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Read about Z-DEX, a chemotherapy treatment that is also called I-DEX, and its possible side effects.

What it is

Z-DEX is a treatment for myeloma. Sometimes this drug combination is called I-DEX. It includes the drugs:

  • Idarubicin (Zavedos) – a chemotherapy drug
  • Dexamethasone – a steroid

How you have it

You usually have Z-DEX chemotherapy as cycles of treatment. Each cycle lasts 3 weeks. Depending on your needs, you may have up to 6 cycles, taking 4 to 5 months in total.

Idarubicin comes as capsules. Swallow them whole with a glass of water. You can take them with a meal.

Dexamethasone comes as tablets or as a liquid that you swallow. Take it after a meal, or with milk, because it can irritate your stomach lining. It can also make it difficult to sleep but taking it early in the day can reduce this effect.

For the first 4 days of each treatment cycle you take both idarubicin and dexamethasone once a day. Then you have no treatment for 17 days. You then start the next treatment cycle.

Taking your tablets or capsules

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.


Don’t breastfeed during this treatment because the drug may come through in your breast milk.

Blood clots

You are more at risk of developing a blood clot during treatment. Drink plenty of fluids and keep moving to help prevent clots.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.


Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Last reviewed: 
14 Jul 2015
  • British National Formulary

    Accessed July 2015

  • Electronic Medicines Compendium

    Accessed July 2015

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