Carfilzomib

NO UK SPC (eMC) POSOLOGY WAS RETRIEVED FOR THIS DRUG — the whole record below is from US labelling (openFDA/DailyMed, KYPROLIS, Onyx Pharmaceuticals, label date 2025-06-18, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=600cd22c-3a74-442e-a65d-c06d47bb892a). UK dosing must be confirmed against the UK SPC before publication. INDICATION: relapsed or refractory multiple myeloma. THREE REGIMENS ARE LISTED IN THE LABEL: (1) 20/70 mg/m² ONCE WEEKLY, 30-minute infusion — with dexamethasone (Kd), daratumumab plus dexamethasone (DKd), or daratumumab and hyaluronidase-fihj plus dexamethasone (DKd): 20 mg/m² Cycle 1 Day 1, escalate to 70 mg/m² Cycle 1 Day 8 if tolerated, then Days 1, 8 and 15 of each 28-day cycle. (2) 20/56 mg/m² TWICE WEEKLY, 30-minute infusion — as monotherapy or with dexamethasone (Kd), daratumumab plus dexamethasone (DKd), daratumumab and hyaluronidase-fihj plus dexamethasone (DKd) or isatuximab plus dexamethasone (Isa-Kd): 20 mg/m² on Cycle 1 Days 1 and 2, escalate to 56 mg/m² from Cycle 1 Day 8 if tolerated, then Days 1, 2, 8, 9, 15 and 16 of each 28-day cycle; as monotherapy give dexamethasone 8 mg orally or intravenously 30 minutes to 4 hours before carfilzomib, and doses may be omitted on Days 8 and 9 from Cycle 13 onward. (3) 20/27 mg/m² TWICE WEEKLY, 10-minute infusion — with lenalidomide and dexamethasone (KRd) or as monotherapy (the label's full detail for this regimen fell beyond the source-fetch limit and was NOT retrieved). HYDRATION: adequate hydration is required before dosing in Cycle 1, especially in patients at high risk of tumour lysis syndrome or renal toxicity — consider oral fluids (30 mL/kg at least 48 hours before Cycle 1 Day 1) and intravenous fluids (250–500 mL before each Cycle 1 dose, with a further 250–500 mL after administration if needed); continue in later cycles as needed and monitor for volume overload. PREMEDICATION: dexamethasone orally or intravenously at least 30 minutes but no more than 4 hours before all Cycle 1 doses to reduce infusion-related reactions; reinstate in later cycles if symptoms occur. Provide thromboprophylaxis when used in combination therapy; consider antiviral prophylaxis for herpes zoster. MONITORING: monitor serum potassium regularly. PAEDIATRIC: safety and effectiveness in paediatric patients have not been established; a trial in 124 patients aged 1 to under 17 years with relapsed/refractory ALL evaluated but did not establish carfilzomib with chemotherapy — no new safety signals, and systemic exposure was within the adult range for the same BSA-based dose. TRUNCATION WARNING: the label's dose-modification tables for toxicity (§2.3) and any renal/hepatic dosing guidance fell beyond the source-fetch limit and were NOT retrieved — clinician must source these separately.