Cancer drugs A to Z list
Carfilzomib, lenalidomide and dexamethasone are cancer drugs. Carfilzomib is also called Kyprolis.
You pronounce these drug names as:
carfilzomib (car-fill-zo-mib)
lenalidomide (len-ah-lid-oh-mide)
dexamethasone (deks-ah-meth-uh-zone)
It is a treatment for myeloma.
You might have this treatment if you have already had treatment and it is no longer working.
Read more about the treatment for myeloma
Carfilzomib is a type of called a proteasome inhibitor.
Proteasomes are found in cells. They break down and recycle proteins that the cell doesn't need anymore. If the proteins don’t get recycled they build up in the cell and the cell dies. Carfilzomib blocks the proteasomes so they can’t recycle the proteins.
Lenalidomide is a type of immunotherapy called an immunomodulator. It stimulates the immune system to attack cancer cells. It also interferes with the chemicals that cells use to tell each other to grow. And it stops cancers from making their own blood vessels. Cancers need a blood supply to be able to grow.
Dexamethasone is a steroid. It helps carfilzomib and lenalidomide work better and to kill myeloma cells.
Find out more about targeted cancer drugs and immunotherapy
You have carfilzomib as a drip into your bloodstream (intravenously).
You take lenalidomide as capsules and dexamethasone as tablets.
You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm. You have a new cannula each time you have treatment.
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.
Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.
You should take dexamethasone tablets after a meal or with milk as they can irritate your stomach. Taking them in the morning might help to stop difficulty in sleeping (insomnia). On the days you are having carfilzomib, your doctor or nurse normally asks you to take the dexamethasone tablets 30 minutes to 4 hours before you have the infusion.
You usually take your lenalidomide capsules at bedtime. This helps you to feel less sleepy at other times of the day. They can be taken with or without food.
You have KRd as cycles of treatment. This means that you have the drugs and then a rest to allow your body to recover. Each cycle of treatment lasts 28 days (4 weeks). You might have up to 18 cycles of treatment with KRD. After this you might continue taking lenalidomide and dexamethasone without carfilzomib.
How often you have treatment may depend on your treatment centre and your situation. The following is an example where the carfilzomib drip is given to you once a week:
You take dexamethasone as tablets once a day in the morning just after breakfast.
You have carfilzomib as a drip into your bloodstream over 30 minutes.
You take lenalidomide as a capsule once a day at bedtime.
You take lenalidomide as a capsule once a day at bedtime.
You take dexamethasone as tablets once a day in the morning just after breakfast.
You have carfilzomib as a drip into your bloodstream over 30 minutes.
You take lenalidomide as a capsule once a day.
You take lenalidomide as a capsule once a day at bedtime.
You take dexamethasone as tablets once a day in the morning just after breakfast.
You have carfilzomib as a drip into your bloodstream over 30 minutes.
You take lenalidomide as a capsule once a day at bedtime.
You take lenalidomide as a capsule once a day at bedtime.
You take dexamethasone as tablets once a day in the morning just after breakfast.
You have no treatment.
You then start your next cycle of treatment.
From cycle 19 onwards you have lenalidomide with dexamethasone and no carfilzomib. This is called .
You continue taking this maintenance treatment for as long as it is working and you are not experiencing too many side effects.
You have blood tests before and during your treatment. They check your levels of and other substances in the blood. They also check how well your liver and kidneys are working.
Before treatment starts you may have a blood test to check for viruses such as hepatitis B, hepatitis C, and HIV. This is called a viral screen.
It’s important for your doctor to know if you have had any of these viruses. This is because this treatment can weaken your and can cause the virus to become active again (reactivation).
You might have heart tests such as an to check how your heart is working.
Side effects can vary from person to person. They also depend on what other treatments you're having.
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
you have severe side effects
your side effects aren’t getting any better
your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.
Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Increased risk of getting an infection is due to a drop in . Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing, or generally feeling unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
You might be breathless and look pale due to a drop in . This is called anaemia.
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs. This is known as petechiae.
You might develop a cough or breathing problems. This could be due to infection such as pneumonia or inflammation of the lungs (pneumonitis). Less commonly you might develop fluid in your lungs. Let your doctor or nurse know straight away if you become breathless or develop a cough.
Blood clots can develop in the deep veins of your body, usually the leg. This is called deep vein thrombosis (DVT). A blood clot can be very serious if it travels to your lungs (pulmonary embolism), although this isn’t common.
Symptoms of a blood clot include:
• pain, redness and swelling around the area where the clot is and may feel warm to touch • breathlessness • pain in your chest or upper back – dial 999 if you have chest pain • coughing up blood
You may have changes in the levels of minerals and salts in your blood, including low levels of sodium, potassium and calcium.
Less commonly you might have high levels of calcium, , potassium, and a protein that picks up inflammation in the body (c-reactive protein). Or low levels of magnesium, phosphate or .
You will have regular blood tests to check these.
Your kidneys may stop working properly. Symptoms might include not passing enough pee, breathlessness, feeling tired and weak, confusion, feeling sick, and you might have swelling in your legs, ankles and feet.
To help prevent kidney damage, it is important to drink plenty of water. You might also have fluids into your vein before, during and after treatment. You have regular blood tests to check how well your kidneys are working.
You might not feel like eating and may lose weight. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
If you have difficulty sleeping, it can help to change a few things about how you try to sleep. Try to go to bed and get up at the same time each day and spend some time relaxing before you go to bed. Some light exercise each day may also help.
Tell your healthcare team if you keep getting headaches. They can give you painkillers to help.
This treatment might make you feel dizzy. Don't drive or operate machinery if you feel dizzy.
Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Tell your healthcare team if you're finding it difficult to walk or complete fiddly tasks such as doing up buttons.
You might also experience numbness or tingling in other parts of your body. Let your healthcare team know if this happens.
Tell your doctor or nurse if you have headaches, nosebleeds, blurred or double vision or shortness of breath. You have your blood pressure checked regularly.
Your hands or other parts of the body could feel shaky. Talk to the team looking after you about this.
Mood changes can include feeling very sad and depressed. Tell your doctor or nurse if you’re feeling depressed. They can arrange for you to talk to someone and give treatment if necessary.
Read about depression and cancer
Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.
Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain . But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables.
Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.
is easier to sort out if you treat it early. Drink plenty and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your healthcare team if you think you are constipated. They can give you a laxative if needed.
Taste changes may make you go off certain foods and drinks. You may also find that some foods taste different from usual or that you prefer to eat spicier foods. Your taste gradually returns to normal a few weeks after your treatment finishes.
You have regular blood and urine tests to check this. If you have diabetes you may need to check your blood sugar levels more often than usual.
You might get muscle cramps or pain in your tummy (abdomen), joints, back, hands and feet. Less commonly you may have pain in areas of the body such as your mouth, throat, bones or chest.
If you have chest pain call 999 or go to your nearest A and E department.
Let your doctor or nurse know about any pain in other parts of your body so that they can find the cause.
Tiredness and weakness (fatigue) can happen during and after treatment. Doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.
You might get a high temperature. Or you might feel cold or start shivering (chills).
Your mouth might get sore. You might have mouth washes to keep your mouth healthy. You can have painkillers to reduce the soreness. Take them half an hour before meals to make eating easier.
If you have a dry mouth it can help to drink plenty of fluids after treatment. An artificial saliva spray into your mouth might help. Ask you healthcare team about this.
Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your healthcare team can tell you what products you can use on your skin to help.
Less commonly you might get redness, become more sensitive to sunlight or develop darker patches of skin.
You might have blurred vision or clouding of the lens (cataract). Contact your healthcare team straight away if you have any new problems with your vision.
You may have swelling of your hands and legs due to a build up of fluid (oedema).
Let your healthcare team know if you have any new swelling, as it can be a sign of kidney or heart problems. They can investigate the cause.
You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes.
Rarely you might have yellowing of the skin and eyes (jaundice) or very dark pee or your liver may stop working.
You have regular blood tests to check for any changes in the way your liver is working. Let your healthcare team know straightaway if you develop these symptoms.
Contact your healthcare team if you have indigestion or heartburn. They can prescribe medicines to help.
You may have headaches, muscle aches (myalgia), a high temperature and shivering. You should contact your advice line urgently if you have these symptoms.
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness - some allergic reactions can be life threatening. Tell your nurse or doctor if you notice any of these symptoms
the if you have had chicken pox or if you have had shingles before
heart problems such as changes to your heartbeat, palpitations, heart failure or chest pain that can spread to arms, neck and jaw and make you feel sweaty, breathless and sick ()
a serious reaction to an infection (sepsis) - signs can include feeling very unwell, not passing urine, being sick, a very high or very low temperature or shivering - contact your advice line straight away if you have any of these symptoms
problems with your bowel or stomach including an infection or bleeding
stomach ulcer
problems with your speech, balance or coordination
feeling anxious or confused
changes to your voice including hoarseness
toothache
aching or weak muscles
sweating more than usual
pain or swelling at the injection site
ringing in your ears (tinnitus) or deafness
feeling generally unwell
a second cancer including or skin cancer
inflammation of your blood vessels – symptoms can vary depending on which blood vessels are affected - general symptoms include feeling very tired, loss of appetite, weight loss, a high temperature, and aches and pains
problems with your balance
fainting
a
nerve pain
changes to your levels in your blood
high uric acid levels including gout
problems peeing including blood in your pee
problems getting an
risk of falling
destruction of red blood cells (haemolytic anaemia)
a blockage in the flow of bile from the liver (cholestasis) – you might have yellowing of the skin or whites of the eyes (jaundice)
low blood pressure
dehydration
flushing
swollen joints
difficulty swallowing
These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:
bleeding in different parts of your body such as the lungs or brain
several body parts (organs) stopping working
a hole in the stomach or bowel wall (perforation)
infection with can become active again if you've had it in the past
inflammation of your pancreas – symptoms include severe tummy pain, feeling or being sick, a high temperature or you may have loose poo
changes to the levels of chemicals in your blood due to the breakdown of tumour cells (tumour lysis syndrome) - you have regular blood tests to check for this
posterior reversible encephalopathy syndrome (PRES)- a rare disorder of the nerves causing headaches, fits, confusion and changes in vision - contact your healthcare team straight away. This condition is usually reversible
problems with the way your blood clots
loss of
inflammation of the bowel (colitis)
reduced blood flow to the tissues in your body such as hands, legs and feet
Stevens Johnson syndrome (SJS) or toxic epidermal necrolysis - a severe skin reaction that may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish, and your eyes may be more sensitive to light. This is serious and could be life threatening
There isn't enough information to work out how often these side effects might happen. You might have one or more of them. They include:
slow wound healing
weaker bones
epilepsy becoming worse (fits)
higher levels of certain types of fat in the blood (cholesterol and triglycerides)
hair thinning or increased hair growth on your body
increased appetite
feeling like the room is spinning (vertigo)
hiccups
farting (flatulence)
changes to your face such as swelling and puffiness (Cushing’s syndrome)
If you have side effects that aren’t listed on this page, you can look at the individual drug pages:
We have more information about side effects and tips on how to cope with them.
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
It is important not to become pregnant or get anyone pregnant whilst you are taking KRd treatment.
Lenalidomide can be harmful to a baby developing in the womb and can cause severe abnormalities. Some people may worry about taking lenalidomide but it doesn’t cause physical defects in adults.
Because lenalidomide can be harmful to the developing baby, your doctor will talk to you before you start treatment. They will make sure that you understand the risks of this treatment and agree to use contraception.
You should continue to use effective contraception for at least 3 months after you stop taking this drug combination.
Let your doctor know straight away if you or your partner become pregnant.
It is not known whether this treatment affects in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Don’t breastfeed during this treatment. This is because the drugs may come through in your breast milk.
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having.
Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, and yellow fever.
You can usually have:
other vaccines, but they might not give you as much protection as usual
the flu vaccine (as an injection)
the coronavirus (COVID-19) vaccine
Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.
You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your is weakened.
Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.
For further information about each drug and the possible side effects go to the electronic Medicines Compendium (eMC) website. You can find patient information leaflets for each drug on this website.
You can report any side effect you have to the Medicines and Healthcare Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 13 May 2026
Next review due: 13 May 2029
Find out about the symptoms, causes, tests to diagnose and treatment for myeloma. This includes chemotherapy, targeted treatments, stem cell transplant (intensive treatment) and current research.
Cancer drugs have side effects and these can vary from person to person. But there are things that you can do to help you cope.
Coping with cancer can be difficult. There is help and support available. Find out about the emotional, physical and practical effects of cancer and how to manage them.
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