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Ixabepilone (Intravenous route)

Pronunciation:

ix-ab-EP-i-lone

Brand Names:

  • Ixempra

Dosage Forms:

  • Powder for Solution

Warnings:

Intravenous route(Powder for Solution)

Contraindicated with capecitabine in patients with AST or ALT greater than 2.5 times the upper limit of normal (ULN) or bilirubin greater than one times ULN due to increased risk of toxicity and neutropenia-related death .

Classifications:

Therapeutic—

Antineoplastic Agent

Pharmacologic—

Mitotic Inhibitor

Chemical—

Epothilone

Uses of This Medicine:

Ixabepilone injection belongs to the group of medicines called antineoplastics (cancer medicines). It is used to treat advanced or metastatic breast cancer (breast cancer that has already spread) after other treatments have failed. Ixabepilone is given alone or with another cancer medicine called capecitabine.

Ixabepilone interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal cells will also be affected by this medicine, other side effects may occur. Some of these may be serious and must be reported to your doctor right away.

This medicine is to be given only by or under the immediate supervision of your doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of ixabepilone injection in the pediatric population. Efficacy has not yet been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ixabepilone injection in the elderly.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersDStudies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amprenavir
  • Atazanavir
  • Carbamazepine
  • Clarithromycin
  • Delavirdine
  • Dexamethasone
  • Fosamprenavir
  • Fosphenytoin
  • Indinavir
  • Itraconazole
  • Ketoconazole
  • Nefazodone
  • Nelfinavir
  • Phenobarbital
  • Phenytoin
  • Rifabutin
  • Rifampin
  • Ritonavir
  • Saquinavir
  • St John's Wort
  • Telithromycin
  • Voriconazole

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Grapefruit Juice

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergy to a medicine (e.g., Taxol®) that contains Cremophor® EL or polyoxyethylated castor oil or
  • Liver disease, severe or
  • Neutropenia (low white blood cell count) or
  • Thrombocytopenia (low platelet count)—Should not be used in patients with these conditions.
  • Diabetes—Use with caution. This medicine may increase your chance of having nerve problems.
  • Heart disease, or history of or
  • Nerve problems (e.g., peripheral neuropathy)—Use with caution. May make these conditions worse.
  • Liver disease, mild—Use with caution. This medicine should not be given with capecitabine to patients with this condition.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine in a hospital. This medicine is given through a needle placed in one of your veins.

This medicine is usually given once every 3 weeks. Each treatment usually takes about 3 hours. You may also receive medicines to help prevent possible allergic reactions to the injection.

This medicine often causes diarrhea, nausea, and vomiting. However, it is very important that you continue to receive the medicine even if you begin to feel ill. Your doctor may give you a medicine to help prevent these side effects.

Grapefruit and grapefruit juice may change the amount of medicine that is absorbed in the body. Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

This medicine comes with a patient information insert. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Check with your doctor right away if you are having burning, numbness, tingling, or painful sensations in the arms, hands, legs, or feet. These could be symptoms of a condition called peripheral neuropathy.

Ixabepilone injection can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood counts are low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or have painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as safety razors and fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash; itching; swelling of the face, tongue, and throat; trouble with breathing; or chest pain after you receive the medicine.

Check with your doctor right away if you have chest pain, difficulty with breathing, a fast or pounding heartbeat, or unusual weight gain. These could be symptoms of a serious heart problem.

Ixabepilone contains alcohol, which may cause some people to become dizzy or drowsy. If any of these side effects occur, do not drive, use machines, or do anything else that could be dangerous if you are not alert.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (e.g., St. John's wort) or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
Black, tarry stools
body aches or pain
burning, numbness, tingling, or painful sensations
burning pain on urination
chest pain
chills
cough
difficult or labored breathing
ear congestion
fever
headache
loss of voice
lower back or side pain
nasal congestion
painful or difficult urination
pale skin
red, swelling, or painful skin
runny nose
scaling of the skin on the hands and feet
shortness of breath
sneezing
sore throat
sores, ulcers, or white spots on the lips, tongue, or inside the mouth
swelling of the hands, ankles, feet, or lower legs
swollen glands
tightness in the chest
tingling of the hands and feet
troubled breathing with exertion
ulceration of the skin
unsteadiness or awkwardness
unusual bleeding or bruising
unusual tiredness or weakness
unusual weight gain
weakness in the arms, hands, legs, or feet
wheezing
Less common
Bleeding gums
blood in the urine or stools
confusion
decreased urination
dizziness
dry mouth
fainting
fast heartbeat
hives
hoarseness
increase in heart rate
irritation
itching
joint pain, stiffness, or swelling
lightheadedness
pinpoint red spots on the skin
rapid breathing
rash
sunken eyes
swelling of the eyelids, face, or lips
thirst
trouble with swallowing
wrinkled skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Bad, unusual, or unpleasant (after) taste
bone pain
change in taste
cracked lips
diarrhea
difficulty having a bowel movement (stool)
discoloration of the fingernails or toenails
feeling of warmth
hair loss or thinning of the hair
heartburn
lack or loss of strength
loss of appetite
nausea
redness of the face, neck, arms, and occasionally, upper chest
stomach pain
sudden sweating
swelling or inflammation of the mouth
vomiting
weight loss
Less common
Darkening of the skin
flaking and falling off of the skin
sleeplessness
trouble with sleeping
unable to sleep
watering of the eyes

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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