Bortezomib


Concise Prescribing Info
Indications/Uses
Multiple myeloma.
Dosage/Direction for Use
Adult : IV 1.3 mg/m2 as bolus on days 1, 4, 8 and 11 of a 21-day cycle, followed by a 10-day rest period (days 12-21). Ensure at least 72-hr gap between consecutive doses.
Dosage Details
Intravenous
Multiple myeloma
Adult: Patients without symptoms or with Grade 1 peripheral neuropathy symptoms: 1.3 mg/m2 as IV bolus over 3-5 sec on days 1, 4, 8 and 11 of a 21-day cycle, followed by a 10-day rest period (days 12-21). At least 72 hr should elapse between consecutive doses.
Special Patient Group
Onset of any Grade 3 non-haematological or Grade 4 haematological toxicities excluding neuropathy: Withhold therapy until toxicities symptoms resolved, then reinitiate at 25% reduced dose. Grade 1 with pain or Grade 2 peripheral neuropathy symptoms: 1 mg/m2 twice wkly for 2 wk (days 1, 4, 8, 11), then a 10-day rest period (days 12-21). At least 72 hr should elapse between consecutive doses. Grade 2 with pain or Grade 3 peripheral neuropathy symptoms: Withhold therapy until toxicity resolves, then reduce dose to 0.7 mg/m2 wkly. Grade 4 peripheral neuropathy symptoms: Discontinue.
Contraindications
Hypersensitivity. Child. Pregnancy and lactation.
Special Precautions
Hepatic or renal impairment; history of syncope, orthostatic hypotension; dehydration. Impairs ability to drive or operate machinery. Monitor for symptoms of peripheral neuropathy. Monitor closely the blood glucose levels in patients receiving oral antidiabetic agents.
Adverse Reactions
Asthenic conditions; pyrexia; GI disturbances, anorexia; dehydration; peripheral neuropathy; thrombocytopenia, neutropenia, anaemia; hypotension; cardiac disorders; bone and body pain; cough, dyspnoea; rash, oedema; hypersensitivity reactions; painful or difficult urination.
Potentially Fatal: Pneumonia, pyrexia, diarrhoea, vomiting, dehydration and nausea.
IV/Parenteral/SC: D
Overdosage
Symptoms include hypotension and thrombocytopenia. Monitor vital signs and admin appropriate supportive care.
Drug Interactions
Concurrent use of amiodarone, antivirals, isoniazid, nitrofurantoin, statins may increase the chance of peripheral neuropathy. Concurrent use of antihypertensives increases the chance of hypotension.
Action
Description: Bortezomib is a reversible inhibitor of the chymotrypsin-like activity of the 26-S proteasome. It prevents targeted proteolysis that affects multiple signaling cascades responsible for normal homeostatic functions within the cell, leading to cell death.
Pharmacokinetics:
Distribution: Protein binding: >80%.
Metabolism: Mainly metabolised via the cytochrome P450 isoenzymes CYP3A4, CYP2C19 and CYP1A2.
Disclaimer: This information is independently developed by MIMS based on Bortezomib from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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