What Is Ixabepilone (Ixempra)? Use and Side Effects – Breast Cancer Treatment

• Active ingredient: Ixabepilone
• Brand name: Ixempra

How Does Ixabepilone Work?

Ixabepilone is an antimicrotubule chemotherapy drug. It acts on the cell division cycle. Microtubules form the cell’s skeleton, and during mitosis chromosomes attach to these structures and move. Ixabepilone binds to part of a microtubule, affecting its structure and function in the cell. This stabilizes microtubule function and prevents the cell from continuing its division cycle, causing the cancer cell to die.

What Is the Aim of Ixabepilone Treatment?

Ixabepilone is designed to kill cancer cells or control the disease by slowing their growth. In 2007, for patients previously given multiple treatments (anthracycline, taxane and capecitabine) whose disease progressed during these treatments, for the treatment of breast cancer treatment, it received FDA approval.

Administration, Dose and Schedule

Ixabepilone 40 mg/m2 is administered on day 1 intravenously (intraVenous = İ.V.), slowly over 3 hours in the first cycle, every 21 days. Administering medication intravenously over a specified period in this way is called an infusion.

Estimated Total Duration of Ixabepilone Treatment

• To minimize allergic reactions that may occur during ixabepilone administration, pheniramine (Avil) and ranitidine (Ranitab) are given before treatment begins.
• Ixabepilone administration may take up to 5 hours. If infusion-related reactions occur, the infusion may need to be stopped.
• Infusion times are based on clinical research but may vary according to physician preference or how well the patient tolerates treatment. Premedications and fluid support may add more time.
• Ixabepilone treatment is generally administered in outpatient chemotherapy units, with patients returning home after treatment.
• Ixabepilone treatment is repeated every 21 days (3 weeks). This interval is known as 1 cycle. Depending on your physician’s recommendation, treatment continues until the drug’s benefit ends and unwanted side effects begin to appear.

What Are the Side Effects of Ixempra?

The following side effects occur in more than 30 percent of patients:

• In the hands and feet, neuropathy: Although rare, this is a serious side effect. Loss of sensation, numbness, tingling and difficulty walking may occur as treatment continues. These effects may become progressively more severe with continued treatment. Your doctor may therefore decide to reduce your dose.
• Weakness
• Muscle and joint pain
• Hair loss
• Nausea and vomiting
• A decrease in white blood cell count (neutropenia) The following side effects occur in approximately 10-29 percent:
• Mouth sores
• Diarrhea
• Muscle and joint pain
• Loss of appetite
• Constipation
• Abdominal pain
• Headache

*Always inform your physician if an unexpected side effect occurs.

How Often Is Monitoring Needed?

Blood tests must be checked before every chemotherapy cycle. Required tests are a complete blood count and a comprehensive metabolic panel (biochemistry). Other blood tests may be added according to the physician’s recommendation.

How Often Is Imaging (Radiological Examination) Needed?

Imaging is performed before treatment and then at intervals to assess the treatment response. Magnetic resonance imaging (MRI), positron emission tomography (PET) and computed tomography (CT) scans are the imaging procedures used.

How Do Blood Test or Imaging Results Affect Treatment?

Depending on the results, your doctor may continue ixabepilone as planned, adjust its dose or change treatment.

Points to Consider During Ixempra Treatment

• Ixempra, containing ixabepilone, is not authorized in our country. It is supplied by the Turkish Pharmacists’ Association’s overseas drug procurement unit. During procurement, your physician and team, on your behalf, submit to the Turkish Medicines and Medical Devices Agency (TITCK) an off-label application. Information about patients approved by TITCK to use the drug is sent through the system to the requesting physician. After approval, your physician prepares a medical report and prescription for you. When the patient or a relative applies with these documents to Turkish Pharmacists’ Association branches in Istanbul or Ankara, the prescribed quantity is delivered to the address under cold-chain conditions to prevent deterioration. Once the drug arrives, store it in your refrigerator door compartment and bring to the hospital the amount your physician specifies before each treatment.
• Before starting ixabepilone treatment, make sure you tell your doctor about your other medications. Your oncology pharmacist should check for interactions between drugs.
• While taking ixabepilone, unless otherwise instructed, every 24 hours (particularly from 24 hours before until 48 hours after infusion), you should drink at least 2-3 liters of fluids.
• Do not drink grapefruit juice while taking ixabepilone. Grapefruit juice increases ixabepilone levels in the blood, increasing the likelihood of other side effects.
• You may be at risk of infection, so avoid crowded places and people who may transmit illness.
• Wash your hands frequently 
• To help treat/prevent mouth sores while taking ixabepilone, use a soft toothbrush. Add 1 dessertspoon of baking soda to a glass of water and rinse your mouth with this solution 3 times a day. This mouthwash prevents mouth sores.
• To reduce nausea, take antinausea medication as your doctor recommends and eat small, frequent meals while taking ixabepilone.
• Avoid sunlight. Use protection factor 15 (or higher) sunscreen and wear protective clothing.
• Do not consume alcohol while taking ixabepilone. If you have difficulty stopping alcohol, discuss this with your doctor.
• Do not become pregnant while taking ixabepilone. Discuss with your doctor or nurse which type of birth control will be safe for you.
• Do not breastfeed during ixabepilone treatment.

Related Topics:

- Information about pregnancy and breastfeeding during and after breast cancer

- All chemotherapy regimens