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Ninlaro (ixazomib) is the first oral proteasome inhibitor approved for multiple myeloma, offering an alternative to injectable proteasome inhibitors for combination therapy.
Ninlaro is FDA-approved, in combination with lenalidomide and dexamethasone, for adult patients with multiple myeloma who have received at least one prior therapy.
Limitation of Use: Ninlaro is not recommended for use in the maintenance setting, or in newly diagnosed multiple myeloma outside of its approved combination regimen, outside of controlled clinical trials — increased deaths were observed with maintenance-setting use in clinical trials.
Ixazomib inhibits the 26S proteasome, disrupting protein degradation pathways that multiple myeloma cells depend on for survival, leading to cell death.
The recommended starting dose is 4 mg orally on Days 1, 8, and 15 of a 28-day cycle, taken at least 1 hour before or 2 hours after food, in combination with lenalidomide and dexamethasone, as determined by the treating hematologist-oncologist.
Ninlaro requires monitoring for several adverse effects, particularly when combined with lenalidomide and dexamethasone.
Monitor platelet counts regularly, especially during the first three cycles.
In two prospective randomized clinical trials in multiple myeloma, treatment with Ninlaro in the maintenance setting resulted in increased deaths. Ninlaro is not recommended for use in the maintenance setting or in newly diagnosed multiple myeloma outside of its approved combination with lenalidomide and dexamethasone.
Diarrhea, constipation, nausea, and vomiting can occur, occasionally requiring antiemetic or antidiarrheal treatment and dose modification.
Monitor for symptoms and adjust dosing as needed.
Monitor for fluid retention and investigate underlying causes; manage with dose adjustment if needed.
A rare but serious risk. Discontinue Ninlaro if thrombotic microangiopathy is suspected.
Monitor hepatic enzymes periodically during treatment.
Ninlaro can cause fetal harm. Effective contraception is required during treatment and for a defined period after the final dose.
Step 1 – Search & request your medicine: The patient or treating doctor submits a request with basic details to initiate the access process.
Step 2 – Verification & eligibility review: The team verifies availability and reviews eligibility against regulatory and clinical requirements to ensure a compliant pathway.
Step 3 – Receive quote & delivery timeline: A transparent quotation is shared, covering medicine cost, logistics, and a clear delivery timeline.
Step 4 – Regulatory approval process: Assistance is provided to secure the approvals and documentation required for legal cross-border access.
Step 5 – Temperature-controlled import & handling: The medicine is sourced and transported under strict GDP-compliant conditions to maintain product integrity.
Step 6 – Secure delivery: The medicine is delivered to the patient or treating hospital, with updates provided at each stage.
Note: From request to delivery, every step is designed to ensure your treatment reaches you safely, compliantly, and without unnecessary delays.
Ninlaro (ixazomib) is manufactured by Takeda Pharmaceutical Company Limited and is the first oral proteasome inhibitor approved for multiple myeloma.
Import of Ninlaro through a Named Patient Program requires a valid prescription from the treating hematologist-oncologist, confirmation of multiple myeloma diagnosis and treatment history, and supporting clinical documentation as required by Indian regulatory authorities.
NPP sources Ninlaro directly from Takeda's authorized supply chain to ensure product authenticity and regulatory compliance.
Ninlaro is sourced through verified, GDP-compliant channels from Takeda's authorized supply chain to ensure authenticity and quality.
Ninlaro capsules should be stored at 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C and 30°C (59°F to 86°F).
Once sourced, Ninlaro is packed and transported under appropriate temperature-controlled conditions to preserve product integrity throughout the import process, with tracking and updates provided at each stage of delivery to the patient or treating hospital in India.
Patients across India can access Ninlaro through NPP's regulated import pathway, with hematology-oncology specialists in major cities supporting the treatment process.
Leading hematology-oncology centers in Mumbai support multiple myeloma diagnosis and treatment coordination for Ninlaro access.
Delhi's major cancer hospitals assist patients with diagnostic confirmation and prescription support for Ninlaro.
Bangalore's oncology network offers access to multiple myeloma treatment planning for eligible patients.
Chennai-based specialists coordinate Ninlaro access alongside comprehensive multiple myeloma care.
Hyderabad's cancer care institutions support patients pursuing Ninlaro therapy.
Kolkata's oncology centers help coordinate documentation and treatment access for Ninlaro.
Pune-based hematologists assist with diagnosis confirmation and Ninlaro treatment planning.
Ahmedabad's specialty hospitals support the import and treatment process for Ninlaro.
Kochi's oncology units assist patients with the documentation needed for Ninlaro access.
Chandigarh's cancer care centers support Ninlaro treatment coordination for patients from North India.
Jaipur's oncology specialists help patients navigate the Ninlaro access process.
Lucknow-based cancer centers assist patients pursuing Ninlaro therapy.
Bhubaneswar's oncology institutions support access to Ninlaro for eligible patients.
Guwahati's specialists help coordinate Ninlaro access for patients across the Northeast.
Patients in other cities across India can also access Ninlaro through NPP's nationwide coordination network.
Written By: Nitin Goswami, Senior Medical Content Writer
Last Updated: 09 September 2026
Sources: FDA • CDSCO
Medically Reviewed By: Shilpi Banerjee, Registered Pharmacist (M.Pharm)
Last Updated: 09 September 2026
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