Ixabepilone | Side Effects, Dosage, Uses & More
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Generic Name:

ixabepilone, Injectable solution

All Brands

  • Ixempra
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Highlights for ixabepilone

Injectable solution
1

Ixabepilone is an injected medication used to treat breast cancer.

2

This drug is used after certain medications don’t work or stop working. It may be used in combination with a drug called capecitabine after the drugs anthracycline and taxane haven’t worked. Or, it may be used alone after the drugs anthracycline, taxane, and capecitabine haven’t worked.

3

Ixabepilone is given by an injection directly into your vein (intravenous infusion) at a clinic or hospital. You won’t take this drug at home.

4

If you have liver problems, you shouldn’t receive ixabepilone with capecitabine. Taking these two drugs together if you have liver problems increases your chance of serious infections due to a very low white blood cell count (neutropenia). This can be fatal.

5

You shouldn’t drink grapefruit juice or eat grapefruit while receiving ixabepilone. Grapefruit can cause you to have too much ixabepilone in your blood. This may cause side effects.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to drug effects that may be dangerous.

Liver problems warning. Your doctor should do blood tests to check your liver function before starting and during treatment with ixabepilone. If you have liver problems, you shouldn’t receive ixabepilone with capecitabine. Taking these two drugs together if you have liver problems increases your risk of serious side effects. It also raises your risk of infections due to a very low white blood cell count (neutropenia). This can be fatal.

Neuropathy

You may feel numbness, tingling, or burning in your hands or feet (neuropathy) while receiving ixabepilone. This may be more likely to happen early during your treatment with ixabepilone. Tell your doctor if you have signs of neuropathy. You may need a lower dose or you may need to stop taking this drug.

Low white blood cell count

Treatment with ixabepilone may cause low levels of white blood cells (leukopenia). This includes low levels of certain white blood cells that help protect the body from infection (neutropenia). If you get an infection when your white blood cells are low, you can become very sick. You may need treatment in the hospital. These infections can even be fatal. Tell your doctor right away if you have symptoms of an infection, including:

  • fever above 100.5°F (38.05°C)
  • chills
  • cough
  • burning or pain when you urinate

Heart problems

Ixabepilone may decrease blood flow to the heart and cause problems with heart function or an abnormal heart rate. This is more likely to happen if you also take capecitabine. Tell your doctor right away if you have any of the following symptoms:

  • chest pain
  • trouble breathing
  • abnormal heart rhythm (palpitations)
  • unexplained weight gain

What is ixabepilone?

Ixabepilone is a prescription drug. It is available as an intravenous (IV) solution. It is only given by a healthcare provider.

Ixabepilone is a generic drug. It’s also available as a brand-name drug called Ixempra. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. Talk to your doctor to see if the generic version will work for you.

This drug may be used as part of a combination therapy. That means you need to take it with another drug called capecitabine.

Why it's used

Ixabepilone is used to treat breast cancer that is metastatic (has spread to other parts of the body) or locally advanced.

More Details

How it works

Ixabepilone belongs to a drug class called microtubule inhibitors. A class of drugs is a group of medications that work in a similar way.

More Details

Why it's used

Ixabepilone is used to treat breast cancer that is metastatic (has spread to other parts of the body) or locally advanced. It can be used in two ways:

  • In combination with a drug called capecitabine after certain drugs (an anthracycline and a taxane) don’t work or stop working
  • As a single drug treatment after certain drugs (an anthracycline, a taxane, and capecitabine) don’t work or stop working

How it works

Ixabepilone belongs to a drug class called microtubule inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Ixabepilone works by blocking cancer cells in the dividing (mitotic) phase of the cell growth cycle. This causes the cells to die.

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ixabepilone Side Effects

Injectable solution

Most Common Side Effects

The more common side effects that can occur with ixabepilone include:

  • tiredness

  • weakness

  • loss of appetite

  • toenail or fingernail problems (such as nail color changes, lines on the nails, slowed growth, or nail loss)

  • hair loss

  • fever

  • decreased red blood cell count (anemia). This can cause:

    • shortness of breath
    • dizziness
    • pale skin
  • joint and muscle pain

  • headache

  • decreased platelets (thrombocytopenia). This can cause:

    • increased bleeding from cuts
    • nosebleeds
    • bleeding gums
    • frequent bruising
  • gastrointestinal problems, such as:

    • nausea
    • vomiting
    • diarrhea
    • constipation
    • abdominal pain
  • sores on your lip, in your mouth, or in your esophagus

  • hand-foot syndrome. Symptoms on your palms and soles of your feet can include:

    • tenderness
    • redness that looks like sunburn
    • dry and peeling skin
    • numbness and tingling

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Neuropathy in your hands or feet. Symptoms can include:

    • numbness, tingling, or burning
    • increased or decreased feeling
  • Low white blood cell count (neutropenia). Symptoms can include signs of infection, such as:

    • fever above 100.5°F (38.05°C)
    • chills
    • cough
    • burning or pain when you urinate
  • Allergic reaction. Symptoms can include:

    • itching, hives (raised itchy welts), or skin rash
    • redness in your face (flushing)
    • sudden swelling of your face, throat, or tongue
    • chest tightness
    • trouble breathing
    • feeling dizzy or faint
    • abnormal heart rhythm (palpitations)
  • Heart problems. Symptoms can include:

    • chest pain
    • trouble breathing
    • abnormal heart rhythm (palpitations)
    • unexplained weight gain
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Ixabepilone may cause drowsiness. Avoid activities that require you to be alert, such as driving or using machinery, until you know how this drug affects you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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ixabepilone May Interact with Other Medications

Injectable solution

Ixabepilone can interact with other medications, herbs, or vitamins you might be taking. Your healthcare provider will look out for interactions with your current medications. Always be sure to tell your doctor about all medications, herbs or vitamins you’re taking.

Food interactions

Don’t drink grapefruit juice or eat grapefruit while receiving ixabepilone. Grapefruit can cause you to have too much ixabepilone in your body. This can lead to side effects.

Alcohol interaction

Alcohol can worsen side effects of this drug, such as dizziness or drowsiness. Avoid doing things that require alertness, such as driving or using machinery, until you know how this drug affects you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Ixabepilone warnings
liver disease
People with liver disease

Liver disease raises your risk of side effects from ixabepilone. These include serious infections due to a very low white blood cell count (leukopenia). This can be fatal. This risk is higher if you are also taking capecitabine.

people with heart disease
People with heart disease

Your doctor will likely monitor you closely while taking ixabepilone. This is because this drug can cause decreased blood flow to the heart, problems with heart function, and an abnormal heart rate. Your risk may be higher if you also take capecitabine.

people with neuropathy
People with neuropathy

If you have neuropathy, it may get worse. This may be more likely to happen early during your treatment with ixabepilone.

pregnant women
Pregnant women

Ixabepilone is a category D pregnancy drug. This means two things:

  1. Studies show a risk of adverse effects to the fetus when the mother takes the drug.
  2. The benefits of taking the drug during pregnancy may outweigh the potential risks in certain cases.

Ixabepilone may harm your unborn baby. You shouldn’t become pregnant when taking ixabepilone. Ask your doctor about using effective birth control while you’re taking ixabepilone.

Tell your doctor if you’re pregnant or plan to become pregnant. Ixabepilone should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

breastfeeding
Women who are breast-feeding

It isn’t known if ixabepilone passes into breast milk. If it does, it may cause serious effects in a breastfeeding child.

You and your doctor may need to decide if you’ll take ixabepilone or breastfeed.

for children
For children

The safety and effectiveness of ixabepilone hasn’t been established in people younger than 18 years.

allergies
Allergies

Serious allergic reactions can occur with ixabepilone. To lower your chance of an allergic reaction, you’ll receive other medications about 1 hour before each treatment with ixabepilone.

Symptoms of an allergic reaction with ixabepilone can include:

  • itching, hives (raised itchy welts), and skin rash
  • reddening of your face (flushing)
  • sudden swelling of your face, throat, or tongue
  • chest tightness
  • trouble breathing
  • feeling dizzy or faint
  • abnormal heart rhythm (palpitations)

If you have a reaction, call your doctor right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

If you’ve had an allergic reaction to this drug before, your doctor may give you steroids before giving it to you again. Your doctor may also administer the drug slowly. If your allergic reaction was severe, your doctor may switch you to a different drug.

Don’t receive injections of ixabepilone if you’re allergic to a medication, such as Taxol, that contains Cremophor EL or polyoxyethylated castor oil.

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How to Take ixabepilone (Dosage)

Injectable solution

Your doctor will determine a dose that’s right for you based on your height and weight. Your general health may affect your dose. Tell your doctor about all health conditions you have before your doctor or nurse administers the drug to you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Ixabepilone comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your breast cancer may get worse.

If you miss doses or appointments

It’s very important to stay on schedule with your infusions. If you miss your appointment, call your doctor right away.

If you take too much

Because this medication is only given by a healthcare worker, it is rare to receive too much. If you do receive too much, symptoms would include more severe side effects than you would have had for previous infusions. These could include:

  • gastrointestinal symptoms such as nausea, loss of appetite, diarrhea, or abdominal pain
  • numbness, tingling, or burning in your hands or feet (neuropathy)
  • tiredness
  • muscle pain

Let your doctor and nurse know if you think you have received too much of this drug. They will monitor you more closely and provide supportive care as needed.

How to tell the drug is working

Your doctor will monitor you closely and let you know if this drug is working.

Ixabepilone is a long-term drug treatment.

How long does it take?

It takes about 3 hours to receive your medication. Your appointment may take longer though. Your doctor may want to observe you after the injection to watch for any reactions.

Can I drive home after?

Ixabepilone may cause drowsiness. You may need a ride home or help leaving the doctor’s office.

Travel

Ixabepilone is given in the hospital or at your doctor’s office. You should plan your travel around your ixabepilone schedule. Talk to your doctor when you’re planning your trip.

Your doctor may do additional tests

Before starting and during your treatment with ixabepilone, your doctor should do blood tests to check your liver function.

Clinical monitoring

During treatment with ixabepilone, your doctor may do tests to check your:

  • liver function
  • white blood cell count, red blood cell count, and platelets
  • heart rate and rhythm
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How Much Does ixabepilone Cost?

Injectable solution

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on August 24, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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