- Multiple myeloma:
- Previously untreated multiple myeloma:
- Cycles 1-4 (twice weekly): IV/SC 3mg/m² on Days 1, 4, 8, 11, 22, 25, 29, and 32
- Cycles 5-9 (once weekly): IV/SC 1.3mg/m² on Days 1, 8, 22, and 29
- Administer in combination with prednisone and melphalan as part of 6 week treatment cycles for 9 cycles
- Previously untreated multiple myeloma:
- Relapsed multiple myleoma:
- IV/SC 1.3mg/m²/dose twice weekly for 2 weeks (Days 1, 4, 8, and 11) followed by a 10-day rest period (Days 12-21)
- Therapy extending beyond 8 cycles: Standard schedule or maintenance schedule of once weekly for 4 weeks (Days 1, 8, 15, and 22) followed by a 13-day rest period (Days 23 to 35)
- Retreatment of adults with multiple myeloma who had previously responded to bortezomib and relapsed at least 6 months following completion of prior bortezomib treatment:
- Administer twice weekly for 2 weeks (days 1, 4, 8, 11) followed by a 10-day rest period (days 12 to 21)
- Treatment may be started at the last tolerated dose
- First line in mantle cell lymphoma (MCL) in previously untreated patients or those who have relapsed:
- Previously untreated MCL:
- IV 3mg/m²/dose IV twice weekly for 2 weeks (days 1, 4, 8, 11) followed by a 10-day rest period (days 12 to 21) for six 3-week cycles
- May continue for 8 cycles if response is first seen at cycle 6
- Give with IV rituximab 375mg/m², IV cyclophosphamide 750mg/m² and IV doxorubicin 50mg/m² on day 1, plus IV prednisone 100mg/m² on days 1-5
- Previously untreated MCL:
- Relapsed MCL:
- IV/SC 3mg/m²/dose twice weekly for 2 weeks (days 1, 4, 8, 11) followed by a 10-day rest period (days 12 to 21)
- Therapy extending beyond 8 cycles: Give standard schedule
- Max: 17 cycles
Injection: 3.5mg
- Doses given at least 72 hours apart
- Consider SC route if there is risk peripheral neuropathy
Proteasome inhibitor anticancer
It reversibly inhibits 26S proteasome, disrupting cellular homeostasis and causing cell death
- Nausea
- Diarrhea
- Peripheral neuropathy
- Fatigue
- Thrombocytopenia
- Vomiting
- Constipation
- Fever
- Anemia
- Anorexia
- Neutropenia
- Headache
- Paresthesia
- Rash
- Weakness
- Hypotension
- Dizziness
- Abdominal pain
- Dyspnea
- Herpes viral infection
- Hypersensitivity to drug/class/components
- Hypersensitivity to boron or mannitol
- Intrathecal use
- ANC <1000 (combo w/ melphalan and prednisone)
- Plt <70,000 (combo w/ melphalan and prednisone)
- Breastfeeding during treatment and 2 months after discontinuation
- Live bacterial vaccines
- Green tea
- Eliglustat
Drug Status
Availability | Prescription only |
Pregnancy | Category D |
Breastfeeding | Contraindicated |
Schedule | Not controlled |
BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
---|---|---|---|---|---|
Bortemib | 2mg | Injection | 1’s | PSM Pharma | PSM Pharma |
Bortemib | 3.5mg | Injection | 1’s | PSM Pharma | PSM Pharma |
Bortimore | 3.5mg | Injection | 1’s | Atlanta Biologicals | Synermed Pharma |
Mibzo | 3.5mg | Injection | 1’s | MSN Labs | MSN Labs |
Velcade | 3.5mg | Injection | 1’s | Jansenn Pharma | Surgipharm Ltd |