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Ixempra Side Effects Center
Medical Editor: John P. Cunha, DO, FACOEP
Ixempra (ixabepilone) is used to treat advanced breast cancer, and is usually given after other cancer medications have been tried without successful treatment. It is a cancer (antineoplastic) medication. Common side effects include pain/redness/swelling at the injection site, weakness, tiredness, muscle/joint pain, nausea and vomiting (may be severe), diarrhea, loss of appetite, headache, dizziness, or drowsiness.
The recommended dosage of Ixempra is 40 mg/mē administered intravenously over 3 hours every 3 weeks. Ixempra may interact with dexamethasone, St. John's wort, barbiturates, HIV /AIDS medicines, antibiotics, antifungal medications, seizure medications, or antidepressants. Tell your doctor all medications and supplements you use. Ixempra is not recommended for use during pregnancy. It may harm a fetus. If you become pregnant or think you may be pregnant, tell your doctor. Women and men using this medication should use 2 forms of birth control (e.g., condoms and birth control pills) to prevent pregnancy; consult your doctor. It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breastfeeding while using this drug is not recommended.
Our Ixempra (ixabepilone) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What is Patient Information in Detail?
Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.
Ixempra in Detail - Patient Information: Side Effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; warmth or tingly feeling; difficulty breathing; swelling of your face, lips, tongue, or throat.
Tell your caregivers at once if you have any of these serious side effects:
- numbness, tingling, burning pain, discomfort, or loss of feeling anywhere in your body;
- fever, chills, body aches, flu symptoms, sores in your mouth and throat;
- easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
- pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;
- sudden numbness or weakness, especially on one side of the body;
- sudden severe headache, confusion, problems with vision, speech, or balance;
- pain or burning when you urinate;
- chest pain or heavy feeling; or
- redness, swelling, and pain on the palms of your hands or the soles of your feet.
Less serious side effects include:
- tired feeling;
- joint or muscle pain;
- hair loss;
- nausea, vomiting, stomach pain, loss of appetite;
- diarrhea or constipation; or
- problems with your fingernails or toenails.
Read the entire detailed patient monograph for Ixempra (Ixabepilone) »
What is Patient Information Overview?
A concise overview of the drug for the patient or caregiver from First DataBank.
Ixempra Overview - Patient Information: Side Effects
Temporary hair loss may occur. Normal hair growth should return after treatment has ended.
Many people using this medication have serious side effects. However, your doctor has prescribed this drug because he or she has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk.
This medication can lower your body's ability to fight an infection. Tell your doctor promptly if you develop any signs of an infection such as painful urination, fever, chills, or persistent sore throat.
Painful sores on the lips, mouth, and throat may occur. To decrease the risk, limit hot foods and drinks, brush your teeth carefully, avoid using mouthwash that contains alcohol, and rinse your mouth frequently with cool water.
Tell your doctor right away if you have any serious side effects, including: swollen hands/ankles/feet, fainting, pale skin, easy/unusual bruising/bleeding, sudden weight gain, signs of a loss of too much body water (e.g., decreased urination, increased thirst, dry mouth).
Ixabepilone can sometimes affect how your nerves work (peripheral neuropathy). Tell your doctor immediately if you develop pain/burning/numbness/tingling of the hands/feet.
You may lessen these types of nerve problems by avoiding cold drinks and ice and by dressing warmly. Tell your doctor immediately if your nerve problems begin to interfere with your normal daily activities (e.g., walking, writing, eating).
Treatment with ixabepilone may sometimes cause your hands/feet to develop a skin reaction called hand-foot syndrome (palmar-plantar erythrodysesthesia), especially when this drug is given with capecitabine. You can prevent or reduce these problems by protecting your hands and feet from a great deal of heat or pressure. Avoid unnecessary exposure to heat (e.g., hot dishwater, long hot baths). Avoid pressure on elbows, knees, and soles of feet (e.g., leaning on elbows, kneeling, long walks). Wear loose clothing. Depending on how severe your hand-foot syndrome is, your doctor may prescribe a medication to reduce the symptoms or decrease/delay your next treatment. If you experience pain/swelling/redness, blisters, or numbness of the hands/feet that affects your usual activities, tell your doctor immediately.
Get medical help right away if any of these rare but very serious side effects occur: fast/irregular heartbeat, shortness of breath, chest pain, bloody/black stools, vomit that looks like coffee grounds, vision changes, seizures, sudden confusion.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), face flushing, tight feeling in chest, severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Read the entire patient information overview for Ixempra (Ixabepilone)»
What is Prescribing information?
The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.
Ixempra FDA Prescribing Information: Side Effects
The following adverse reactions are discussed in greater detail in other sections.
- Peripheral neuropathy [see WARNINGS AND PRECAUTIONS]
- Myelosuppression [see WARNINGS AND PRECAUTIONS]
- Hypersensitivity reactions [see WARNINGS AND PRECAUTIONS]
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, the adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in other clinical trials and may not reflect the rates observed in clinical practice.
Unless otherwise specified, assessment of adverse reactions is based on one randomized study (Study 046) and one single-arm study (Study 081). In Study 046, 369 patients with metastatic breast cancer were treated with IXEMPRA 40 mg/m² administered intravenously over 3 hours every 21 days, combined with capecitabine 1000 mg/m² twice daily for 2 weeks followed by a 1-week rest period. Patients treated with capecitabine as monotherapy (n=368) in this study received 1250 mg/m² twice daily for 2 weeks every 21 days. In Study 081, 126 patients with metastatic or locally advanced breast cancer were treated with IXEMPRA 40 mg/m² administered intravenously over 3 hours every 3 weeks.
The most common adverse reactions ( ≥ 20%) reported by patients receiving IXEMPRA were peripheral sensory neuropathy, fatigue/asthenia, myalgia/arthralgia, alopecia, nausea, vomiting, stomatitis/mucositis, diarrhea, and musculoskeletal pain. The following additional reactions occurred in ≥ 20% in combination treatment: palmar-plantar erythrodysesthesia (hand-foot) syndrome, anorexia, abdominal pain, nail disorder, and constipation. The most common hematologic abnormalities ( > 40%) include neutropenia, leukopenia, anemia, and thrombocytopenia.
Table 4 presents nonhematologic adverse reactions reported in 5% or more of patients. Hematologic abnormalities are presented separately in Table 5.
Table 4: Nonhematologic Drug-related Adverse Reactions Occurring
in at Least 5% of Patients with Metastatic or Locally Advanced Breast Cancer
Treated with IXEMPRA
|System Organ Classa/Preferred Term||Study 046||Study 081|
|IXEMPRA with capecitabine n=369||Capecitabine n=368||IXEMPRA monotherapy n=126|
|Total (%)||Grade 3/4 (%)||Total (%)||Grade 3/4 (%)||Total (%)||Grade 3/4 (%)|
|Infections and Infestations|
|Upper respiratory tract infectionb||4||0||3||0||6||0|
|Blood and Lymphatic System Disorders|
|Immune System Disorders|
|Metabolism and Nutrition Disorders|
|Nervous System Disorders|
|Motor neuropathyb||16||5d||< 1||0||10||1d|
|Lacrimation increased||5||0||4||< 1d||4||0|
|Respiratory, Thoracic, and Mediastinal Disorders|
|Gastroesophageal reflux diseaseb||7||1d||8||0||6||0|
|Skin and Subcutaneous Tissue Disorders|
|Nail disorderb||24||2d||10||< 1d||9||0|
|Palmar-plantar erythrodysesthesia syndromeb,f||64||18d||63||17d||8||2d|
|Skin exfoliationb||5||< 1d||3||0||2||0|
|Musculoskeletal, Connective Tissue, and Bone Disorders|
|General Disorders and Administrative Site Conditions|
|Chest painb||4||1d||< 1||0||5||1d|
|a System organ class presented
as outlined in Guidelines for Preparing Core Clinical Safety Information
on Drugs by the Council for International Organizations of Medical Sciences
b A composite of multiple MedDRA Preferred Terms.
c NCI CTC grading for febrile neutropenia ranges from Grade 3 to 5. Three patients (1%) experienced Grade 5 (fatal) febrile neutropenia. Other neutropenia-related deaths (9) occurred in the absence of reported febrile neutropenia [see WARNINGS AND PRECAUTIONS].
d No grade 4 reports.
e Peripheral sensory neuropathy (graded with the NCI CTC scale) was defined as the occurrence of any of the following: areflexia, burning sensation, dysesthesia, hyperesthesia, hypoesthesia, hyporeflexia, neuralgia, neuritis, neuropathy, neuropathy peripheral, neurotoxicity, painful response to normal stimuli, paresthesia, pallanesthesia, peripheral sensory neuropathy, polyneuropathy, polyneuropathy toxic and sensorimotor disorder. Peripheral motor neuropathy was defined as the occurrence of any of the following: multifocal motor neuropathy, neuromuscular toxicity, peripheral motor neuropathy, and peripheral sensorimotor neuropathy.
f Palmar-plantar erythrodysesthesia (hand-foot syndrome) was graded on a 1-3 severity scale in Study 046.
Table 5: Hematologic Abnormalities in Patients with Metastatic
or Locally Advanced Breast Cancer Treated with IXEMPRA
|IXEMPRA with capecitabine n=369||Capecitabine n=368||IXEMPRA monotherapy n=126|
|Grade 3 (%)||Grade 4 (%)||Grade 3 (%)||Grade 4 (%)||Grade 3 (%)||Grade 4 (%)|
|a G-CSF (granulocyte colony stimulating factor) or GM-CSF (granulocyte macrophage stimulating factor) was used in 20% and 17% of patients who received IXEMPRA in Study 046 and Study 081, respectively.|
The following serious adverse reactions were also reported in 1323 patients treated with IXEMPRA as monotherapy or in combination with other therapies in Phase 2 and 3 studies.
Blood and Lymphatic System Disorders: coagulopathy, lymphopenia
Hepatobiliary Disorders: acute hepatic failure, jaundice
Skin and Subcutaneous Tissue Disorders: erythema multiforme
Musculoskeletal, Connective Tissue Disorders, and Bone Disorders: muscular weakness, muscle spasms, trismus
Renal and Urinary Disorders: nephrolithiasis, renal failure
General Disorders and Administration Site Conditions: chills
Investigations: increased transaminases, increased blood alkaline phosphatase, increased gamma-glutamyltransferase
Radiation recall has been reported during postmarketing use of IXEMPRA. Because this reaction was reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate the frequency or establish a causal relationship to drug exposure.
Read the entire FDA prescribing information for Ixempra (Ixabepilone) »
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