Using These Drugs Together To Treat Multiple Myeloma
Although a single drug may be used to treat multiple myeloma, it is preferable to use at least 2 or 3 different kinds of drugs in combination because the cancer responds better. For example:
- Lenalidomide and dexamethasone
- Carfilzomib , lenalidomide, and dexamethasone
- Bortezomib , cyclophosphamide, and dexamethasone
- Elotuzumab , lenalidomide, and dexamethasone
- Bortezomib, liposomal doxorubicin, and dexamethasone
- Panobinostat, bortezomib, and dexamethasone
- Melphalan and prednisone , with or without thalidomide or bortezomib
- Vincristine, doxorubicin , and dexamethasone
- Dexamethasone, cyclophosphamide, etoposide, and cisplatin
- Dexamethasone, thalidomide, cisplatin, doxorubicin, cyclophosphamide, and etoposide , with or without bortezomib
- Selinexor, bortezomib, dexamethasone
The choice and dose of drug therapy depend on many factors, including the stage of the cancer, the age and kidney function of the patient as well as how frail the patient may be. If a stem cell transplant is planned, most doctors avoid using certain drugs, like melphalan, that can damage the bone marrow.
Financial And Insurance Assistance
If you need financial support to pay for Revlimid, or if you need help understanding your insurance coverage, help is available.
Celgene, the manufacturer of Revlimid, offers a program called Celgene Patient Support. For more information and to find out if youre eligible for support, call 800-931-8691 or visit the program website.
You should take Revlimid according to your doctor or healthcare providers instructions.
Feeling Or Being Sick
Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.
It is important to take anti sickness medicines as prescribed even if you dont feel sick. It is easier to prevent sickness rather than treating it once it has started.
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How Is This Drug Best Taken
Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
- Take this drug at the same time of day.
- Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
- You will need to take special care when handling this drug. Check with the doctor or pharmacist to see how to handle this drug.
- Take with or without food.
- Take with a full glass of water.
- Swallow whole. Do not chew, break, or crush.
- Do not open the capsules.
- People who are pregnant or of childbearing age must not touch the capsules.
- If you touch a broken capsule, or the drug inside the capsule, wash the area with soap and water.
- If a broken capsule or the drug inside the capsule touches your eyes, rinse your eyes right away with water.
- Do not donate blood while using this drug and for 1 month after stopping.
- Do not donate sperm while using this drug and for 1 month after stopping.
- If you have upset stomach, throwing up, diarrhea, or are not hungry, talk with your doctor. There may be ways to lower these side effects.
- Talk with your doctor before getting any vaccines. Use of some vaccines with this drug may either raise the chance of an infection or make the vaccine not work as well.
Make Every Dose Everyone’s Responsibility
The good news is that your healthcare team, caregivers, and loved ones can all help with adherence. This way, the responsibility doesn’t fall entirely on you. Talk with your care team about the importance of adherence and how you can work together to stay on treatment. When talking with your healthcare team specifically, consider the following suggestions for your adherence conversation.
- Ask questions to fully understand your treatment and clarify anything that’s confusing
- Ask for information about potential side effects of treatment
- Always talk to your doctor, as there are changes that can be made to your dose for certain side effects
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How Are Treatment Progress And Side Effects Monitored
Lab tests play a big role in monitoring treatment progress and side effects. Your doctor will use lab tests to help diagnose and assess your multiple myeloma. Take a look at the Lab Test Tracker to familiarize yourself with the terms and reference ranges for different tests. This way, you can have a more productive conversation when speaking with your doctor about your treatment progress. Learn about NINLARO and side effects.
- Other common side effects have occurred. Tell your healthcare provider if you get new or worsening signs or symptoms of the following:
- back pain
- skin rash and pain as a result of reactivation of the chicken pox virus
- lowered white blood cells called neutrophils that may increase the risk of infection
- vision conditions including blurred vision, dry eye and pink eye
These are not all the possible side effects of NINLARO. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Darzalex Can Also Cause:
Changes in blood testsDARZALEX® can affect the results of blood tests to match your blood type. These changes can last for up to 6 months after your final dose of DARZALEX®. Your healthcare provider will do blood tests to match your blood type before you start treatment with DARZALEX®. Tell all of your healthcare providers that you are being treated with DARZALEX® before receiving blood transfusions.
DARZALEX® can decrease white blood cell counts, which help fight infections, and blood cells called platelets, which help to clot blood. Tell your healthcare professionals if you develop fever or have signs of bruising or bleeding.
Questions to ask before and after treatment
Here are a few things you may want to ask your doctor so you can be better prepared for treatment with DARZALEX®:
- What side effects should I watch for?
- Do I need to make any changes to my diet during or after treatment?
- What kind of exercise can or should I do while being treated?
- What type of follow-up will I need after treatment and when?
- How will we know if the cancer has come back? What should I watch for?
DARZALEX® is a prescription medicine used to treat adults with multiple myeloma:
It is not known if DARZALEX® is safe and effective in children.
Do not receive DARZALEX® if you have a history of a severe allergic reaction to daratumumab or any of the ingredients in DARZALEX®. See below for a complete list of ingredients.
How will I receive DARZALEX®?
DARZALEX® may cause serious reactions, including:
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Precautions While Using Revlimid
It is very important that your doctor check your progress closely at regular visits to see if the medicine is working properly and to allow for a change in the dose. Blood and urine tests may be needed to check for any unwanted effects.
Women should take the necessary precautions to avoid pregnancy while using lenalidomide. Begin 2 forms of reliable contraception 4 weeks before starting lenalidomide. Continue contraceptive measures during treatment and for at least 4 weeks after the last dose. Routine pregnancy tests are necessary with this medicine. Call your doctor for emergency contraception information if you think you are pregnant.
Men, even those who have had a vasectomy, must prevent pregnancy in their sexual partners during treatment with this medicine and for at least 4 weeks after the last dose. Do not donate sperm while using this medicine. Call your doctor for emergency contraception information if you think your sexual partner may be pregnant.
Do not donate blood during treatment and for at least 4 weeks after the last dose.
This medicine may increase your risk of having blood clots. Check with your doctor right away if you have the following symptoms: anxiety, chest pain, fainting, a fast heartbeat, sudden shortness of breath or troubled breathing, or pain, redness, or swelling in the arm or leg.
Do not receive pembrolizumab together with dexamethasone and lenalidomide or similar medicines if you have multiple myeloma.
Can Revlimid Cause Other Cancers To Occur
Its possible. In clinical studies, people who took Revlimid had a higher risk of developing new cancers. This included leukemia, myelodysplastic syndromes, and skin cancer.
Talk to your doctor about your risk of developing new cancers if you take Revlimid. Other factors can increase your risk of developing new cancers, such as genetics and using tobacco. Your doctor will check for new symptoms of cancer during your treatment.
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Discussing Your Multiple Myeloma Treatment
If you have multiple myeloma, you’ll be cared for by a team, which is usually led by a consultant haematologist who specialises in myeloma.
The team will discuss your condition and recommend the best treatment for you. However, the final decision to begin treatment will be yours.
Before visiting hospital to discuss your treatment options, it may be useful to write a list of questions to ask the specialist.
For example, you may want to find out the advantages and disadvantages of a particular treatment.
Are There Any Other Precautions Or Warnings For This Medication
Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.
Bleeding: Lenalidomide may cause a reduced number of platelets in the blood, which can make it difficult to stop cuts from bleeding. If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible. Your doctor will order routine blood tests to make sure potential problems are caught early.
Blood clots: Lenalidomide increases the risk of developing blood clots in the legs and lungs. If you experience sudden shortness of breath, blurred vision, difficulty speaking, chest pain, arm or leg pain, and swelling, contact your doctor immediately.
Blood donation: Do not give blood during and for 4 weeks after your treatment with lenalidomide. If a pregnant woman received your donated blood, her baby could be exposed to lenalidomide and might be born with birth defects.
Diabetes: Lenalidomide may cause an increase in blood sugar levels and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.
Children: The safety and effectiveness of using this medication have not been established for children.
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When You Have It
You take lenalidomide every day for 3 weeks and then have a break for 1 week. This is one cycle of treatment. You then start the next cycle.
If you forget to take lenalidomide at your regular time but less than 12 hours have passed, take the capsule straight away. If more than 12 hours have passed do not take the capsule but just take your next capsule at the usual time the next day.
Bisphosphonates For Bone Disease
Myeloma cells can weaken and even break bones. Drugs called bisphosphonates can help bones stay strong by slowing down this process. They can also help reduce pain in the weakened bone. Sometimes, pain medicines such as NSAIDs or narcotics will be given along with bisphosphonates to help control or lessen the pain. Bone pain can be a difficult symptom to treat during and after treatment for myeloma.
The drugs used most often for treating bone problems in people with myeloma are the bisphosphonates pamidronate and zoledronic acid and the drug denosumab . These drugs are given intravenously or subcutaneously . Most patients are treated once a month at first, but they may be able to be treated less often later on if they are doing well. Treatment with one of these drugs helps prevent further bone damage and events related to weakened bones such as fractures, hypercalcemia , and spinal cord compression in multiple myeloma patients.
Your doctor might recommend that you have a dental checkup before starting treatment. That way, any dental problems can be taken care of before starting the drug. They might also recommend taking calcium and Vitamin D supplements while on the medicine to help your body build bone.
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Some Common Side Effects
These are not all of the possible side effects of REVLIMID. Your healthcare provider may adjust your dose or have you temporarily or permanently stop taking REVLIMID if you develop certain serious side effects. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
It Could Shorten Your Life
Treating multiple myeloma usually requires multiple therapies. After the first phase of treatment, most people will go on maintenance therapy, which can last for years.
Staying on a treatment long-term has its downsides. This includes side effects, repeated tests, and keeping up with a medication routine. The definite upside is that staying on treatment can help you live longer.
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Lenalidomide May Cause Side Effects Tell Your Doctor If Any Of These Symptoms Are Severe Or Do Not Go Away:
- diarrhea
- change in ability to taste
- pain or burning of the tongue, mouth, or throat
- burning or tingling in the hands or feet
- difficulty falling asleep or staying asleep
- depression
- joint, muscle, bone, or back pain
- painful, frequent, or urgent urination
- sweating
- bloody, cloudy, or painful urination
- increased or decreased urination
If you are taking lenalidomide to treat multiple myeloma and you also receive melphalan or a blood stem cell transplant, you may have a higher risk of developing new cancers. Talk to your doctor about the risks of taking lenalidomide. Your doctor will check you for new cancers during your treatment with lenalidomide.
Lenalidomide may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
How Serious Is My Multiple Myeloma
If you have multiple myeloma, the doctor will want to find out how advanced it is. This is called staging.
The stage of multiple myeloma is based on the results of x-rays and certain blood or urine tests. Be sure to ask the doctor about the stage of your multiple myeloma and what it means for you.
Questions to ask the doctor:
- Do you know the stage of my cancer?
- If not, how and when will you find out the stage of the cancer?
- Would you explain to me what the stage means in my case?
- Based on the stage of the cancer, how long do you think Ill live?
- What will happen next?
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