{
  "schema_version": 1,
  "kind": "condition",
  "id": "multiple-myeloma",
  "name": "Multiple myeloma (plasma cell myeloma)",
  "category": "chronic",
  "sources": "ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class BD25.03 - condition scope only, no dose · Multiple Myeloma - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK534764/ · No dose - referral pathway, no medicine given in primary care",
  "review_status": "reviewed",
  "verified_against": "No dose - referral pathway, no medicine given in primary care · Multiple myeloma (plasma cell myeloma) - disease-level clinical article (multiple-myeloma-clinical.txt)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1228,
      "generic": "No drug therapy in primary care (Referral & Advice)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": "Needs urgent haematology referral for diagnosis (protein studies, bone marrow) and chemotherapy; GP can offer cautious analgesia (avoiding NSAIDs, which risk worsening the renal impairment common in myeloma) while arranging referral.",
      "adult_duration": "Refer, with advice",
      "dose_source": "No dose - referral pathway, no medicine given in primary care",
      "rationale": "Needs urgent haematology referral for diagnosis (protein studies, bone marrow) and chemotherapy; GP can offer cautious analgesia (avoiding NSAIDs, which risk worsening the renal impairment common in myeloma) while arranging referral.",
      "cautions": [
        "RED FLAG - Acute metastatic spinal cord compression (severe new back pain, lower limb motor weakness, sensory level, urinary retention): assess urgently and refer.",
        "No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.",
        "RED FLAG - Spinal cord compression resulting from vertebral fracture or plasmacytoma is an emergency requiring immediate intervention.",
        "RED FLAG - Bone pain or pathological fracture, renal impairment, unexplained anaemia, hypercalcaemia symptoms (confusion, constipation, thirst), or recurrent infections."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children follow the same pathway: recognise and refer. No primary-care medicine is implied.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "multiple-myeloma"
    }
  ]
}