{"id":1680,"date":"2023-06-25T17:31:26","date_gmt":"2023-06-25T17:31:26","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/bortezomib\/"},"modified":"2023-06-25T19:47:48","modified_gmt":"2023-06-25T19:47:48","slug":"bortezomib","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/bortezomib\/","title":{"rendered":"Bortezomib"},"content":{"rendered":"

<\/p>\n

Bortezomib<\/h1>\n

CLINICAL USE<\/h3>\n

Treatment of multiple myeloma for people who have already tried at least 2 prior therapies and have disease progression<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

1.3 mg\/m2 twice weekly for 2 weeks (days 1, 4, 8 and 11) followed by a 10-day rest period<\/p>\n

PHARMACOKINETICS<\/h3>\n
  • Molecular weight                           :384.2<\/li>\n
  • %Protein binding                           :82.9<\/li>\n
  • %Excreted unchanged in urine     : Small amount<\/li>\n
  • Volume of distribution (L\/kg)       :>500 litres<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :5\u201315\/unknown
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n

    30\u201350 Dose as in normal renal function 10\u201330 Dose as in normal renal function. Monitor carefully.<\/li>\n

  • <10           : A reduced dose may be required. Monitor carefully
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :Unlikely to be dialysed. Dose as in GFR <10 mL\/min<\/li>\n
  • HD                     :Unlikely to be dialysed. Dose as in GFR <10 mL\/min<\/li>\n
  • HDF\/high flux   :Unknown dialysability. Dose as in GFR <10 mL\/min<\/li>\n
  • CAV\/VVHD      :Unlikely to be dialysed. Dose as in GFR=10\u201330 mL\/min
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugsNone known<\/p>\n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    3.5 mL sodium chloride 0.9%<\/p>\n

    Route<\/h4>\n

    IV bolus<\/p>\n

    Rate of Administration<\/h4>\n

    3 to 5 seconds<\/p>\n

    Comments<\/h4>\n

    Administer within 8 hours of reconstitution<\/p>\n

    OTHER INFORMATION<\/h4>\n<\/li>\n
  • Consecutive doses should be at least 72 hours apart<\/li>\n
  • Normal doses have been used in patients with a GFR of 10\u201330 mL\/min but there is an increased risk of adverse effects. (Jagannath S, Barlogie B, Berenson JR, et al. Bortezomib in recurrent and\/or refractory multiple myeloma. Cancer. 2005; 103(6): 1195\u20131200)<\/li>\n
  • Some trials have used doses of 1 mg\/m 2 in patients with a GFR of 10\u201330 mL\/min, with similar efficacy and incidence of side effects<\/li>\n
  • Both hypo- and hyperkalaemia have been reported with bortezomib as has hypophosphataemia and hypomagnesaemia<\/li>\n
  • There have been incidences of renal impairment, renal colic, proteinuria, dysuria, urinary frequency, urinary hesitation and haematuria<\/li>\n
  • Anecdotally, has been used at normal doses in a few haemodialysis patients; in some of the patients platelet infusions have been required<\/li>\n
  • In patients with peripheral neuropathy then bortezomib has a high probability of exacerbating it.<\/li>\n","protected":false},"excerpt":{"rendered":"

    Bortezomib CLINICAL USE Treatment of multiple myeloma for people who<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1680","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1680","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1680"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1680\/revisions"}],"predecessor-version":[{"id":2872,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1680\/revisions\/2872"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1680"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1680"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1680"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}