Bortezomib

Bortezomib is used in the treatment of multiple myeloma and mantle-cell lymphoma. It shows its working by stopping or slowing down the growth of cancer cells. Bortezomib is given as an injection by a qualified medical professional. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to. Fatigue, nausea, vomiting, and loss of appetite are some common side effects of this medicine. You may be advised to drink plenty of fluids every day during the treatment. You should not drive or operate machinery as medicine may cause tiredness and dizziness. This medicine may reduce the number of blood cells (decrease red blood and white blood cells) in your blood, thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells along with heart, liver, and blood uric acid levels. Before taking Bortezomib, consult with your doctor if you have any liver, kidney, heart disease or bleeding problem. It is important to consult a doctor if you develop symptoms like memory loss or trouble in thinking. Many other medicines can affect, or be affected by, this medicine so let your healthcare team know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. The use of effective contraception by both males and females during treatment is important to avoid pregnancy. Bortezomib is an anti-cancer medication. It works by blocking or slowing the breakdown of proteins in cells. As a result, there is an increase in a number of proteins in the cancer cells leading to their death.

• Multiple myeloma • Mantle-cell lymphoma

Bortezomib is a reversible inhibitor of the chymotrypsin-like activity of the 26-S proteasome. It prevents targeted proteolysis that affects multiple signaling cascades responsible for normal homeostatic functions within the cell, leading to cell death.

Adult Dose: Mantle Cell Lymphoma Indicated for treatment of patients with mantle cell lymphoma as first-line in previously untreated patients or those who have relapsed Previously untreated MCL 1.3 mg/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 rituximab 375 mg/m² IV, cyclophosphamide 750 mg/m² IV, and doxorubicin 50 mg/m² IV on day 1, plus prednisone 100 mg/m² IV on days 1-5 Relapsed MCL 1.3 mg/m²/dose IV/SC 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 Multiple Myeloma Previously untreated multiple myeloma Administer in combination with prednisone and melphalan as part of 6-wk treatment cycles for 9 cycles Cycles 1-4 (twice weekly): 1.3 mg/m² IV/SC on Days 1, 4, 8, 11, 22, 25, 29, and 32 Cycles 5-9 (once weekly): 1.3 mg/m² IV/SC on Days 1, 8, 22, and 29 Relapsed multiple myeloma 1.3 mg/m²/dose IV/SC 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) Re-treatment Indicated for re-treatment of adults with multiple myeloma who had previously responded to bortezomib and relapsed at least 6 months following completion of prior bortezomib treatment Treatment may be started at the last tolerated dose Administer twice weekly for 2 weeks (days 1, 4, 8, 11) followed by a 10-day rest period (days 12 to 21) Hepatic impairment Moderate-to-severe (bilirubin >1.5x ULN): Reduce to 0.7 mg/m² in the first cycle; consider dose escalation to 1 mg/m² or further dose reduction to 0.5 mg/m² in subsequent cycles based on tolerability

Your doctor or nurse will give you this medicine. Kindly do not self administer.

If you miss a dose of Bortezomib, please consult your doctor.

Common: • Low blood platelets • Fatigue • Peripheral neuropathy (tingling and numbness of feet and hand) • Psychiatric disturbances • Nausea • Vomiting • Loss of appetite • Fever • Anemia (low number of red blood cells) • Diarrhea • Decreased appetite • Decreased white blood cell count (neutrophils) • Constipation

[UNSAFE] Bortezomib may cause side effects which could affect your ability to drive. Bortezomib might cause tiredness, dizziness, fainting, or blurred vision which may affect your ability to drive. Before taking bortezomib, consult your doctor if you have any of the following disease conditions: disease of liver, kidney, heart or infections like fever with rash or genital sores, diabetes, low number of red or white blood cells or bleeding problems. Drink plenty of fluids every day during your treatment with bortezomib. Tell your doctor if you are or planning to become pregnant or are breastfeeding. Consult your doctor if you have signs of serious brain infection such as memory loss, trouble in thinking, difficulty with walking or loss of vision. Do not drive or operate machinery after taking bortezomib as it may cause tiredness, dizziness, fainting or blurred vision.

Hypersensitivity. Child. Pregnancy and lactation.

Concurrent use of amiodarone, antivirals, isoniazid, nitrofurantoin, statins may increase the chance of peripheral neuropathy. Concurrent use of antihypertensives increases the chance of hypotension.

[UNSAFE] Bortezomib may cause excessive drowsiness with alcohol.

[CONSULT YOUR DOCTOR] Bortezomib is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.

[UNSAFE] Bortezomib is unsafe to use during breastfeeding. Data suggests that the drug may cause toxicity to the baby.

[CAUTION] Bortezomib should be used with caution in patients with severe kidney disease. Dose adjustment of Bortezomib may be needed. Please consult your doctor. Limited information is available on the use of Bortezomib in these patients. [CAUTION] Bortezomib should be used with caution in patients with liver disease. Dose adjustment of Bortezomib may be needed. Please consult your doctor.

Please tell me the interpretation of the attach report, if possible. Also guide for further treatment process. U r having multiple myeloma Multiple myeloma can be cured or not Yes, if diagnosed at the right stage the injection said is Haemaz fort Injection of 5 ml, total 4 nos. injection is injected to sickle cell disease patient, if Hb is 7 gram, what will be the effect to patient? we dont treat sickle cell anaemia online, u need to consult hematologist Multiple sceloris_glatira injection 6 months can cure ? there is no curative trt in Ms; this drug lowers rate of progresion and lowers risk of disability Pus disharge from maxilla.Patient has multiple myeloma Tooth exfoliated from the jaw post which this change was noted OPG reveals radiolucency in that site Visit to a dentist for proper treatment by surgery. Report shows higher esr value what should i do. A very high ESR usually has an obvious cause, such as a severe infection, marked by an increase in globulins, polymyalgia rheumatica or temporal arteritis. A health practitioner will typically use other follow-up tests, such as blood cultures, depending on the person's symptoms. People with multiple myeloma or Waldenstrom's macroglobulinemia (tumors that make large amounts of immunoglobulins) typically have very high ESRs even if they don't have inflammationNeed to correlate clinicallyKindly consult your doctor Sir my mother has undergone brain biopsy and the result was large B cell lymphoma I want to know what can be done to her You need to start her on chemotherapy What is LENALIDOMIDE & why should it be taken ? Lenalidomide is a anti myeloma medicine