• 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
  • 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
  • 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