Bortezomib is a proteasome inhibitor indicated for:

• Treatment of patients with multiple myeloma
• Treatment of patients with mantle cell lymphoma who have received at least 1 prior therapy

The recommended dose of Bortezomib is 1.3 mg/m2 administered as a 3 to 5 second bolus intravenous injection. Dose adjustment may be used to manage adverse events that occur during treatment

Bortezomib is contraindicated in patients with hypersensitivity to bortezomib, boron, or mannitol

Most commonly reported adverse reactions (incidence ≥30%) in clinical studies include asthenic conditions, diarrhea, nausea, constipation, peripheral neuropathy, vomiting, pyrexia, thrombocytopenia, psychiatric disorders, anorexia and decreased appetite, neutropenia, neuralgia, leukopenia and anemia. Other adverse reactions, including serious adverse reactions, have been reported

Women should avoid becoming pregnant while being treated with Bortezomib. Pregnant women should be apprised of the potential harm to the fetus

Peripheral neuropathy, including severe cases, may occur - manage with dose modification or discontinuation. Patients with preexisting severe neuropathy should be treated with Bortezomib only after careful risk-benefit assessment.

Hypotension can occur. Caution should be used when treating patients receiving antihypertensives, those with a history of syncope, and those who are dehydrated. 

Patients with risk factors for, or existing heart disease, should be closely monitored.

Acute diffuse infiltrative pulmonary disease has been reported.

Nausea, diarrhea, constipation, and vomiting have occurred and may require use of antiemetic and antidiarrheal medications or fluid replacement.

Thrombocytopenia or neutropenia can occur; complete blood counts should be regularly monitored throughout treatment.

Tumor Lysis Syndrome, Reversible Posterior Leukoencephalopathy Syndrome, and acute hepatic failure have been reported.

Pregnancy & Lactation

Pregnancy Category D. Women of childbearing potential should avoid becoming pregnant while being treated with Bortezomib. Bortezomib administered to rabbits during organogenesis at a dose approximately 0.5 times the clinical dose of 1.3 mg/m2 based on body surface area caused post implantation loss and a decreased number of live fetuses.