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Drugs currently in use in multiple myeloma* Updated August 2026

*This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your h ealthcare team for all drug recommendations.

Drugs currently in use in multiple myeloma* –

updated August 2026 *This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Remarks

Frontline and Relapse Treatments Alkylating Agent

melphalan (generic, branded as Alkeran®, Emovela®)

For use in treatment of multiple myeloma (MM); approved for use throughout disease course (see Remarks)

IV (intravenous injection): 200 mg/m2 Oral: 6 mg (3 tablets) daily

Suppression of blood cell counts, hypersensitivity reactions, gastrointestinal toxicity, pulmonary toxicity, infertility, secondary malignancies (leukemia)

Used as high-dose therapy in auto ASCT; can be used in combination with prednisone +/- third drug (melphalan + prednisone + Velcade [VMP]; melphalan + prednisone + Revlimid [RMP])

Alkylating Agent

cyclophosphamide (generic, branded as Cytoxan®)

For the treatment of MM, alone or in combination with other agents

IV: 40-50 mg/kg divided over 2-5 days Oral: 300 mg/m2 once weekly

Suppression of blood cell counts, infections, urinary tract and renal toxicity, cardiotoxicity, pulmonary toxicity, secondary malignancies, fever, alopecia (IV), nausea, vomiting, diarrhea

Sometimes used to mobilize stem cells from the marrow to the peripheral blood for harvest prior to ASCT; in combination therapies orally or by IV with CyBorD [Cytoxan + Velcade (bortezomib) + dexamethasone], or by IV in DCEP (dexamethasone + cyclophosphamide + etoposide + cisplatin) and VD-PACE (bortezomib + dexamethasone + cisplatin + doxorubicin + cyclophosphamide + etoposide)

Drugs currently in use in multiple myeloma* –

updated August 2026 *This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

For the treatment of RRMM in combination with dexamethasone for patients who have received at least four prior lines of therapy whose disease is refractory to at least one PI, one IMiD, and one CD38directed MAb

Central line IV Pepaxto is not currently available for prescribing.

Fatigue, nausea, diarrhea, fever, respiratory tract infection

Remarks

Frontline and Relapse Treatments Alkylating Agent

melphalan flufenamide Pepaxto® (Oncopeptides)

Oncopeptides provides patients with continued access to melphalan flufenamide via the Individual Patient Expanded Access Investigational Drug Application (IND) process if deemed appropriate by their treating physician.

Blood counts need to be monitored for leukocytes decrease, platelets decrease, lymphocytes decrease, neutrophils decrease, hemoglobin decrease, and creatinine increase. Can cause embryo-fetal toxicity and secondary malignancies. PATIENT SUPPORT: Oncopeptides 1-866-522-8894

Drugs currently in use in multiple myeloma* –

updated August 2026 *This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

BCMA-directed therapy for RRMM.

IV: Blenrep is administered as an intravenous infusion once every 3 weeks, over approximately 30 minutes each time, until disease progression or unacceptable toxicity. It is given at a starting dose of 2.5 mg/kg, but the dose may be reduced in subsequent infusions

Keratopathy, thrombocytopenia, infusionrelated reactions, embryofetal toxicity

Remarks

Frontline and Relapse Treatments Antibody drug conjugate(ADC) -- BCMA

belantamab mafodotin Blenrep® (GlaxoSmithKline)

In combination with bortezomib and dexamethasone for adults with relapsed or refractory multiple myeloma who have received at least two prior lines of therapy, including a proteasome inhibitor and an immunomodulatory agent

The most common side effects of BLENREP include vision or eye changes such as findings on eye exam (keratopathy), decreased vision or blurred vision, nausea, low blood cell counts, fever, infusionrelated reactions, tiredness, and changes in kidney or liver function blood tests. Conduct ophthalmic examinations (visual acuity and slit lamp) at baseline, prior to each dose, and promptly for worsening symptoms. (continued on the next page)

On October 23, 2025, the U.S. Food and Drug Administration (FDA) announced its approval of Blenrep® (belantamab mafodotin-blmf)— "a B-cell maturation antigen (BCMA)-directed antibody and microtubule inhibitor conjugate — with bortezomib and dexamethasone for adults with relapsed or refractory multiple myeloma who have received at least two prior lines of therapy, including a proteasome inhibitor and an immunomodulatory agent." The approval is supported by data from the phase III DREAMM-7 trial. Visit this article in the IMF Newsroom to learn more.

It is common for the drug to be given less frequently to reduce the risk of side effects. GlaxoSmithKline - 1-877-768-0092

Drugs currently in use in multiple myeloma* –

updated August 2026 *This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

In combination with bortezomib in patients who have not previously received bortezomib and have received at least one prior therapy

IV regular doxorubicin: 9 mg/m2 days 1-4 of a 28-day cycle; 20 mg/ m2 IV doxorubicin liposome injection: 30 mg/m2 day 1 of a 28- day cycle

Cardiotoxicity, secondary cancers, decreased blood cell counts, infusion site reactions, change in the color of urine, infection, lower sperm count, early menopause, hair loss, nausea, vomiting, mouth sores, eye problems, allergic reactions; Doxil also causes hand-foot syndrome.

Remarks

Frontline and Relapse Treatments Anthracycline

doxorubicin; doxorubicin hydrochloride liposome injection (generic, branded as Doxil®)

Lipsomal doxorubicin (Doxil) went off patent. Now there is an FDA-approved generic for Doxil as well as generic doxorubicin.

Drugs currently in use in multiple myeloma* –

updated August 2026 *This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

BCMA-directed therapy for the treatment of RRMM in patients who have received four prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 antibody.

SQ injection: The recommended dosage of ELREXFIO is step-up doses of 12 mg on Day 1, 32 mg on Day 2, and 76 mg on Day 3, followed by once-weekly dosing of 76 mg.

Cytokine release syndrome (CRS), immune effector cellassociated neurotoxicity syndrome (ICANS), infections, neutropenia, hepatotoxicity (liver injury or impairment), embryo-fetal toxicity.

Remarks

Frontline and Relapse Treatments Bispecific T-cell Engager antibody (bispecific, BsAb)

elranatamab-bcmm Elrexfio® (Pfizer)

-Can cause cytokine release syndrome (CRS), a potentially severe or fatal uncontrolled immune reaction in which cytokines become highly elevated and trigger an overwhelming immune system response that can damage body tissues and organs. CRS is managed by prevention using a step-up dose schedule. ----Premedication with tocilizumab before receiving bispecifics and CAR T-cell therapy is also being used in clinical trials. Should CRS occur, treatment depends on symptom severity, with mild cases (Grade 1-2) managed through supportive care like fluids, oxygen, and anti-inflammatory medications. Severe cases (Grade 34) may require tocilizumab, alone or with steroids, to control the immune response and cytokine storm. -Can cause hepatotoxicity. (continued on the next page)

Drugs currently in use in multiple myeloma* –

updated August 2026 *This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

See previous page

Remarks

Frontline and Relapse Treatments Bispecific T-cell Engager antibody (bispecific, BsAb)

elranatamab-bcmm Elrexfio® (Pfizer)

Monitor liver enzymes and bilirubin at baseline and during treatment as clinically indicated.

-Can cause ICANS, a form of neurotoxicity that can occur days or weeks after taking ELREXFIO, with symptoms such as headache, encephalopathy, and motor dysfunction. ICANS often occurs alongside or after cytokine release syndrome (CRS) but can also develop independently. -Can cause severe, life-threatening, or fatal infections. Monitor patients for signs and symptoms of infection and treat appropriately. Withhold in patients with active infection during the step-up dosing schedule. (continued on the next page)

Drugs currently in use in multiple myeloma* –

updated August 2026 *This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

See previous page

Remarks

Frontline and Relapse Treatments Bispecific T-cell Engager antibody

elranatamab-bcmm Elrexfio® (Pfizer)

Can cause neutropenia. Monitor complete blood cell counts at baseline and periodically during treatment.

Embryo-Fetal Toxicity: May cause fetal harm. Advise females and males of reproductive potential of the potential risk to the fetus and to use effective contraception. PATIENT SUPPORT: Pfizer 1-877-744-5675

Drugs currently in use in multiple myeloma* –

updated August 2026 *This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

For the treatment of RRMM in patients who have received four prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 antibody.

As an infusion through a needle in your vein (called an intravenous or IV infusion).

Cytokine release syndrome (CRS); neurologic toxicities; infections; neutropenia (a reduced level of neutrophils, a type of white blood cell necessary to combat bacterial infection) and/or febrile neutropenia (the development of fever, often with signs of infection, in a patient with neutropenia); hepatotoxicity (liver injury or impairment); embryo-fetal toxicity

Remarks

Frontline and Relapse Treatments Bispecific T-cell Engager antibody (bispecific, BsAb)

linvoseltamab-gcpt Lynozyfic

See the IMF Publication Understanding LYNOZYFIC (linvoseltamab-gcpt) for dosing information.

Can cause cytokine release syndrome (CRS), a potentially severe or fatal uncontrolled immune reaction in which cytokines become highly elevated and trigger an overwhelming immune system response that can damage body tissues and organs. CRS is managed by prevention using a step-up dose schedule. Premedication with tocilizumab before receiving bispecifics and CAR T-cell therapy is also being used in clinical trials. Should CRS occur, treatment depends on symptom severity, with mild cases (Grade 1-2) managed through supportive care like fluids, oxygen, and anti-inflammatory medications. Severe cases (Grade 3-4) may require tocilizumab, alone or with steroids, to control the immune response and cytokine storm. . (continued on the next page)

Drugs currently in use in multiple myeloma* –

updated August 2026 *This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

See previous page.

Remarks

Frontline and Relapse Treatments Bispecific T-cell Engager antibody (bispecific, BsAb)

linvoseltamab-gcpt Lynozyfic

Can cause neutropenia and/or febrile neutropena. Monitor complete blood cell counts at baseline and periodically during treatment. Embryo-Fetal Toxicity: May cause fetal harm. Advise females and males of reproductive potential of the potential risk to the fetus and to use effective contraception. Advise patients who are breastfeeding or plan to breastfeed. (continued on the next page)

Drugs currently in use in multiple myeloma* – updated August 2026 *This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

See previous page.

Remarks

Frontline and Relapse Treatments Bispecific T-cell Engager antibody (bispecific, BsAb)

linvoseltamab-gcpt Lynozyfic

PATIENT SUPPORT: Regeneron offers the Lynozyfic Surround program, which provides financial and educational resources to support patients throughout their treatment with Lynozyfic.

For more information regarding Lynozyfic Surround or access and support, patients can call 1-844-RGNHEME (1-844-746-4363) or visit regeneron.com

Drugs currently in use in multiple myeloma* –

updated August 2026 *This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

GPRC5D-directed therapy for the treatment of RRMM in patients who have received four prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 antibody

SQ injection: The recommended dosage of TALVEY is step-up doses of 0.01 mg/kg on Day 1, 0.06 mg/kg on Day 2, and 0.4 mg/kg on Day 3, followed by once-weekly dosing of 0.4 mg/kg.

For patients whose healthcare team recommends bi-weekly dosing of TALVEY, the step-up doses are 0.01 mg/kg on Day 1, 0.06 mg/kg on Day 4, 0.4 mg/kg on Day 7, and 0.8 mg/kg on Day 10, followed by 0.8 mg/kg every two weeks.

Cytokine release syndrome (CRS); immune effector cellassociated neurotoxicity syndrome (ICANS); infections; cytopenias; hepatotoxicity (liver injury or impairment); embryo-fetal toxicity; oral toxicity such as dry mouth, distortion of sense of taste, or dysphagia (difficulty in swallowing); skin-related toxicities; and nail-related toxicities.

Remarks

Frontline and Relapse Treatments Bispecific T-cell Engager antibody (bispecific, BsAb)

talquetamab Talvey® (Janssen)

Drugs currently in use in multiple myeloma* –

updated August 2026 *This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

See previous page.

Remarks

Frontline and Relapse Treatments Bispecific T-cell Engager antibody (bispecific, BsAb)

talquetamab Talvey® (Janssen)

during treatment as clinically indicated. Can cause ICANS, a form of neurotoxicity that can occur days or weeks after taking TALVEY, with symptoms such as headache, encephalopathy, and motor dysfunction. ICANS often occurs alongside or after cytokine release syndrome (CRS) but can also develop independently. Can cause severe or fatal infections. Monitor patients for signs and symptoms of infection and treat appropriately. Withhold in patients with active infection during the step-up dosing schedule.

Can cause cytopenias (e.g. neutropenia, thrombocytopenia). Discuss with your provider if this occurs.

Drugs currently in use in multiple myeloma* – updated

August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

In the U.S., Tecvayli (teclistamab-cqyv) is approved: • In combination with daratumumab and hyaluronidase-fihj for adults with RRMM who have received at least one prior line of therapy, including a proteasome inhibitor and an immunomodulatory agent. • As monotherapy for adults with RRMM who have received at least four prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent and an anti-CD38 monoclonal antibody.

SQ injection: The recommended dosage of TECVAYLI is step-up doses of 0.06 mg/kg and 0.3 mg/ kg followed by 1.5 mg/kg once weekly until disease progression or unacceptable toxicity.

Pyrexia, cytokine release syndrome, musculoskeletal pain, injection site reaction, fatigue, upper respiratory tract infection, nausea, headache, pneumonia, and diarrhea.

Remarks

Frontline and Relapse Treatments Bispecific T-cell Engager antibody (bispecifc, BsAb)

teclistamab (cqyv) Tecvayli® (Janssen)

Can cause cytokine release syndrome (CRS), a potentially severe or fatal uncontrolled immune reaction in which cytokines become highly elevated and trigger an overwhelming immune system response that can damage body tissues and organs. CRS is managed by prevention using a step-up dose schedule. Premedication with tocilizumab before receiving bispecifics and CAR T-cell therapy is also being used in clinical trials. Should CRS occur, treatment depends on symptom severity, with mild cases (Grade 1-2) managed through supportive care like fluids, oxygen, and anti-inflammatory medications. Severe cases (Grade 3-4) may require tocilizumab, alone or with steroids, to control. Can cause hepatotoxicity, including fatalities. (continued on the next page)

Drugs currently in use in multiple myeloma* –updated

August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

See previous page.

Remarks

Frontline and Relapse Treatments Bispecific T-cell Engager antibody (bispecific, BsAb)

teclistamab (cqyv) Tecvayli® (Janssen)

As of August 2026, according to this press release from Johnson & Johnson, ""the European Commission (EC) has approved an indication extension for TECVAYLI® (teclistamab) in combination with daratumumab for the treatment of adults with relapsed or refractory multiple myeloma (RRMM) who have received at least one prior therapy."

Monitor liver enzymes and bilirubin at baseline and during treatment as clinically indicated.

Can cause severe, life-threatening, or fatal infections. Monitor patients for signs and symptoms of infection and treat appropriately. Withhold in patients with active infection during the step-up dosing schedule. Monitor complete blood cell counts at baseline and periodically during treatment. Hypersensitivity and local injection site reactions can occur. Withhold or consider permanent discontinuation based on severity. (continued on the next page)

Drugs currently in use in multiple myeloma* –updated

August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

See previous page.

Remarks

Frontline and Relapse Treatments Bispecific T-cell Engager antibody (bispecifc, BsAb)

teclistamab (cqyv) Tecvayli® (Janssen)

Embryo-Fetal Toxicity: May cause fetal harm. Advise females and males of reproductive potential of risk to the fetus and to use effective contraception PATIENT SUPPORT: Janssen Biotech, Inc. 1-800-526-7736

Drugs currently in use in multiple myeloma* –updated

August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

No specific FDA approval for myeloma; approved for “palliative management of leukemias and lymphomas.”

Oral therapy given in 4 mg tablets at a dose of 20-40 mg weekly.

Infections, cardiac conditions/ fluid retention, acne, rash, elevated blood glucose, GI disorders, weight gain, coughing, hoarseness, osteoporosis, muscle pain, ophthalmologic disorders, psychiatric effects, sleeplessness

Remarks

Frontline and Relapse Treatments Corticosteroid

dexamethasone (generic, branded as Decadron®)

Used in most regimens for front-line and relapsed MM; not often used in maintenance because of side effects from long-term use

May be used as monotherapy, given orally at 40 mg, 4 days on, 4 days off, for urgent management. Can be given IV.

Caution about drug interactions—see the IMF publication Understanding Dexamethasone for details. Several studies have demonstrated that reducing dex dose in combination therapy improves tolerance, extending treatment duration and overall survival (OS). Dose reductions may be recommended following initial cycles of therapy as they have shown response.

Drugs currently in use in multiple myeloma* –updated

August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Approved in combination with dexamethasone for the treatment of newly diagnosed myeloma, but is used throughout the disease course, including for maintenance therapy (without dex)

Oral: approved at 200 mg daily, but is rarely given above 100 mg daily because it is effective at lower doses and higher doses are not generally well tolerated

Embryo-fetal toxicity, venous and arterial thromboembolism, peripheral neuropathy, constipation, drowsiness, dizziness, low white blood cell counts, rash

Remarks

Frontline and Relapse Treatments Immunomodulatory agent

thalidomide Thalomid® (plus dex) (Bristol Myers Squibb)

Patients must participate in a REMS (risk assessment and management program).

Both partners must use contraception. Causes irreversible peripheral neuropathy. PATIENT SUPPORT: Bristol Myers Squibb 1-800-861-0048 https://www.bmsaccesssupport.com

Drugs currently in use in multiple myeloma* –updated

August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Approved throughout the disease course, including as maintenance therapy (without dex)

Oral: 25 mg days 1-21 of a 28- day cycle, maintenance 10 mg continuous,

Embryo-fetal toxicity, low white blood cell counts, low platelet counts, hepatoxicity, venous and arterial thromboembolism, diarrhea, fatigue, anemia, constipation, rash, decreased appetite

Remarks

Frontline and Relapse Treatments Immunomodulatory agent

lenalidomide Revlimid® (Bristol Myers Squibb)

To learn more on dosing, read the IMF Publication Understanding Revlimid.

Patients must participate in a REMS (risk assessment and management program); both partners must use contraception. Patients should receive anti-thrombotic prophylaxis (type determined by risk factors). PATIENT SUPPORT: Bristol Myers Squibb 1-800-861-0048 https://www.bmsaccesssupport.

*As of March 2022, TEVA Generics offers a generic version of Revlimid. 1888-838-2872. Prescribing information, boxed warnings, and medication guide can be found here.

Drugs currently in use in multiple myeloma* –updated

August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with yourhealthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

In combination with dexamethasone for the treatment of patients with mm who have relapsed after at least 2 prior therapies including Revlimid and a proteasome inhibitor

Oral: 4 mg days 1-21 of a 28-day cycle

Embryo-fetal toxicity, low white blood cell counts, low red blood cell counts, low platelet counts, venous and arterial thromboembolism, fatigue, weakness, dizziness and confusion, constipation, nausea, diarrhea, neuropathy

Remarks

Frontline and Relapse Treatments Immunomodulatory drug

pomalidomide Pomalyst® (Bristol Myers Squibb)

For detailed dosing information, read the IMF Publication Understanding Pomalyst.

PATIENT SUPPORT: Bristol Myers Squibb 1-800-861-0048 https://www.bmsaccesssupport. .

Drugs currently in use in multiple myeloma* – updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Approved for treatment throughout the myeloma disease course, in combination with nearly all other FDA-approved antimyeloma therapies.

IV or SQ (subcutaneous injection) at 1.3mg/m2 days 1,4,8,11 every 21 days

Peripheral neuropathy (PN) (subcutaneous [SQ] administration preferred), fatigue, nausea, diarrhea, thrombocytopenia, low blood pressure; more rarely headache, insomnia, fever, back pain, muscle cramps, heart problems, lung problems, brain swelling, tumor lysis syndrome, hepatoxicity.

Remarks

Frontline and Relapse Treatments Proteasome Inhibitor (PI)

bortezomib Velcade® (Takeda)

To learn more about dosing, read the IMF publication Understanding Velcade® (bortezomib) for injection

May be given weekly for patients with PN or other ongoing side effect(s) and for frailer patients; dose may also be reduced to 1.0 mg/m2. Patients should be given antiviral prophylaxis for herpes zoster (shingles) infection.

PATIENT SUPPORT: Takeda Oncology 1-866-835-2233 Velcade prescribing information

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

As a single agent for adult pts w/ RRMM who have received at least 1 or more prior lines of therapy including bortezomib and an IMiD® and have demonstrated disease progression on or within 60 days after last therapy.

IV: 10-minute infusion twice- weekly on 2 consecutive days for 3 weeks out of every 4-week cycle-- 20mg/m2 cycle 1, days 1+2; 27mg/m2 cycle 1 days 8,9,15,16 and all future cycles

Fatigue, anemia, thrombocytopenia, shortness of breath, diarrhea, fever, low blood pressure, cardiac failure and other cardiac events, infusion reactions, embryofetal toxicity

Remarks

Frontline and Relapse Treatments Proteasome Inhibitor (PI)

carfilzomib Kyprolis® (Amgen)

For the treatment of adult pts with RRMM who have received one to three lines of therapy in combination with dexamethasone; or lenalidomide and dexamethasone; or daratumumab and dexamethasone.

Patients with pre-existing heart conditions may be at greater risk for cardiac complications. Outperformed Vel/dex in RRMM for PFS, OS regardless of age, cytogenetics, prior Rx. Patients should receive antiviral prophylaxis for herpes zoster (shingles) infection. PATIENT SUPPORT: AMGEN 1-888-427-7478 https://www.amgensupportplus.com/p atient

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

In combination with Rev/dex for treatment of patients with MM who have received at least 1 prior therapy

Oral: 4mg on days 1,8,15 of a 28-day cycle

Thrombocytopenia, neutropenia, diarrhea, constipation, nausea, vomiting, peripheral neuropathy, peripheral edema (swelling of the feet) rash, liver toxicity, back pain, upper respiratory tract infection, blurred vision, dry eye, conjunctivitis, embryofetal toxicity.

Remarks

Frontline and Relapse Treatments Proteasome Inhibitor (PI)

ixazomib Ninlaro® (Takeda)

To learn more, read the IMF publication Understanding NINLARO® (ixazomib) capsules

Dose at 3 mg for pts with moderate to severe liver or kidney impairment. Causes embryo-fetal toxicity. Both partners must use contraception. Patients should receive antiviral prophylaxis for herpes zoster (shingles) infection. PATIENT SUPPORT: Takeda Oncology 1-844-617-6468, option 2 https://www.ninlaro.com

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

CD38-directed therapy for multiple myeloma IV: in combination with lenalidomide and dexamethasone in newly diagnosed patients who are ineligible for autologous stem cell transplant (ASCT) and in patients with relapsed or refractory multiple myeloma who have received at least 1 prior therapy SQ: Darzalex Faspro SQ can be given on the same schedule as Darzalex IV, but it is administered as an injection into the abdomen that takes only a few minutes. Patients are monitored for a few hours after the first one or two doses. (continued on the next page)

IV: 16mg/kg weekly for cycles 1-8, every 2 wks cycles 9-24, every 4 wks cycle 25 onward Injection: 1,800 mg and 30,000 units *Different dosing schedules are used for different combinations; please refer to the prescribing information for more detail

IV: Infusion reactions, fatigue, nausea, back pain, fever, cough, low blood cell counts.

Remarks

Frontline and Relapse Treatments Monoclonal Antibody (mAb)

daratumumab Darzalex® and Darzalex Faspro® (Janssen))

SQ: The recommended dosage of Darzalex Faspro is 1,800 mg Darzalex plus 30,000 units hyaluronidase per 15 mL (120 mg and 2,000 units/mL) solution in a (continued on the next page)

Injection: Serious allergic reactions and other severe systemic administrationrelated reactions, injection site reactions, decreases in blood cell counts, changes in blood tests, upper respiratory infection, fatigue, nausea, diarrhea, shortness of breath, trouble sleeping, fever, cough, muscle spasms, back pain, vomiting, cold-like symptoms, peripheral neuropathy, constipation, pneumonia

IV: Patients must be premedicated prior to infusion to reduce/prevent infusion reactions. Patients should receive antiviral prophylaxis for herpes zoster (shingles) infection. Can affect the results of blood tests to match blood type. Interference with SPEP and IFE tests. Injection: Patients must be premedicated and post medicated. Patients should receive antiviral prophylaxis for herpes zoster (shingles) infection. Tell your HCP if you have a history of breathing problems, have had shingles, have had or might have a hepatitis B infection, are pregnant or plan to become pregnant, are breastfeeding or plan to breastfeed. (continued on the next page)

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

See previous page.

Remarks

Frontline and Relapse Treatments Monoclonal Antibody (mAb)

daratumumab Darzalex® and Darzalex Faspro® (Janssen))

In combination with bortezomib, melphalan and prednisone in newly diagnosed patients who are ineligible for ASCT in combination with bortezomib, thalidomide, and dexamethasone in newly diagnosed patients who are eligible for ASCT (continued on the next page)

Darzalex Faspro® may harm your unborn baby and it is not known if it passes into your breast milk. Can affect the results of blood tests to match blood type. Interference with SPEP and IFE tests. Is contraindicated in patients with a history of severe hypersensitivity to daratumumab hyaluronidase or any of the components of the formulation.

PATIENT SUPPORT: Janssen 1-877-553-2792 https://www.jnjwithme.com/patient/da rzalex/withme/cost-support/

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

In combination with carfilzomib and dexamethasone in patients with relapsed or refractory multiple myeloma who have received 1 to 3 prior lines of therapy

See previous page.

Remarks

Frontline and Relapse Treatments Monoclonal Antibody (mAb)

daratumumab Darzalex® and Darzalex Faspro® (Janssen))

In combination with pomalidomide and dexamethasone in patients who have received at least 2 prior therapies including or therapies including lenalidomide and a PI; as monotherapy, in patients who have received at least

PATIENT SUPPORT: Janssen 1-877-553-2792 https://www.jnjwithme.com/patient/da rzalex/withme/cost-support/

(continued on the next page)

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations. Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

As a standalone therapy (monotherapy) in patients who have received at least three prior lines of therapy, including a proteasome inhibitor and an immunomodulatory agent such as Pomalyst (pomalidomide), Revlimid (lenalidomide), or Thalomid (thalidomide).

See previous page.

Remarks

Frontline and Relapse Treatments Monoclonal Antibody (mAb)

daratumumab Darzalex® and Darzalex Faspro® (Janssen)

See previous page.

As standalone therapy in patients with RRMM who have received at least 3 prior lines of therapy, including a proteasome inhibitor (Velcade, Kyprolis, or Ninlaro) and an immunomodulatory agent (Pomalyst, Revlimid, or thalidomide), or [continued on the next page]

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

who are double-refractory to a proteasome inhibitor and an immunomodulatory agent.

See previous page.

Remarks

Frontline and Relapse Treatments Monoclonal Antibody (mAb)

daratumumab Darzalex® and Darzalex Faspro® (Janssen)

See previous page.

As standalone therapy for or patients with high-risk (HR) smoldering multiple myeloma (SMM): In combination with Tecvayli (teclistamab) for adults with RRMM who have received at least one prior line of therapy, including a proteasome inhibitor and an immunomodulatory agent.

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

As of March 2026, Johnson & Johnson announced via press release that "the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has granted approval for a Type II variation to the labelling for DARZALEX®(daratumumab) subcutaneous (SC) formulation."

See previous page.

Remarks

Frontline and Relapse Treatments Monoclonal Antibody (mAb)

daratumumab Darzalex® and Darzalex Faspro® (Janssen)

See previous page.

Drugs currently in use in multiple myeloma* –

updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

SLAMF7-directed therapy for multiple myeloma

IV: 10mg/kg once weekly in a 28-day cycle for cycles 1+2; thereafter every other week, days 1 and 15, every 28 days.

Infusion reactions, low red blood cell count, low lymphocytes, low white blood cell count, low platelet count, infections, fatigue, diarrhea, fever, constipation, muscle spasms, decreased appetite

Remarks

Frontline and Relapse Treatments Monoclonal Antibody (mAb)

elotuzumab Empliciti® (BMS)

In combination with lenalidomide and dex after 1-3 prior therapies. In combination with pomalidomide and dex after at least 2 prior therapies including lenalidomide and a proteasome inhibitor

To learn more, read the IMF publication Understanding EMPLICITI® (elotuzumab).

Patients should receive anti-thrombotic prophylaxis (type determined by risk factors) for the combination with Rd due to high incidence of deep vein thrombosis and pulmonary embolism. Patients must be premedicated before each dose to prevent infusion reactions. PATIENT SUPPORT: Bristol-Myers Squibb 1-844-367-5424 https://www.empliciti.com

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

CD38-directed therapy for multiple myeloma

IV: 10mg/kg every week for 4 weeks, then every 2 weeks until disease progression or unacceptable toxicity

Neutropenia, infection, infusion reaction, diarrhea

Remarks

Frontline and Relapse Treatments Monoclonal Antibody (mAb)

isatuximab Sarclisa® (Sanofi)

In combination with the proteasome inhibitor Velcade® (bortezomib), the immunomodulatory agent Revlimid® (lenalidomide), and the steroid dexamethasone, or Isa-VRd, for adult patients with newly diagnosed multiple myeloma (NDBMM) who are not eligible for an autologous stem cell transplant (ASCT).

Patients must be premedicated before each dose to prevent infusion reactions. Can affect the results of blood tests to match blood type. Interference with SPEP and IFE tests. Monitor patients for development of second primary malignancies. Potential for embryo-fetal toxicity. PATIENT SUPPORT: Sanofi 1-833-930-2273. CareASSIST by Sanofi

In combination with pomalidomide and dexamethasone to treat adults who (continued on the next page)

Drugs currently in use in multiple myeloma* –

updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

have received at least 2 prior therapies, including lenalidomide and a proteasome inhibitor, to treat multiple myeloma

See previous page.

Remarks

Frontline and Relapse Treatments Monoclonal Antibody (mAb)

isatuximab Sarclisa® (Sanofi) and Sarlisca Escena (for subctaneous injection)

See previous page.

CD38-directed therapy for multiple myeloma In combination with carfilzomib and dexamethasone, for the treatment of adult patients with relapsed or refractory multiple myeloma who have received 1 to 3 prior lines of therapy [continued on the next page]

Drugs currently in use in multiple myeloma* –

updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

As of July 2026, the U.S. FDA "approved isatuximabirfc (Sarclisa Escena, Sanofi-Aventis U.S. LLC) for subcutaneous injection for multiple myeloma indications," which include:

See previous page.

Remarks

Frontline and Relapse Treatments Monoclonal Antibody (mAb)

isatuximab Sarclisa® (Sanofi) and Sarlisca Escena (for subctaneous injection)

See previous page.

in combination with pomalidomide and dexamethasone, for the treatment of adult patients with multiple myeloma who have received at least one prior line of therapy including lenalidomide and a proteasome inhibitor, [continued on the next page]

Drugs currently in use in multiple myeloma* –

updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

in combination with carfilzomib and dexamethasone, for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three prior lines of therapy, and

See previous page.

Remarks

Frontline and Relapse Treatments Monoclonal Antibody (mAb)

isatuximab Sarclisa® (Sanofi) and Sarclisa Escena (for subcutaneous injection)

See previous page.

in combination with bortezomib, lenalidomide and dexamethasone, for the treatment of adult patients with newly diagnosed multiple myeloma who are not eligible for an autologous stem cell transplant.

Drugs currently in use in multiple myeloma* –

updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

In combination with bortezomib and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy.

XVd Oral: 100 mg (five 20mg tablets) taken orally once weekly on Day 1 in combination with bortezomib and dexamethasone

Thrombocytopenia, fatigue, nausea, anemia, decreased appetite, decreased weight, diarrhea, vomiting, hyponatremia, neutropenia, leukopenia, constipation, dyspnea, serious infection, neurological toxicity, embryo-fetal toxicity, and cataracts

Remarks

Frontline and Relapse Treatments Nuclear export inhibitor

selinexor Xpovio® (Karyopharm)

In combination with dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least four prior therapies and whose disease is refractory to at least two proteasome inhibitors, at least two immunomodulatory agents, and an anti-CD38

Xd Oral: 80mg (four 20mg tablets) taken in combination with dexamethasone on Days 1 and 3 of each week until disease progression or unacceptable toxicity

Doctor must carefully monitor blood counts and body weight at baseline and during treatment, especially during the first two months of treatment. Patients should receive a prophylactic antinausea agent prior to and during treatment. PATIENT SUPPORT: Karyopharm 1-877-527-9493 https://www.karyforward.com

Drugs currently in use in multiple myeloma* –updated

August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations. Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Abecma is a B-cell maturation antigen (BCMA)-directed genetically modified autologous T cell immunotherapy indicated for the treatment of adult patients with relapsed or refractory multiple myeloma after two or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody.

The patient’s own T cells are genetically modified to recognize and attack BCMA on the surface of the patient’s myeloma cells.

The safety profile of Abecma is well-established and predictable, including cytokine release syndrome (CRS) and neurologic toxicities that are mostly lowgrade with early onset and resolution.

Remarks

Frontline and Relapse Treatments CAR T-cell therapy

idecabtagene vicleucel Abecma® (BMS)

Before giving you Abecma, your doctor will prepare your body by giving you chemotherapy for 3 days. Your Abecma dose is administered by an intravenous infusion given in one or more infusion bags. The infusion usually takes up to 30 minutes for each infusion bag. For at least 7 days after the infusion, you will be monitored daily at the certified healthcare facility where you received your treatment. (continued on the next page)

The most common side effects of Abecma are fatigue, fever of 100.4°F/38°C or higher, chills or shivering, severe nausea or diarrhea, decreased appetite, headache, dizziness or lightheadedness, confusion, difficulty speaking or slurred speech, cough, difficulty breathing, and fast or irregular heartbeat.

Cytokine Release Syndrome (CRS), neurologic toxicities, Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome (HLH/MAS), hypersensitivity reactions, infections, prolonged cytopenias, hypogammaglobulinemia, secondary malignancies, effects on ability to drive and use machines.

Patients must follow a Risk Evaluation and Mitigation Strategy (REMS) called ABECMA REMS PATIENT SUPPORT: BMS 1-888-805-4555 https://www.celltherapy360.com

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations. Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Remarks

See previous page.

Premedicate with acetaminophen and an H1-antihistamine. Avoid prophylactic use of dexamethasone or other systemic corticosteroids.

See previous page.

Frontline and Relapse Treatments CAR T-cell therapy

idecabtagene vicleucel Abecma® (BMS)

*This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations. 37

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Remarks

CARVYKTI is a B-cell maturation antigen (BCMA)-directed, genetically modified autologous T cell immunotherapy indicated for the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least 1 prior line of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody.

CARVYKTI is made from a patient’s own white blood cells, collected and reprogrammed to find and attack multiple myeloma cells.

The most common nonlaboratory adverse reactions are pyrexia, cytokine release syndrome, hypogammaglobulinemia, hypotension, musculoskeletal pain, fatigue, infectionspathogen unspecified, cough, chills, diarrhea, nausea, encephalopathy, decreased appetite, upper respiratory tract infection, headache, tachycardia, dizziness, dyspnea, edema, viral infections, coagulopathy, constipation, and vomiting. (continued on the next page)

Cytokine Release Syndrome (CRS), including fatal or life-threatening reactions, occurred in patients following treatment with CARVYKTI. Do not administer CARVYKTI to patients with active infection or inflammatory disorders. Treat severe or life-threatening CRS with tocilizumab or tocilizumab and corticosteroids.

Frontline and Relapse Treatments CAR T-cell therapy

ciltacabtagene autoleucel Carvykti® (Janssen Oncology and Legend Biotech)

It is given to the patient over 30-60 minutes in a one-time, single-dose infusion of chimeric antigen receptor (CAR)positive viable T cells in one infusion bag. Before you get CARVYKTI, your healthcare provider will give you chemotherapy for 3 days to prepare your body. After getting CARVYKTI, you will be monitored by the certified healthcare facility where you received your treatment for at least 10 days after the infusion.

Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS), which may be fatal or life-threatening, occurred following treatment with CARVYKTI, including before CRS onset, concurrently with CRS, after CRS resolution, or in the absence of CRS. Monitor for neurologic events after treatment with CARVYKTI. Provide supportive care and/or corticosteroids as needed. (continued on the next page)

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Remarks

See previous page.

The most common laboratory adverse reactions include thrombocytopenia, neutropenia, anemia, aminotransferase elevation, and hypoalbuminemia.

Parkinsonism and Guillain-Barré syndrome and their associated complications resulting in fatal or lifethreatening reactions have occurred following treatment with CARVYKTI. (Hemophagocytic Lymphohistiocytosis/ Macrophage Activation Syndrome (HLH/MAS), including fatal and lifethreatening reactions, occurred in patients following treatment with CARVYKTI. HLH/MAS can occur with CRS or neurologic toxicities. Prolonged and/or recurrent cytopenias with bleeding and infection and requirement for stem cell transplantation for hematopoietic recovery occurred following treatment with CARVYKTI.

Frontline and Relapse Treatments CAR T-cell therapy

ciltacabtagene autoleucel Carvykti® (Janssen Oncology and Legend Biotech)

Patients must follow a CARVYKTI REMS program: 1-844-672-0067 PATIENT SUPPORT: Janssen 1-800-5597875 for MyCARVYKTI Patient Support Program

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

In August 2026, the U.S. Food and Drug Administration (FDA) granted accelerated approval to ZENBEXUS (iberdomide), in combination with Darzalex Faspro® (daratumumab and hyaluronidase-fihj) and dexamethasone as treatment for adults with relapsed/refractory myeloma (RRMM) who have received at least one prior line of therapy — including a proteasome inhibitor and an immunomodulatory agent.

Iberdomide is an oral pill.

Key risks of iberdomide include the following: Low blood counts (especially neutrophils). This increases the risk of infection. Blood clots. Patients taking iberdomide should be given medication to prevent blood clots.

Remarks

Frontline and Relapse Treatments CELMoDs (cereblon E3 ligase modulators)

iberdomide (ZENBEXUS Bristol Myers Squibb Brand name)

Patients may also experience low-grade fatigue and diarrhea. The risk of peripheral neuropathy and cardiac complications is low. Iberdomide is associated with Grade 3 infection and anemia, and Grade 3 or 4 neutropenia.

Drugs currently in use in multiple myeloma* –

updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Remarks

bisphosphonate

pamidronate disodium Aredia®

For the treatment of osteolytic bone metastases in conjunction with standard antineoplastic therapy

IV: 90mg infused over 24 hours once monthly

Renal toxicity, fever, vein irritation, general aches and pains, ONJ (osteonecrosis of the jaw)

Long-term use (5+ years) can lead to atypical fractures of the femur; patients without documented myeloma-related bone disease should not take bisphosphonates

bisphosphonate

zoledronate, zoledronic acid Zometa® (Novartis)

Zometa may be recommended for myeloma patients, even if you do not have current bone disease. Zometa is the preferred bonetargeted treatment in patients with newly diagnosed myeloma, except in certain circumstances, such as patients with impaired kidney function (continued on the next page)

IV: 4 mg over no less than 15 minutes every 3-4 weeks; usually 3045 minutes once monthly

Renal toxicity, fever, vein irritation, general aches and pains, ONJ

Long-term use (5+ years) can lead to atypical fractures of the femur; patients without documented myeloma-related bone disease should not take bisphosphonates; dose should be reduced for patients with renal impairment; 500 mg calcium and 400 IU vitamin D should be taken daily. PATIENT SUPPORT: Novartis 1-800-277-2254, or https://www.novartis.com/usen/patients-and-caregivers/patientassistance

Supportive Care

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Remarks

zoledronate, zoledronic acid Zometa® (Novartis)

If you have kidney impairment, your doctor may offer another medication, such as Xgeva® (denosumab).

See previous page.

Supportive Care bisphosphonate

Hypocalcemia or low calcium levels in your blood must be corrected before starting treatment with Zometa. Your doctor will do a blood test to measure your calcium levels before starting treatment. Depending on the results, your doctor may recommend taking calcium and vitamin D supplements. Calcium and vitamin D are often given as pills to take at home. (continued on the next page)

Drugs currently in use in multiple myeloma* –updated August 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Remarks

You may not be eligible to take Zometa if you are pregnant because Zometa can cause harm to a developing unborn baby.

See previous page.

See previous page

Frontline and Relapse Treatments bisphosphonate

zoledronate, zoledronic acid Zometa® (Novartis)

There are other reasons you may not be a candidate for Zometa. Please see the package insert for more information and discuss Zometa with your doctor.

Drugs currently in use in multiple myeloma* –

updatedAugust 2026* This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations

Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Remarks

denosumab Xgeva® (Amgen)

Prevention of skeletalrelated events in patients with multiple myeloma

SQ: 120mg every 4 weeks as a subcutaneous injection in the upper arm, upper thigh, or abdomen

Hypocalcemia, ONJ, atypical femoral fracture, embryofetal toxicity, diarrhea, nausea, anemia, back pain, thrombocytopenia, peripheral edema, hypocalcemia, upper respiratory tract infection, rash, and headache

All patients should receive calcium and vitamin D.

Supportive Care Bone-modifying agent

Oral exam should be done prior to starting treatment. If a patient stops denosumab, that patient must be given bridging therapy with a bisphosphonate to prevent rapid bone breakdown.

PATIENT SUPPORT AMGEN 1-866-822-4832 https://www.xgeva.com/findsupport#treatment-resources Stem cell mobilizer

motixafortide Aphexda® (BioLineRX))

Reversible CXCR4 antagonist for use in combination with GCSF to mobilize hematopoietic stem cells prior to ASCT in patients with MM.

SQ: 1.25mg/kg body weight given as a slow injection, 10-14 hours prior to first apheresis. (continued on the next page)

Injection site reactions (73%) including pain, redness, and itching at the injection site; itching (38%); flushing (33%); back pain (21%), hypersensitivity reaction.

May cause embryo-fetal harm.

Motixafortide should not be used in people with leukemia. (continued on the next page)

Drugs currently in use in multiple myeloma* – updated March 2026 Drug Type

Generic | Brand Name

Indication

Route of Administration, Dose

Side Effects

Remarks

motixafortide Aphexda® (BioLineRX))

See previous page.

A second dose can be administered 10 to 14 hours before a third apheresis, if necessary

See previous page.

Premedicate all patients before each dose of this drug to reduce the risk of hypersensitivity and injection site reactions. Administer approximately 30 to 60 minutes before injection of this drug:

Supportive Care Stem cell mobilizer

• Diphenhydramine (12.5 mg IV or 25 mg to 50 mg orally, or another H1antihistamine) • H2 blocker (e.g., famotidine) • Leukotriene inhibitor (e.g., montelukast) • The addition of an analgesic medication (e.g., acetaminophen) to the premedication regimen is recommended. PATIENT SUPPORT: BioLineRx Connect 866-524-5646

*This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your h ealthcare team for all drug recommendations. 45

Drugs currently in use in multiple myeloma* – updated March 2026 Drug Type

Generic | Brand Indication Name

Route of Administration, Dose

Side Effects

Remarks

plerixafor Mozobil® (Genzyme/Sanofi)

SQ: Weight-based daily dosing, given approximately 11 hours prior to each apheresis

Nausea, vomiting, diarrhea, tiredness, headache, dizziness, joint or muscle pain, injection site reaction, low platelets

May cause embryo-fetal harm May be scheduled or used “on demand”

Supportive Care Stem cell mobilizer

Reversible CXCR4 antagonist for use in combination with GCSF to mobilize hematopoietic stem cells prior to ASCT in patients with NHL or MM

<83 kg: 20mg fixed-dose or a dose based on 0.24mg/kg body weight 83-160kg: 0.24mg/kg body weight >160kg: fixed-dose at 40mg

*This document is not an exhaustive list of all drugs used in multiple myeloma. The IMF encourages you to consult with your healthcare team for all drug recommendations.