Bortezomib is a drug used in the treatment of multiple myeloma and one type of lymph node cancer, namely mantle cell lymphoma. This drug is available in injectable form and can only be given by a doctor or medical officer under the supervision of a doctor.

Bortezomib is a cancer drug belonging to the class of proteasome inhibitors ( proteasome inhibitors ). This drug works by blocking the role of the proteasome, resulting in disruption of protein metabolism in cells. This way of working then triggers the death process of cancer cells.

Trademarks of bortezomib: Bormib, Bortecade 1, Bortecade 3,5, Bortero, Fonkozomib, Teoxib, Tezobell, Velcade

What is Bortezomib

class Prescription drug
Category Anticancer (proteasome inhibitor)
Benefit Treating multiple myeloma and mantle cell lymphoma ( mantle cell lymphoma )
Used by Mature
Bortezomib for pregnant and lactating women Category D: There is positive evidence of a risk to the human fetus, but the benefits may outweigh the risks, for example in dealing with a life-threatening situation. It is not known whether Bortezomib passes into breast milk. However, because of the potential for negative effects on a nursing infant, do not breastfeed while using this medicine.
Drug form Inject

Precautions Before Using Bortezomib

Bortezomib will be given by a doctor or medical officer under the supervision of a doctor. There are several things you should know before undergoing treatment with bortezomib, namely:

  • Tell your doctor about your history of allergies. Bortezomib should not be given to patients who are allergic to this drug, boron , or mannitol .
  • Tell your doctor if you have or have ever had peripheral nerve disease (peripheral neuropathy), liver disease, kidney disease , dehydration, heart disease , blood clotting disorders, blood disorders , diabetes, orthostatic hypotension , or infectious diseases .
  • Tell your doctor if you are taking certain medications, supplements, or herbal products.
  • Tell your doctor if you plan to have any vaccinations while taking bortezomib.
  • Tell your doctor if you are taking bortezomib before having any surgery, including dental surgery.
  • Use effective contraception to prevent pregnancy while on treatment with bortezomib, because this drug should not be used in pregnant women or those planning a pregnancy.
  • Do not breastfeed during treatment for up to 2 months after the end of last therapy with bortezomib.
  • Avoid direct contact with someone who is experiencing an infectious disease that is easily transmitted, because this drug can increase your risk of infection.
  • Do not drive a vehicle, operate heavy machinery, or do anything that requires alertness after using bortezomib, because this drug can cause dizziness.
  • Do not consume alcoholic beverages while on treatment with bortezomib, as this can increase the risk of side effects.
  • See a doctor immediately if you have an allergic drug reaction , overdose, or serious side effects.

Dosage and Rules for Use Bortezomib

The doctor will determine the dose of bortezomib according to the patient's condition and body surface area (LPT). In general, the following are the dosages for using bortezomib:

Condition: Multiple myeloma

  • Dosage cycles 1–4: 1.3 mg/m 2 The drug is administered twice a week on days 1, 4, 8, 11, 22, 25, 29, and 32.
  • Cycle 5–9: 1.3 mg/m 2 The drug is administered once a week, on days 1, 8, 22, and 29.
  • Dosage if multiple myeloma recurs: 1.3 mg/m 2 Administration of the drug is done twice a week on days 1, 4, 8, 11, followed by a rest period for 10 days. Treatment was extended to more than 8 cycles, given once a week, for 4 weeks (days 1, 8, 15, 22), followed by a rest period of 13 days (days 23 to 35).

Condition: Mantle  cell lymphoma

  • Typical dosage: 1.3 mg/m 2  LPT administered 2 times a week, for 2 weeks (on days 1, 4, 8, 11). This is followed by a rest period of 10 days (12 to 21 days). Treatment will be combined with rituximab, cyclophosphamide, doxorubicin, and prednisone.
  • Dosage if lymphoma recurs: Usual dose is repeated, then treatment may be extended for more than 8 cycles given once a week, for 4 weeks (days 1, 8, 15, 22), followed by a rest period of 13 days (day -23 to 35).

How to Use Bortezomib Properly

Bortezomib will be given by a doctor or medical personnel on the doctor's instructions. This medicine will be given by injection into the skin or a vein. Always follow the doctor's advice and recommendations while using bortezomib.

Before and after treatment with bortezomib, you may need to have a complete blood count, liver function tests, and kidney function tests. Increase your consumption of water while on bortezomib treatment.

Bortezomib can cause dizziness or fainting if you get up too quickly from a lying position. To prevent this risk, get up slowly, then place your feet on the floor in a sitting position for a few minutes before standing up.

Interactions of Bortezomib with Other Drugs

The following are some drug interactions that can occur if bortezomib is used with certain drugs:

  • Increased risk of peripheral neuropathy if used with amiodarone , isoniazid, statin cholesterol drugs, nitrofurantoin , and antiviral drugs
  • Increased risk of developing hypotension when used with antihypertensive drugs
  • Decreased blood levels of bortezomib and its effectiveness when used with phenobarbital , apalutamide, carbamazepine, or enzalutamide
  • Increased risk of developing serious infections when used with golimumab, adalimumab , baricitinib, fingolimod , certolozumab , bortezomib or etanercept
  • Decreased effectiveness of live vaccines, such as the BCG vaccine or typhoid vaccine
  • Decreased bone marrow function and white blood cell count when used with deferiprone or clozapine

Side Effects and Dangers of Bortezomib

Side effects that may occur after using bortezomib are:

  • The injection site is painful, red, bruised, bleeding or hard
  • Nausea or vomiting
  • Headache or dizziness
  • Abdominal pain and loss of appetite
  • Constipation or diarrhea
  • Sleep disturbance
  • Flu symptoms
  • The body feels tired

Call your doctor if the side effects above don't improve or get worse. Immediately see a doctor if you experience an allergic drug reaction or serious side effects, such as:

  • Chest pain , shortness of breath, swelling in the feet or hands
  • Severe headache, fainting , or confusion
  • Easy bruising , bloody bowel movements, pale skin, black vomit
  • Peripheral neuropathy, which can be characterized by symptoms, such as tingling , numbness, pain, or burning in the hands or feet
  • Infectious disease, which can be characterized by symptoms, such as fever , sore throat, chills, which do not improve
  • Liver disease, which can be characterized by symptoms, such as jaundice , severe abdominal pain, or dark urine
  • Tumor lysis syndrome , which can be characterized by symptoms such as back pain, painful urination, or infrequent urination
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