ixazomib can be decreased when combined with Olaparib.Olsalazine Olsalazine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Opium Ixazomib may decrease the excretion rate of Opium which could result in a higher serum level.Oritavancin The metabolism of Ixazomib can be increased when combined with Oritavancin.Orphenadrine The metabolism of Ixazomib can be decreased when combined with Orphenadrine.Oseltamivir Oseltamivir may decrease the excretion rate of Ixazomib which could result in a higher serum level.Osilodrostat The metabolism of Ixazomib can be decreased when combined with Osilodrostat.Osimertinib The metabolism of Ixazomib can be decreased when combined with Osimertinib.Oxacillin Oxacillin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Oxaprozin Oxaprozin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Oxazepam Oxazepam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Oxcarbazepine The metabolism of Ixazomib can be increased when combined with Oxcarbazepine.Oxetacaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Oxetacaine.Oxybenzone Oxybenzone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Oxybuprocaine.Oxybutynin The metabolism of Ixazomib can be decreased when combined with Oxybutynin.Oxyphenbutazone Oxyphenbutazone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Oxyquinoline Ixazomib may decrease the excretion rate of Oxyquinoline which could result in a higher serum level.Paclitaxel The metabolism of Ixazomib can be increased when combined with Paclitaxel.Pacritinib The serum concentration of Ixazomib can be increased when it is combined with Pacritinib.Palbociclib The metabolism of Ixazomib can be decreased when combined with Palbociclib.Paliperidone Paliperidone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Palonosetron Palonosetron may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pamidronic acid Pamidronic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pantoprazole Pantoprazole may decrease the excretion rate of Ixazomib which could result in a higher serum level.Parecoxib Parecoxib may decrease the excretion rate of Ixazomib which could result in a higher serum level.Paromomycin Paromomycin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pasireotide The metabolism of Ixazomib can be decreased when combined with Pasireotide.Patent Blue Ixazomib may decrease the excretion rate of Patent Blue which could result in a higher serum level.Pazopanib The metabolism of Ixazomib can be decreased when combined with Pazopanib.Pegaptanib Pegaptanib may decrease the excretion rate of Ixazomib which could result in a higher serum level.Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Ixazomib.Pemetrexed Ixazomib may decrease the excretion rate of Pemetrexed which could result in a higher serum level.Penbutolol Penbutolol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pentaerythritol t Pentaerythritol tetranitrate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pentamidine Pentamidine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pentastarch Pentastarch may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pentetic acid Ixazomib may decrease the excretion rate of Pentetic acid which could result in a higher serum level.Pentobarbital The metabolism of Ixazomib can be increased when combined with Pentobarbital.Pentostatin Ixazomib may decrease the excretion rate of Pentostatin which could result in a higher serum level.Pentoxifylline Pentoxifylline may decrease the excretion rate of Ixazomib which could result in a higher serum level.Perampanel The metabolism of Ixazomib can be increased when combined with Perampanel.Perindopril Perindopril may decrease the excretion rate of Ixazomib which could result in a higher serum level.Permethrin Permethrin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Phenazopyridine Phenazopyridine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Phenelzine Phenelzine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Phenobarbital The metabolism of Ixazomib can be increased when combined with Phenobarbital.Phenol The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Phenol.Phentolamine Phentolamine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Phenylbutazone The metabolism of Ixazomib can be increased when combined with Phenylbutazone.Phenytoin The metabolism of Ixazomib can be increased when combined with Phenytoin.Pholcodine Pholcodine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Phosphoric acid Phosphoric acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Phylloquinone Phylloquinone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Picosulfuric acid Picosulfuric acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pimavanserin The metabolism of Ixazomib can be decreased when combined with Pimavanserin.Pimozide The metabolism of Ixazomib can be decreased when combined with Pimozide.Pindolol Pindolol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Piperacillin Piperacillin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Piperaquine The metabolism of Ixazomib can be decreased when combined with Piperaquine.Piracetam Piracetam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Piretanide Piretanide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Piroxicam Piroxicam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pitolisant The serum concentration of Ixazomib can be decreased when it is combined with Pitolisant.Plazomicin Ixazomib may decrease the excretion rate of Plazomicin which could result in a higher serum level.Plerixafor Plerixafor may decrease the excretion rate of Ixazomib which could result in a higher serum level.Polythiazide Polythiazide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Pomalidomide Pomalidomide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Posaconazole The metabolism of Ixazomib can be decreased when combined with Posaconazole.Potassium Potassium may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Potassium acetate Ixazomib may decrease the excretion rate of Potassium acetate which could result in a higher serum level.Potassium bic Ixazomib may decrease the excretion rate of Potassium bicarbonate which could result in a higher serum level.Potassium cation Potassium cation may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Potassium chloride Potassium chloride may decrease the excretion rate of Ixazomib which could result in a higher serum level.Potassium citrate Potassium citrate may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Potassium nitrate Ixazomib may decrease the excretion rate of Potassium nitrate which could result in a higher serum level.Potassium per Potassium perchlorate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Potassium sulfate Ixazomib may decrease the excretion rate of Potassium sulfate which could result in a higher serum level.Pralatrexate Pralatrexate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pralidoxime Pralidoxime may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pralsetinib The metabolism of Ixazomib can be increased when combined with PralsetinibPramipexole Pramipexole may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pramocaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Pramocaine.Prasugrel Prasugrel may decrease the excretion rate of Ixazomib which could result in a higher serum level.Prednisolone The metabolism of Ixazomib can be increased when combined with Prednisolone.Prednisolone ac The metabolism of Ixazomib can be increased when combined with Prednisolone acetate.Prednisolone The metabolism of Ixazomib can be increased when combined with Prednisolone phosphate.Prednisone Prednisone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Prednisone acet The metabolism of Ixazomib can be increased when combined with Prednisone acetate.Pregabalin Pregabalin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pretomanid The metabolism of Ixazomib can be decreased when combined with Pretomanid.Prilocaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Prilocaine.Primaquine The metabolism of Ixazomib can be decreased when combined with Primaquine.Primidone The metabolism of Ixazomib can be increased when combined with Primidone.Probenecid The metabolism of Ixazomib can be increased when combined with Probenecid.Procainamide Ixazomib may decrease the excretion rate of Procainamide which could result in a higher serum level.Procaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Procaine.Procaine benz Procaine benzylpenicillin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Promethazine Promethazine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Propantheline Propantheline may decrease the excretion rate of Ixazomib which could result in a higher serum level.Proparacaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Proparacaine.Propiverine Ixazomib may decrease the excretion rate of Propiverine which could result in a higher serum level.Propofol The metabolism of Ixazomib can be decreased when combined with Propofol.Propoxycaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Propoxycaine.Propranolol Propranolol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Prucalopride Prucalopride may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pyrantel Ixazomib may decrease the excretion rate of Pyrantel which could result in a higher serum level.Pyrazinamide Pyrazinamide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pyridoxine Pyridoxine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Pyrithione Pyrithione may decrease the excretion rate of Ixazomib which could result in a higher serum level.Quetiapine Quetiapine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Quinethazone Quinethazone may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Quinidine The metabolism of Ixazomib can be decreased when combined with Quinidine.Quinine The metabolism of Ixazomib can be increased when combined with Quinine.Quinupristin The metabolism of Ixazomib can be decreased when combined with Quinupristin.Rabeprazole Rabeprazole may decrease the excretion rate of Ixazomib which could result in a higher serum level.Raloxifene The metabolism of Ixazomib can be decreased when combined with Raloxifene.Ramelteon Ramelteon may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ranitidine Ranitidine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ranolazine The metabolism of Ixazomib can be decreased when combined with Ranolazine.Rasagiline Rasagiline may decrease the excretion rate of Ixazomib which could result in a higher serum level.Remdesivir The metabolism of Ixazomib can be decreased when combined with Remdesivir.Reserpine Reserpine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Resorcinol Ixazomib may decrease the excretion rate of Resorcinol which could result in a higher serum level.Ribavirin Ribavirin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ribociclib The metabolism of Ixazomib can be decreased when combined with Ribociclib.Ribostamycin Ixazomib may decrease the excretion rate of Ribostamycin which could result in a higher serum level.Rifabutin The metabolism of Ixazomib can be increased when combined with Rifabutin.Rifampicin The metabolism of Ixazomib can be increased when combined with Rifampicin.Rifamycin The metabolism of Ixazomib can be increased when combined with Rifamycin.Rifapentine The metabolism of Ixazomib can be increased when combined with Rifapentine.Rilonacept The metabolism of Ixazomib can be increased when combined with Rilonacept.Rilpivirine The metabolism of Ixazomib can be decreased when combined with Rilpivirine.Ritonavir The serum concentration of Ixazomib can be increased when it is combined with Ritonavir.Rivaroxaban Rivaroxaban may decrease the excretion rate of Ixazomib which could result in a higher serum level.Rizatriptan Rizatriptan may decrease the excretion rate of Ixazomib which could result in a higher serum level.Rofecoxib The metabolism of Ixazomib can be increased when combined with Rofecoxib.Roflumilast The metabolism of Ixazomib can be decreased when combined with Roflumilast.Ropivacaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Ropivacaine.Rosiglitazone Rosiglitazone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Rosuvastatin The metabolism of Ixazomib can be decreased when combined with Rosuvastatin.Roxithromycin The metabolism of Ixazomib can be decreased when combined with Roxithromycin.Rucaparib The metabolism of Ixazomib can be decreased when combined with Rucaparib.Rufinamide The metabolism of Ixazomib can be increased when combined with Rufinamide.Ruxolitinib Ruxolitinib may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sacubitril Sacubitril may decrease the excretion rate of Ixazomib which could result in a higher serum level.Salbutamol Salbutamol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Salicylamide Salicylamide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Salicylic acid Salicylic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Salmon calcitonin Salmon calcitonin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Salsalate Salsalate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Saquinavir The metabolism of Ixazomib can be decreased when combined with Saquinavir.Sarilumab The metabolism of Ixazomib can be increased when combined with Sarilumab.Satralizumab The serum concentration of Ixazomib can be decreased when it is combined with Satralizumab.Saxagliptin Saxagliptin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Secobarbital The metabolism of Ixazomib can be increased when combined with Secobarbital.Secukinumab The metabolism of Ixazomib can be increased when combined with Secukinumab.Selenious acid Ixazomib may decrease the excretion rate of Selenious acid which could result in a higher serum level.Selenium Ixazomib may decrease the excretion rate of Selenium which could result in a higher serum level.Sibutramine Sibutramine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Siltuximab The metabolism of Ixazomib can be increased when combined with Siltuximab.Simeprevir The metabolism of Ixazomib can be decreased when combined with Simeprevir.Siponimod The metabolism of Ixazomib can be decreased when combined with Siponimod.Sitagliptin Sitagliptin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sitaxentan The metabolism of Ixazomib can be decreased when combined with Sitaxentan.Sodium acetate Sodium acetate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sodium auroth Sodium aurothiomalate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sodium fluoride Sodium fluoride may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sodium sulfate Sodium sulfate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sofosbuvir Sofosbuvir may decrease the excretion rate of Ixazomib which could result in a higher serum level.Solriamfetol Ixazomib may decrease the excretion rate of Solriamfetol which could result in a higher serum level.Somatostatin The metabolism of Ixazomib can be decreased when combined with Somatostatin.Somatrogon The metabolism of Ixazomib can be increased when combined with Somatrogon.Sorafenib Sorafenib may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sorbitol Sorbitol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sotorasib The serum concentration of Ixazomib can be decreased when it is combined with Sotorasib.Spironolactone Spironolactone may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.St. John's Wort The metabolism of Ixazomib can be increased when combined with St. John's Wort.Stiripentol The metabolism of Ixazomib can be decreased when combined with Stiripentol.Streptomycin Ixazomib may decrease the excretion rate of Streptomycin which could result in a higher serum level.Strontium chloride Ixazomib may decrease the excretion rate of Strontium chloride which could result in a higher serum level.Sucralfate Sucralfate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sulbactam Sulbactam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sulfadiazine Sulfadiazine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sulfamethoxazole The metabolism of Ixazomib can be decreased when combined with Sulfamethoxazole.Sulfasalazine Sulfasalazine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sulfinpyrazone The metabolism of Ixazomib can be increased when combined with Sulfinpyrazone.Sulindac Sulindac may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sumatriptan Sumatriptan may decrease the excretion rate of Ixazomib which could result in a higher serum level.Suvorexant The metabolism of Ixazomib can be decreased when combined with Suvorexant.Sy Estrogens, A Synthetic Conjugated Estrogens, A may decrease the excretion rate of Ixazomib which could result in a higher serum level.Sy Estrogens, B Synthetic Conjugated Estrogens, B may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tacrolimus The metabolism of Ixazomib can be decreased when combined with Tacrolimus.Tadalafil Tadalafil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tamoxifen The metabolism of Ixazomib can be increased when combined with Tamoxifen.Tamsulosin Tamsulosin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tasimelteon The metabolism of Ixazomib can be decreased when combined with Tasimelteon.Tazemetostat The metabolism of Ixazomib can be decreased when combined with Tazemetostat.Technetium Tc-99m Technetium Tc-99m exametazime may decrease the excretion rate of Ixazomib which could result in a higher serum level.Technetium Tc Technetium Tc-99m mebrofenin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Technetium Technetium Tc-99m oxidronate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Technetium Technetium Tc-99m pyrophosphate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tecovirimat The metabolism of Ixazomib can be increased when combined with Tecovirimat.Teduglutide Teduglutide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tegafur Tegafur may decrease the excretion rate of Ixazomib which could result in a higher serum level.Telaprevir The metabolism of Ixazomib can be decreased when combined with Telaprevir.Telavancin Telavancin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Telithromycin The metabolism of Ixazomib can be decreased when combined with Telithromycin.Telotristat ethyl The serum concentration of Ixazomib can be decreased when it is combined with Telotristat ethyl.Temazepam Temazepam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Temozolomide Temozolomide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Teniposide The metabolism of Ixazomib can be decreased when combined with Teniposide.Tenofovir alafe The serum concentration of Tenofovir alafenamide can be increased when it is combined with Ixazomib.Tenofovir diso Tenofovir disoproxil may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tenoxicam Tenoxicam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Terbinafine The metabolism of Ixazomib can be increased when combined with Terbinafine.Terbutaline Terbutaline may decrease the excretion rate of Ixazomib which could result in a higher serum level.Terfenadine The metabolism of Ixazomib can be decreased when combined with Terfenadine.Testolactone Testolactone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Testosterone The metabolism of Ixazomib can be increased when combined with Testosterone.Testosterone Ixazomib may decrease the excretion rate of Testosterone cypionate which could result in a higher serum level.Testosterone ena Ixazomib may decrease the excretion rate of Testosterone enanthate which could result in a higher serum level.Testosterone prop Testosterone propionate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Testosterone unde Ixazomib may decrease the excretion rate of Testosterone undecanoate which could result in a higher serum level.Tetracaine The risk or severity of methemoglobinemia can be increased when Ixazomib is combined with Tetracaine.Tetracycline The metabolism of Ixazomib can be decreased when combined with Tetracycline.Tetradecyl hydrog Ixazomib may decrease the excretion rate of Tetradecyl hydrogen sulfate (ester) which could result in a higher serum level.Thiabendazole Thiabendazole may decrease the excretion rate of Ixazomib which could result in a higher serum level.Thiamylal The metabolism of Ixazomib can be increased when combined with Thiamylal.Thiethylperazine Thiethylperazine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tiaprofenic acid Tiaprofenic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Ticagrelor The metabolism of Ixazomib can be decreased when combined with Ticagrelor.Ticlopidine Ticlopidine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tiludronic acid Tiludronic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Timolol Timolol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tinidazole Tinidazole may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tiopronin Tiopronin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tiotropium Tiotropium may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tipranavir The metabolism of Ixazomib can be decreased when combined with Tipranavir.Tirofiban Tirofiban may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tixocortol Tixocortol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tobramycin Ixazomib may decrease the excretion rate of Tobramycin which could result in a higher serum level.Tocilizumab The metabolism of Ixazomib can be increased when combined with Tocilizumab.Tocopherol Ixazomib may decrease the excretion rate of Tocopherol which could result in a higher serum level.Tolazamide Tolazamide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tolbutamide Tolbutamide may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tolcapone Tolcapone may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tolfenamic acid Tolfenamic acid may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tolmetin Tolmetin may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tolterodine Tolterodine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tolvaptan Tolvaptan may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Topiramate The metabolism of Ixazomib can be increased when combined with Topiramate.Topotecan Topotecan may decrease the excretion rate of Ixazomib which could result in a higher serum level.Torasemide Torasemide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Tositumomab Tositumomab may decrease the excretion rate of Ixazomib which could result in a higher serum level.Tramadol Tramadol may decrease the excretion rate of Ixazomib which could result in a higher serum level.Trametinib Trametinib may decrease the excretion rate of Ixazomib which could result in a higher serum level.Triamcinolone The metabolism of Ixazomib can be increased when combined with Triamcinolone.Triamterene Triamterene may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Triazolam Triazolam may decrease the excretion rate of Ixazomib which could result in a higher serum level.Trichlormethiazide Trichlormethiazide may increase the excretion rate of Ixazomib which could result in a lower serum level and potentially a reduction in efficacy.Triclabendazole The metabolism of Ixazomib can be decreased when combined with Triclabendazole.Triethylenetetramine Triethylenetetramine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Trifluridine Trifluridine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Trimebutine Trimebutine may decrease the excretion rate of Ixazomib which could result in a higher serum level.Trimethoprim Trimethoprim may decrease the excretion rate of Ixazomib which could result in a higher serum level.Trimetrexate Trimetrexate may decrease the excretion rate of Ixazomib which could result in a higher serum level.Troglitazone The metabolism of Ixazomib can be increased when combined with Troglitazone.Troleandomycin The metabolism of Ixazomib can be decreased when combined with Troleandomycin.Tropisetron Ixazomib may decrease the excretion rate of Tropisetron which could result in a higher serum level.Tucatinib The metabolism of Tucatinib can be decreased when combined with Ixazomib.Vaborbactam Ixazomib may decrease the excretion rate of Vaborbactam which could result in a higher serum level.Valaciclovir Valaciclovir may decrease the excretion rate of Ixazomib which could result in a higher serum level.Valbenazine Ixazomib may decrease the excretion rate of Valbenazine which could result in a higher serum level.Valdecoxib Valdecoxib may decrease the excretion rate of Ixazomib which could result in a higher serum level.Valganciclovir Valganciclovir may decrease the excretion rate of Ixazomib which could result in a higher serum level.Valproic acid The metabolism of Ixazomib can be decreased when combined with Valproic acid.Vancomycin Ixazomib may decrease the excretion rate of Vancomycin which could result in a higher serum level.Varenicline Varenicline may decrease the excretion rate of Ixazomib which could result in a higher serum level.Vemurafenib The metabolism of Ixazomib can be increased when combined with Vemurafenib.Venetoclax The metabolism of Ixazomib can be decreased when combined with Venetoclax.Pregnancy and Lactation AU TGA pregnancy category: C US FDA pregnancy category: Not assigned. Pregnancy This drug can cause fetal harm when administered to a pregnant woman. Females of reproductive potential should be advised to avoid becoming pregnant while being treated with this drug. Male and female patients of reproductive potential should use effective contraceptive measures during and for 90 days following therapy with this drug. Females using oral hormonal contraceptives should additionally use a barrier method of contraception. Based on animals and the drug mechanism of action, this drug can cause fetal harm. Lactation No information is available on the clinical use of ixazomib during breastfeeding. Because its half-life is about 9.5 days, it is likely to accumulate in the infant. It is also given in combination with leflunomide and dexamethasone, which may increase the risk to the infant. The manufacturer recommends that breastfeeding be discontinued during ixazomib therapy and for 90 days after the last dose.Why is this medication prescribed?

Ixazomib is used in combination with lenalidomide (Revlimid) and dexamethasone to treat multiple myeloma (cancer of the plasma cells in the bone marrow) that has worsened after treatment with other chemotherapy medications. Ixazomib is in a class of medications called proteasome inhibitors. It works by helping to kill cancer cells.

How should this medicine be used?

Ixazomib comes as a capsule to take by mouth. It is usually taken with water on an empty stomach, at least 1 hour before or 2 hours after eating. It is taken on days 1,8, and 15 of a 28 day treatment cycle. Take ixazomib at around the same time on every day that you take it. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take…

Before taking ixazomib,tell your doctor and pharmacist if you are allergic to ixazomib, any other medications, or any of the ingredients in ixazomib capsules. Ask your pharmacist for a list of the ingredients. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements you are taking or plan to take. Be sure to mention any of the following: carbamazepine (Epitol, Equetro, Carbatrol, Tegretol, Teril), efavirenz (Sustiva, in Atripla), nevirapine (Viramune), phenobarbital, pioglitazone (Actos, in Actoplus, Duetact, Oseni), phenytoin (Dilantin, Phenytek), rifabutin (Mycobutin), and rifampin (Rifadin, Rimactane, in Rifamate, Rifater). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor what herbal products you are taking, especially St. John's wort. tell your doctor if you have or have ever had liver or kidney disease. tell your doctor if you are pregnant or plan to become pregnant, or plan to father a child. You should not become pregnant while you are taking ixazomib. Use effective birth control during your treatment with ixazomib and for 90 days after your final dose. If you are a male and your partner can become pregnant, you should use effective birth control during your treatment and for 90 days after your final dose. Talk to your doctor about birth control methods that will work for you. If you or your partner become pregnant while taking ixazomib, call your doctor immediately. Ixazomib can harm the fetus. tell your doctor if you are breastfeeding. You should not breastfeed while you are taking ixazomib.What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is within 72 hours (3 days) of your next scheduled dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/208462lbl.pdf https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/208462s012s013lbl.pdf https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208462s001lbl.pdf https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/208462s010lbl.pdf https://pubchem.ncbi.nlm.nih.gov/compound/Ixazomib https://pubchem.ncbi.nlm.nih.gov/compound/Ixazomib-citrate https://www.ncbi.nlm.nih.gov/books/NBK564364/ https://www.cancer.gov/about-cancer/treatment/drugs/ixazomibcitrate https://go.drugbank.com/drugs/DB09570 https://www.drugs.com/monograph/ixazomib-citrate.html https://en.wikipedia.org/wiki/Ixazomib https://www.cancer.gov/about-cancer/treatment/drugs/ixazomibcitrate https://medlineplus.gov/druginfo/meds/a616008.html https://www.mayoclinic.org/drugs-supplements/ixazomib-oral-route/side-effects/drg-20165209 https://www.webmd.com/drugs/2/drug-170507/ninlaro-oral/details/list-contraindications CAS Common Chemistry https://creativecommons.org/licenses/by-nc/4.0/ https://commonchemistry.cas.org/detail?cas_rn=1072833-77-2 ChemIDplus https://www.nlm.nih.gov/copyright.html https://pubchem.ncbi.nlm.nih.gov/substance/?source=chemidplus&sourceid=1072833772 https://pubchem.ncbi.nlm.nih.gov/source/ChemIDplus DrugBank https://www.drugbank.ca/legal/terms_of_use https://www.drugbank.ca/drugs/DB09570 EPA DSSTox https://www.epa.gov/privacy/privacy-act-laws-policies-and-resources https://comptox.epa.gov/dashboard/DTXSID701025662 https://comptox.epa.gov/dashboard/chemical-lists/ European…

References

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Written by Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist

Dr. Md. Harun Ar Rashid, MPH, MD, PhD, is a highly respected medical specialist celebrated for his exceptional clinical expertise and unwavering commitment to patient care. With advanced qualifications including MPH, MD, and PhD, he integrates cutting-edge research with a compassionate approach to medicine, ensuring that every patient receives personalized and effective treatment. His extensive training and hands-on experience enable him to diagnose complex conditions accurately and develop innovative treatment strategies tailored to individual needs. In addition to his clinical practice, Dr. Harun Ar Rashid is dedicated to medical education and research, writing and inventory creative thinking, innovative idea, critical care managementing make in his community to outreach, often participating in initiatives that promote health awareness and advance medical knowledge. His career is a testament to the high standards represented by his credentials, and he continues to contribute significantly to his field, driving improvements in both patient outcomes and healthcare practices. Born and educated in Bangladesh, Dr. Rashid earned his BPT from the University of Dhaka before pursuing postgraduate training internationally. He completed his MD in Internal Medicine at King’s College London, where he developed a special interest in inflammatory arthritis and metabolic bone disease. He then undertook a PhD in Orthopedic Science at the University of Oxford, conducting pioneering research on cytokine signaling pathways in rheumatoid arthritis. Following his doctoral studies, Dr. Rashid returned to clinical work with a fellowship in interventional pain management at the Rx University School of Medicine, refining his skills in image-guided joint injections and minimally invasive pain-relief techniques.