Why is this medication prescribed?

Pepaxto (melphalan flufenamide) is a medication used in the treatment of multiple myeloma, a type of cancer that affects plasma cells in the bone marrow. Multiple myeloma is a cancer of the plasma cells, which are a type of white blood cell that produces antibodies to help the body fight infection.

Pepaxto is a peptide-drug conjugate that delivers melphalan, a chemotherapy drug, to cancer cells. It is used in combination with the corticosteroid dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least four prior lines of therapy and whose disease is refractory to at least one proteasome inhibitor, one immunomodulatory agent, and one CD38-directed monoclonal antibody.

How should this medicine be used?

Here are some general guidelines for the use of Pepaxto:

• Administration: Pepaxto is administered intravenously (IV), which means it is given directly into a vein. The infusion is typically done by a healthcare professional in a clinical setting, such as a hospital or a specialized infusion center.
• Dosage: The dosage of Pepaxto can vary depending on factors such as the patient’s overall health, weight, and other medical conditions. Your healthcare provider will determine the appropriate dosage for your specific situation.
• Frequency: Pepaxto is often given in cycles, with a period of treatment followed by a rest period. The specific schedule and duration of treatment will be determined by your healthcare provider.
• Pre-treatment: Before starting Pepaxto, your healthcare team may administer pre-medications to help manage potential side effects, such as nausea or allergic reactions. It’s essential to follow their instructions regarding these pre-medications.
• Monitoring: During treatment, your healthcare team will monitor your response to Pepaxto and assess for any potential side effects. Regular blood tests and other diagnostic tests may be conducted to ensure the medication is working effectively and to manage any adverse effects.
• Side Effects: Like any medication, Pepaxto may cause side effects. Common side effects can include fatigue, nausea, vomiting, diarrhea, low blood cell counts, and others. It’s important to report any side effects promptly to your healthcare provider.
• Follow-up: After completing a cycle of Pepaxto, you will likely have follow-up appointments with your healthcare provider to assess your response to treatment and determine the next steps in your care.

Always consult with your oncologist or healthcare provider for personalized advice regarding the use of Pepaxto, as individual circumstances can vary. They will provide you with the most accurate information based on your specific medical history and current health status.

Other uses for this medicine

Pepaxto is primarily indicated for the treatment of relapsed or refractory multiple myeloma. Its use is specific to this condition, and it is not commonly prescribed for other purposes. Always consult with your healthcare provider for the most current and accurate information on Pepaxto’s uses.

What special precautions should I follow?

Here are some general precautions and considerations associated with the use of Pepaxto:

• Medical History: Inform your healthcare provider about your complete medical history, including any pre-existing conditions, allergies, or previous reactions to medications.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, it’s crucial to discuss this with your healthcare provider. Pepaxto may have potential risks to a developing fetus, and appropriate precautions or alternative treatments may need to be considered.
• Blood Cell Counts: Pepaxto can affect blood cell counts, including white blood cells, red blood cells, and platelets. Regular blood tests will likely be conducted to monitor these counts during treatment.
• Infections: Due to the potential impact on the immune system, there may be an increased risk of infections. Inform your healthcare provider if you experience any signs of infection, such as fever, chills, or persistent cough.
• Liver and Kidney Function: Pepaxto can affect liver and kidney function. Your healthcare provider may monitor these functions through blood tests.
• Cardiac Function: Individuals with pre-existing cardiac conditions may require special monitoring during Pepaxto treatment. Inform your healthcare provider about any heart-related issues.
• Concomitant Medications: Inform your healthcare provider about all the medications, vitamins, and supplements you are taking, as certain drugs may interact with Pepaxto.
• Infusion Reactions: Some individuals may experience infusion-related reactions during or shortly after receiving Pepaxto. Your healthcare provider will monitor you for any signs of such reactions and provide appropriate interventions if needed.
• Secondary Cancers: There is a potential risk of developing secondary cancers with the use of certain cancer treatments, including Pepaxto. Discuss this risk with your healthcare provider.

Remember, these precautions are general in nature, and individual circumstances may vary. Always follow your healthcare provider’s specific recommendations and guidelines for the use of Pepaxto, and inform them of any changes in your health or any side effects you may be experiencing.

What special dietary instructions should I follow?

There are no specific dietary instructions widely associated with Pepaxto. However, it’s important to maintain a balanced and nutritious diet to support overall health. If you have specific dietary concerns or restrictions, discuss them with your healthcare provider or a registered dietitian.

What should I do if I forget a dose?

If you miss a dose of Pepaxto, it’s crucial to contact your healthcare provider immediately for guidance. The management of missed doses may depend on various factors, including the timing of the next scheduled dose, the reason for the missed dose, and the individual patient’s overall treatment plan.

What side effects can this medication cause?

Pepaxto (melphalan flufenamide) is a medication used in the treatment of multiple myeloma. Like many medications, Pepaxto can cause side effects. It’s important to note that not everyone will experience these side effects, and the severity can vary from person to person. Additionally, your healthcare provider will closely monitor you during treatment to manage any side effects that may occur. Common side effects associated with Pepaxto may include:

• Hematologic Effects: Low blood cell counts (anemia, leukopenia, thrombocytopenia): This can lead to fatigue, increased risk of infections, and easy bruising or bleeding.
• Gastrointestinal Effects:
  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
• Fatigue: Feeling tired or weak is a common side effect.
• Peripheral Neuropathy: Numbness, tingling, or pain in the hands or feet.
• Fever: Some individuals may experience fever.
• Respiratory Issues: Cough or shortness of breath.
• Infusion-Related Reactions: Some patients may experience reactions during or shortly after the infusion, such as fever, chills, or difficulty breathing.
• Hepatic (Liver) Effects: Elevated liver enzymes may occur.
• Renal (Kidney) Effects: Changes in kidney function may occur.
• Cardiac Effects: Fluid retention, heart failure, and other cardiac issues are possible, especially in individuals with pre-existing heart conditions.
• Secondary Malignancies: There is a potential risk of developing secondary cancers with the use of certain cancer treatments, including Pepaxto.

It’s crucial to promptly report any unusual or severe side effects to your healthcare provider. They can provide guidance on managing side effects and may adjust your treatment plan if needed.

Remember that this list is not exhaustive, and individual experiences may vary. Your healthcare provider will discuss the potential risks and benefits of Pepaxto with you before starting treatment and will closely monitor your response throughout the course of therapy. If you have specific concerns about Pepaxto or its side effects, discuss them with your healthcare team for personalized guidance.

What should I know about storage and disposal of this medication?

Storage and Disposal of Pepaxto:

Storage:

• Temperature: Store Pepaxto as directed by your healthcare provider or pharmacist. It may need to be stored at a specific temperature. Typically, many medications are stored at room temperature, but confirm this with your provider.
• Protect from Light: Some medications can be sensitive to light. Check if Pepaxto should be stored away from direct light.
• Secure Location: Keep Pepaxto in a secure location, out of reach of children and pets.

Disposal:

• Disposal Instructions: Follow your healthcare provider’s or pharmacist’s instructions for the proper disposal of Pepaxto. Do not dispose of it in household trash without specific guidance.
• Unused Medication: If you have any unused Pepaxto or leftover medication, consult with your healthcare provider or pharmacist on the appropriate disposal method.

In case of emergency/overdose

• Seek Medical Attention: In case of an overdose or emergency, seek immediate medical attention by calling your local emergency number.
• Symptoms of Overdose: Symptoms of an overdose may include increased severity of side effects. It’s essential to report any unusual symptoms or reactions to your healthcare provider promptly.

What other information should I know?

• Regular Follow-ups: Attend all scheduled appointments with your healthcare provider for regular check-ups and monitoring during Pepaxto treatment.
• Inform Healthcare Providers: Make sure that all healthcare providers you see are aware that you are taking Pepaxto. This includes dentists, surgeons, and other specialists.
• Medication Interactions: Inform your healthcare provider about all the medications, vitamins, and supplements you are taking, as Pepaxto may interact with other drugs.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss this with your healthcare provider. Pepaxto may have specific considerations during pregnancy and lactation.
• Side Effect Management: Be aware of common side effects and know how to manage them. Report any unusual or severe side effects to your healthcare provider.
• Patient Education Materials: Your healthcare provider or pharmacist may provide you with educational materials about Pepaxto. Make sure to read and understand this information.

Always consult with your healthcare provider or pharmacist for the most accurate and up-to-date information regarding the storage, disposal, and emergency procedures for Pepaxto based on your specific situation.