Rash Management for Patients Taking IRd (Ixazomib-Lenalidomide-Dexamethasone)

Clinical Pearls Podcasts published on June 19, 2017
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R. Donald Harvey, III, PharmD, BCOP, FCCP, FHOPA
Associate Professor
Department of Pharmacology
Department of Hematology and Medical Oncology
Emory University School of Medicine
Director, Phase I Clinical Trials Section
Winship Cancer Institute of Emory University
Atlanta, Georgia

Rash Management for Patients Taking IRd (Ixazomib-Lenalidomide-Dexamethasone)
  • Both ixazomib and lenalidomide have been associated with rash
    • Dose adjustment guidelines and dose hold guidelines have been provided for patients with grade 2 rash
    • Grade 2 rash: rash covering 25% or more of body surface area, usually in the trunk area
    • Can be associated with itching or pruritus
    • Some patients may find the rash disconcerting but not uncomfortable
  • Initial management of rash: focus on lenalidomide
    • Much shorter half-life than ixazomib
    • Holding lenalidomide is a quick tactic for understanding whether or not the rash is due to that drug
    • If the rash resolves when lenalidomide is held, patients can restart the regimen once the rash has resolved
  • If rash persists with lenalidomide being held, the rash may be due to ixazomib, and this drug may need to be held separately from lenalidomide
Last modified: June 16, 2017
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