BORTEZOMIB
Background and Date of Approval
Bortezomib is a first-generation proteasome inhibitor approved for medical use on 13 May 2003.
Uses
Bortezomib has been developed to treat adult patients diagnosed with Multiple myeloma and mantle cell lymphoma.
How is it administered?
Bortezomib is available in the form of single dose vial containing lyophilized powder for injection in the doses 1mg, 2mg, 2.5mg, 3.5mg. Bortezomib Injection is intended for administration through intravenous and subcutaneous route only. Your healthcare provider will calculate the accurate dose depending on your health condition and the route of administration.
Side Effects
The common side effects that are likely to occur while you are on the treatment with Bortezomib are diarrhoea, rash, nausea, thrombocytopenia, neutropenia, tiredness, fever, vomiting, constipation, loss of appetite, etc. Serious side effects include heart problems, dizziness, confusion, tumor lysis syndrome, peripheral neuropathy, respiratory problems, liver problems, low blood cell counts. If you experience any allergic reactions such as swelling of lips, eyes, face, or tongue, hives, skin rashes, breathing trouble, report to your doctor immediately.
Warnings
Contact your doctor immediately if you experience increase in blood pressure, bleeding, fever or constipation. During the Bortezomib treatment, your doctor may periodically monitor your blood cell counts, platelets, blood sugar, electrolytes, liver and kidney parameters to prevent serious complications. Report to your doctor if you have been diagnosed with anaemia, liver problems, kidney disease, heart problem, etc. Get immediate medical attention if you experience itchy skin, rashes, or signs of infection or bleeding.
Precautions
Bortezomib can cause potential risk to the foetus. Hence it is advisable to use an effective contraception during treatment with bortezomib and for 7 months following the last dose. male patients with female partners of reproductive potential should use an effective contraceptive during treatment with bortezomib and for four months following the last dose. Report to your healthcare provider immediately if you or your female partner become pregnant during treatment or within 7 months after the last dose. It is not recommended to breastfeed during treatment with bortezomib and for two months after the last dose.
Word of Advice
Bortezomib may cause dizziness, postural hypotension and confusion. It is advisable to avoid driving or undertaking activities requiring sustained focus during treatment. Maintain adequate fluid intake to prevent dehydration. Monitor your blood sugar levels regularly if you are taking antidiabetic medication, and inform your doctor of any observed fluctuations in blood glucose.
References
Takeda Pharmaceuticals U.S.A., Inc., US Food & Drug Administration, [Revised on Aug 2022] [Accessed on 9th Sep 2022], https://www.velcade.com/files/pdfs/VELCADE_PRESCRIBING_INFORMATION.pdf Anton Wellstein, Giuseppe Giaccone, Michael B. Atkins, and Edward A. Sausville, Pathway-Targeted Therapies: Monoclonal Antibodies, Protein Kinase Inhibitors, and Various Small Molecules, Goodman & Gilmanâs Pharmacological Basis of Therapeutics, 13th Edition, 2018, 1203-1236.
Frequently Asked Questions
Is it safe to use Bortezomib during pregnancy?
Bortezomib is unsafe during pregnancy as it has the tendency to cause fetal harm. Your healthcare provider will conduct pregnancy test before and during treatment with Bortezomib to rule out pregnancy and prevent complications.
Who should not take Bortezomib Injection?
People who have experienced allergic reactions to Bortezomib, boron and mannitol should not take Bortezomib Injection. This injection is not intended for administration through intrathecal (spinal) route.
What are the common side effects of Bortezomib Injection?
Diarrhoea, rash, nausea, thrombocytopenia, neutropenia, tiredness, peripheral neuropathy, fever, vomiting, constipation, loss of appetite are the most common side effects of Bortezomib.
When should you contact your physician?
Reach out to your health care provider and immediate medical attention if you experience increase in blood pressure, bleeding, fever, abnormal heart rhythm, skin rashes, neuropathic pain, weakness or constipation.
What parameters will be monitored during treatment with Bortezomib?
During treatment with Bortezomib, your health care provider will monitor RBC, WBC, platelets, liver, blood glucose and kidney parameters.
How would you know if you are allergic to Bortezomib Injection?
Hypersensitivity reactions like severe itching, rashes, fever, peeling of skin, redness, rapid heartbeat, breathing trouble, dizziness and swelling of lips, mouth, tongue or throat indicate that you are allergic to Bortezomib. Seek medical attention from your healthcare provider immediately if you experience any of the above symptoms.
What should you avoid during treatment with Bortezomib?
Avoid taking medications like ketoconazole or rifampin during treatment with Bortezomib Injection.