Bortezomib

Indications & Dose:

Treatment of multiple myeloma that has progressed despite the use of at least one therapy and where the patient has already had or is unable to have haematopoietic stem cell transplantation (either as monotherapy or in combination with pegylated liposomal doxorubicin or dexamethasone) Treatment of previously untreated multiple myeloma in patients who are not eligible for high-dose chemotherapy with haematopoietic stem cell transplantation (in combination with melphalan and prednisolone) Induction treatment of previously untreated multiple myeloma in patients who are eligible for high-dose chemotherapy with haematopoietic stem cell transplantation (in combination with dexamethasone or with dexamethasone and thalidomide) .

BY INTRAVENOUS INJECTION OR SUBCUTANEOUS INJECTION Adult: (consult local protocol)

Contraindications:

Acute diffuse infiltrative pulmonary disease

. pericardial disease

Side Effects:

Common or very common Constipation (cases of ileus reported). decreased appetite . diarrhoea . dyspnoea . fatigue . headache . herpes zoster. hypotension . myalgia . paraesthesia . peripheral neuropathy . pyrexia .rash . reactivation of herpes zoster. sensory neuropathy .

Uncommon Acute diffuse infiltrative pulmonary disorders . heart failure . posterior reversible encephalopathy syndrome (discontinue treatment). pulmonary hypertension .

seizures Rare Autonomic neuropathy .

Very rare Progressive multifocal leucoencephalopathy .

Frequency not known Alopecia . bone-marrow suppression . extravasation . hyperuricaemia . nausea .oral mucositis . thromboembolism .tumour lysis syndrome . vomiting.

PREGNANCY Toxicity in animal studies.

BREAST FEEDING Discontinue breast-feeding.

HEPATIC IMPAIRMENT Reduce dose in moderate to severe impairment.

Cautions:

Amyloidosis . cardiovascular disease . consider antiviral prophylaxis for herpes zoster infection . dehydration . history of syncope . pulmonary disease (discontinue if interstitial lung disease develops).risk factors for seizures .risk of neur-opathy-consult product literature.

Precautions:

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Interaction:

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Warnings:

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Adverse Effects:

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Lactations:

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Special Precautions:

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Counselling:

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Side Effects Or Adverse Reactions:

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Patient And Carer Advice:

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