If you’ve been diagnosed with multiple myeloma, your doctor may suggest Ninlaro as a treatment option for you. It’s a prescription medication used in adults who’ve already tried at least one other treatment for this condition. It’s taken with two other medications for multiple myeloma.

Ninlaro comes as a capsule you take by mouth. It contains the active ingredient ixazomib. (This is what makes the drug work.) Ninlaro belongs to a group of medications called proteasome inhibitors.

This article describes the dosages of Ninlaro, as well as its form, strengths, and how to take it. To learn more about Ninlaro, see this in-depth article.

Note: This article covers Ninlaro’s typical dosages, which are provided by the drug’s manufacturer. But when using Ninlaro, always take the dosage your doctor prescribes.

This article describes the typical dosages of Ninlaro. But your doctor will determine your dosing schedule (how much and how often you’ll take the drug).

You’ll likely take Ninlaro together with two other medications for multiple myeloma. Your doctor will tell you more about these drugs, including their recommended dosages.

What is the form of Ninlaro?

Ninlaro comes as a capsule you take by mouth.

What strengths does Ninlaro come in?

Ninlaro is available in the following strengths:

  • 2.3 milligram (mg)
  • 3 mg
  • 4 mg

What are the typical dosages of Ninlaro?

The typical starting dose of Ninlaro is 4 mg. You’ll take this dose once per week for 3 weeks (as close to the same day and time each week as possible). Then you’ll take 1 week off.

You’ll follow this 4-week schedule for as long as your doctor recommends that you take Ninlaro.

Depending on how well your body breaks down this medication, your doctor may prescribe a lower dose. Ultimately, they’ll prescribe the lowest dose that provides the desired effect. Always be sure to take the dosage your doctor prescribes for you.

Is Ninlaro taken long term?

Yes. If you and your doctor determine it’s safe and effective for you, you’ll likely take Ninlaro long term.

Dosage adjustments

In certain cases you may need a dose adjustment of Ninlaro. Your doctor may recommend a dose reduction if you have negative side effects, or if you have liver or kidney problems.

If you have liver problems, your doctor may decrease your dose of Ninlaro. Liver problems can cause your body to take longer to break down this medication. This could increase the level of drug in your body, which could increase your risk for side effects.

If you have serious kidney problems, your doctor may prescribe a lower dose of Ninlaro based on renal dosing guidelines. Renal (kidney-related) problems can cause your kidneys to take longer to remove this medication from your body. This too could increase the level of drug in your body, which could increase your risk for side effects.

Your doctor will monitor how you respond to treatment and discuss any needed dosing changes with you.

If you miss a dose of Ninlaro, and it’s:

  • 72 hours or more until your next scheduled dose, take the missed dose
  • less than 72 hours until your next dose, skip the missed dose and take your next dose at its scheduled time

Do not take two doses of Ninlaro at once. This may increase your risk of side effects.

If you miss more than one dose of Ninlaro, talk with your doctor. They’ll give you guidance on what to do.

If you need help remembering to take your dose of Ninlaro on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

Your dosage of Ninlaro may depend on other health conditions you have that affect how Ninlaro works in your body.

Your doctor will check your liver and kidney function before you start and during your treatment with Ninlaro. If you have kidney or liver problems, your doctor may start you on a lower dose of Ninlaro to reduce your risk of side effects. If you develop liver or kidney problems while taking Ninlaro, they may reduce your dose.

Ninlaro comes as a capsule you swallow. You’ll take your dose with a glass of water on an empty stomach either 1 hour before meals or 2 hours after you eat.

You should not break, crush, or chew Ninlaro capsules. This can affect how it works. If you get Ninlaro powder on your hands or other parts of your body, wash the area with soap and water right away.

For information on Ninlaro expiration, storage, and disposal, see this article.

Accessible drug containers and labels

If you have trouble reading the prescription label on your medication, tell your doctor or pharmacist. Some pharmacies provide medication labels that:

  • have large print or use braille
  • feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

If you have trouble opening medication bottles, let your pharmacist know. They may be able to supply Ninlaro in an easy-open container. Your pharmacist may also have some tips that can help make it simpler to open the drug’s container.

Do not take more Ninlaro than your doctor prescribes. Taking more than this can lead to serious side effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

Taking too much Ninlaro can also result in death. It’s extremely important to always take this medication exactly as prescribed.

What to do in case you take too much Ninlaro

Call your doctor right away if you think you’ve taken too much Ninlaro. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. If you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room.

The sections above describe the typical dosages provided by the drug manufacturer. If your doctor recommends Ninlaro for you, they’ll prescribe the dosage that’s right for you.

Remember, you shouldn’t change your dosage of Ninlaro without your doctor’s recommendation. Only take Ninlaro exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • Will a lower dose of Ninlaro still work for my condition?
  • What if I vomit up my dose of Ninlaro?
  • Will my dose be increased if the current dose isn’t working for me?


Will my Ninlaro dose be less effective if I take it with food?



It’s possible.

Taking Ninlaro with food can reduce the amount of the drug that’s absorbed (taken in) by your body. This could make Ninlaro less effective for treating your condition.

For this reason, it’s important to take Ninlaro on an empty stomach. This means you’ll take the drug at least 1 hour before or 2 hours after you eat.

If you have other questions about taking Ninlaro with food, talk with your doctor.

Amber Watson, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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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 another 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.