Contraindications of ixazomib (Enleri) and which groups should be cautious

Ixazomib (Ixazomib) is an oral proteasome inhibitor commonly used in the treatment of multiple myeloma. It is especially suitable for maintenance therapy in combination with lenalidomide and dexamethasone or for patients with relapsed multiple myeloma. It inhibits the activity of 26S proteasome and blocks the protein degradation pathway of tumor cells, thereby inducing apoptosis of cancer cells. Although the efficacy is remarkable, there are certain taboos and precautions during use, which need to be strictly followed by doctors and patients.

Ixazomib is contraindicated in patients who are allergic to the drug or its ingredients, including excipients. **Severe liver impairment (Child-Pugh C) or severe renal insufficiency (eGFR <30 mL/min/1.73m²)** is generally not recommended for use because drug metabolism and excretion are limited, and blood drug concentrations may be too high, increasing the risk of toxicity. Pregnant and lactating women are also contraindicated because the drug may have potential adverse effects on the fetus or infant.

For patients with mild to moderate liver damage or renal insufficiency, the dosage should be adjusted under the guidance of a doctor, and plasma concentration and related laboratory indicators should be closely monitored. Elderly patients, patients with cardiac insufficiency or patients with peripheral neuropathy should also be used with caution, as ixazomib may cause peripheral neuropathy or aggravate symptoms such as edema and fatigue. At the same time, patients taking CYP3A inhibitors or inducers should be evaluated for drug interaction risks.

Before using ixazomib, a comprehensive evaluation of liver and kidney function, hemogram and previous medication history should be carried out. During the treatment process, hematological indicators, liver and kidney functions, and neurological symptoms need to be regularly monitored, and the dose should be adjusted according to tolerance. Following the contraindications and precautions can not only reduce the incidence of adverse events, but also ensure maximum efficacy and provide a safe and standardized treatment plan for patients with multiple myeloma.

Reference materials:https://www.drugs.com/