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Proteasome inhibitor (specialist)

Bortezomib

Brand names: Velcade

Adult dose

Dose: 1.3mg/m² SC twice weekly per cycle (per protocol)
Route: SC / IV
Frequency: Per cycle

Clinical pearls

  • NICE TA228 / TA427 / TA755: multiple myeloma 1st-line / relapsed; mantle cell lymphoma
  • BSH myeloma; ESMO
  • SC route preferred over IV (less neuropathy); aciclovir prophylaxis

Contraindications

  • Severe hepatic impairment
  • Pregnancy
  • Hypersensitivity

Side effects

  • Peripheral neuropathy (very common)
  • Cytopenias
  • GI upset
  • Hepatotoxicity
  • Heart failure
  • HSV/VZV reactivation (give aciclovir prophylaxis)
  • Tumour lysis

Interactions

  • Strong CYP3A4 inhibitors
  • Antidiabetics (hypo or hyper)

Monitoring

  • FBC
  • LFTs
  • Neurological exam
  • BP
  • Glucose

Reference: BNF; NICE TA228; NICE TA427; BSH myeloma; ESMO; SmPC; https://bnf.nice.org.uk/drugs/bortezomib-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.