If you have a certain type of cancer, your doctor might suggest Ninlaro (ixazomib) as a treatment option for you. Learning about the possible side effects of this drug can help you decide if it’s a good option for you.

Ninlaro is a prescription medication that’s used to treat multiple myeloma (a rare type of cancer) in certain situations. It’s used for this purpose in adults.

Ninlaro comes as a capsule that you swallow. It’s typically used as a long-term treatment. For more information about Ninlaro, including details about its uses, see this in-depth article.

Like other drugs, Ninlaro can cause mild or serious side effects. Read on to learn more.

Some people may experience mild or serious side effects during their Ninlaro treatment.

Examples of Ninlaro’s commonly reported side effects may include:

* To learn more about this side effect, see the “Side effects explained” section below.

These aren’t all the side effects Ninlaro may cause. Read on to learn about other possible mild and serious side effects of the drug.

Ninlaro can cause mild side effects.

Examples of mild side effects that have been reported with Ninlaro include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And don’t stop using Ninlaro unless your doctor recommends it.

Ninlaro may cause mild side effects other than the ones listed above. See the Ninlaro patient information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Ninlaro, visit MedWatch.

Ninlaro may cause rare but serious side effects.

Serious side effects that have been reported with Ninlaro include:

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after using Ninlaro. But this side effect wasn’t reported in studies.

If you develop serious side effects while taking Ninlaro, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Below are answers to some frequently asked questions about the side effects of Ninlaro.

How long does Ninlaro stay in your system?

Each dose of Ninlaro may stay in your system for about 47 days after you take it.

The length of time that Ninlaro’s side effects may last will vary from person to person. However, many of Ninlaro’s side effects are short term. They’ll usually go away within the first 3 months after you start taking the drug.

But it’s possible that some of Ninlaro’s side effects may last longer. If you have bothersome side effects from Ninlaro that don’t go away, talk with your doctor.

Does Ninlaro cause hair loss?

No, Ninlaro isn’t known to cause hair loss. This side effect wasn’t reported in studies of the drug.

But cancer drugs other than Ninlaro can cause this side effect. For example, chemotherapy is known to cause hair loss.

Talk with your doctor if you’re concerned about hair loss from Ninlaro or other treatments you may be using for cancer. They can discuss your risk of this side effect, as well as ways to manage hair loss if it happens.

Can Ninlaro cause heart-related side effects?

Less commonly, Ninlaro may cause certain heart-related side effects.

For example, Ninlaro may cause thrombotic microangiopathy. With this condition, blood clots form in the small blood vessels of the body. In some cases, this can lead to a heart attack.

Ninlaro belongs to a group of drugs called proteasome inhibitors. And other drugs in this group may cause different heart-related side effects. For example, Velcade (bortezomib) and Kyprolis (carfilzomib) may cause heart problems, such as heart failure and abnormal heart rhythms.

If you’re concerned about your risk of heart-related side effects with Ninlaro, talk with your doctor.

Learn more about some of Ninlaro’s side effects.

Eye problems

Eye problems are a common side effect of Ninlaro. Examples of eye problems this drug may cause include dry eyes, blurry vision, or pink eye.

What might help

If you’re concerned about eye problems with Ninlaro, talk with your doctor. They can suggest ways to manage these side effects.

Peripheral neuropathy

Peripheral neuropathy is a common side effect of Ninlaro.

Peripheral neuropathy refers to nerve damage that leads to numbness, weakness, or pain. These symptoms usually happen in the feet, hands, legs, or arms.

Peripheral neuropathy may cause other symptoms as well. These include:

  • being unable to feel changes in heat or cold
  • ulcers (sores) or infections on your legs or feet
  • having a decreased or increased ability to feel pain

What might help

If you have symptoms of peripheral neuropathy, tell your doctor right away. They may adjust your dosage of Ninlaro or prescribe a different treatment for your condition.

Gastrointestinal problems

Gastrointestinal problems were some of the most commonly reported side effects during studies of Ninlaro. You may experience diarrhea, constipation, nausea, or vomiting while taking Ninlaro. Typically, these side effects are mild, but occasionally they can be more severe.

What might help

If these side effects continue, contact your doctor. They may prescribe medications that can help treat diarrhea, nausea, or vomiting. If your gastrointestinal problems are very severe, your doctor may stop your treatment with Ninlaro altogether.

Skin reactions

You may have skin reactions with Ninlaro.

Rash was a common skin reaction in studies of the drug. But skin rash may also be a sign of an allergic reaction, which can be a serious side effect of Ninlaro. (For details, see “Allergic reaction” just below.)

Less commonly, Ninlaro may also cause other serious skin conditions, including:

What might help

If you develop a rash while taking Ninlaro, tell your doctor right away. They’ll make sure your rash isn’t a sign of an allergic reaction or a more serious skin condition.

Allergic reaction

Like most drugs, Ninlaro can cause an allergic reaction in some people. But this side effect wasn’t reported in studies.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. To help manage symptoms, they may suggest an over-the-counter antihistamine you take by mouth, such as Benadryl (diphenhydramine). Or they may recommend a product you apply to your skin, such as hydrocortisone cream.

If your doctor confirms you had a mild allergic reaction to Ninlaro, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Ninlaro, they may have you switch to a different treatment.

Keeping track of side effects

During your Ninlaro treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of drug you were taking when you had the side effect
  • how soon after starting that dose you had the side effect
  • what your symptoms were from the side effect
  • how it affected your daily activities
  • what other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help your doctor learn more about how Ninlaro affects you. And your doctor can use this information to adjust your treatment plan if needed.

Ninlaro may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Ninlaro. The list below includes factors to consider.

  • Liver problems. Ninlaro may cause liver problems, such as fatty liver. If you already have liver problems, you may have a higher risk of these side effects. Before starting Ninlaro treatment, talk with your doctor about any liver problems you may have. They can advise if it’s safe for you to take Ninlaro. They may also need to prescribe you a lower dosage of Ninlaro.
  • Kidney problems. If you have kidney problems, be sure to tell your doctor before you start taking Ninlaro. They may give you a lower dosage of Ninlaro than they would if you didn’t have kidney problems.
  • Allergic reaction. If you’ve had an allergic reaction to Ninlaro or any of its ingredients, you should not take Ninlaro. Ask your doctor what other medications are better options for you.

Alcohol use and Ninlaro

There aren’t any known safety issues with drinking alcohol while taking Ninlaro.

But keep in mind that alcohol can cause side effects that are similar to those of Ninlaro. Examples include diarrhea, nausea, and vomiting. So drinking alcohol while taking Ninlaro could worsen these side effects.

If you drink alcohol, talk with your doctor about the amount that’s safe for you to drink while taking Ninlaro.

Pregnancy and breastfeeding while taking Ninlaro

It may not be safe to take Ninlaro during pregnancy or while breastfeeding. Ninlaro can cause harm to a fetus, so you should avoid becoming pregnant during treatment with the drug.

If you or your partner can become pregnant, you should use effective nonhormonal birth control while taking Ninlaro. And you should continue to use birth control for at least 90 days after your last dose of the drug.

If you use hormonal birth control, such as birth control pills, you should also use a barrier method of birth control. Examples include a diaphragm or a condom. You’ll also be given a pregnancy test before starting Ninlaro. If you think you may be pregnant while taking Ninlaro, tell your doctor right away.

It isn’t known if Ninlaro can pass into breast milk while breastfeeding or if it affects how your body produces breast milk. To be safe, you shouldn’t breastfeed while using Ninlaro and for at least 90 days after your last dose.

Before starting Ninlaro treatment, tell your doctor if you’re pregnant or planning a pregnancy. Also, tell them if you’re breastfeeding or if you plan to breastfeed. They’ll discuss your treatment options with you.

Ninlaro is a drug used to treat multiple myeloma (a rare type of cancer). Many of its side effects are mild, but it’s possible you may have serious side effects.

If you have questions about Ninlaro’s side effects, talk with your doctor or pharmacist. Below are a few questions you may want to ask:

  • How can I manage the side effects I might have with Ninlaro?
  • Will other drugs I’m taking increase my risk of side effects from Ninlaro?
  • What symptoms of shingles should I watch for while taking Ninlaro?


While I’m taking Ninlaro, will I need to have any lab tests to monitor for side effects from the drug?



Yes, you’ll need to have lab tests because you should be monitored closely for certain side effects while taking Ninlaro.

You’ll need to have regular blood tests. Your doctor will use these to monitor certain blood cell levels. For example, your doctor will check your platelet level and absolute neutrophil count. Low platelet levels can affect the ability of your body to form blood clots. Low neutrophil levels can increase your risk of infections.

The blood tests will also monitor your liver function by looking at liver enzyme levels. High liver enzyme levels may indicate liver damage.

In addition, blood tests will show how your multiple myeloma is responding to treatment.

You doctor will also monitor you for any signs of infection.

Tanya Kertsman, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Was this helpful?

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.