Treatment of multiple myeloma and relapsed or refractory mantle cell lymphoma
Investigational -Treatment of relapse acute lymphocytic leukemia and acute myeloid leukemia
THIS MEDICATION IS TO BE ADMINISTERED BY A CHEMO-TRAINED NURSE. IF THE NURSE IS NOT CHEMO-TRAINED, THEY ARE TO CONTACT THE UNIT NURSE EDUCATOR OR ADVANCED PRACTICE NURSE.
- Available as sterile lyophilized powder containing 3.5 mg/vial (and 35 mg of mannitol/vial). Preservative free.
- Store vials at room temperature [15 -30C]. Protect from light.
- Dilute with 3.5 mL of normal saline for 1 mg/mL clear and colorless solution [pH of approximately 5-6]. Store at room temperature. Stable for 8 hours in syringe or original vial exposed at normal indoor lighting.
- Solutions Compatible: NS
- DO NOT mix with any other drugs
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
|IV Direct||YES: administer over 3-5 seconds; do not further dilute|
|IV Intermittent Infusion||NO|
|IV Continuous Infusion||NO|
|INTRATHECAL||NO - FATAL|
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Use Investigational supply from NCI
· 1.3 mg/m2/dose on Days 1, 4 and 8. Doses must be separated by at least 72 hours.
Usual dose: 1 - 1.3 mg/m2/day days 1,4,8 and 11
Immediate (hours to days):
-Fever (~ 35%), rigors (~10%), rash/urticaria (~25%), pruritus (~12%)
-Hypersensitivity reactions (< 1%), hypotension, diarrhea (common), nausea, constipation,
-Anorexia, vomiting, abdominal pain, abnormal taste, dyspepsia, dizziness, headache
Other (days to weeks)
-Neutropenia, thrombocytopenia, anemia
-Peripheral neuropathy (>20%), musculoskeletal pain,
sensory neuropathy (>20%)
-Cough, dyspnea, respiratory failure (rare)
-Blurred vision, mood changes, anxiety, insomnia
-Herpes virus infections reactivation
· Patients must meet specific criteria for hepatic and pulmonary function and neurologic status to receive each dose of Bortezomib
· Treatment for unusual side effects is available through the study chair identified on the front page of the protocol and/or pharmacy.
Extravasation Hazard: Irritant
· Monitor for pulmonary toxicity and neuropathies prior to each dose
· Monitor hepatic function
· Multiple drug-drug, drug-food and drug-supplement interactions (including green tea and dietary vitamin C). Consult pharmacy and/or protocol appendix prior to start of new concomitant agent.
· Avoid the following enzyme-inducing anticonvulsants: carbamazepine, felbamate, phenobarbital, phenytoin, primidone, oxcarbazepine
. Fevers and chills may occur 2 to 6 hours after IV administration. If this occurs, premedication with acetaminophen, H1 antihistamine, and hydrocortisone may decrease the severity of fever and chills.
- COG Chemotherapy Administration Guidelines Volume 7 September 2015