section name header

Pronunciation

bor-TEZ-o-mib

Classifications

Therapeutic Classification: antineoplastics

Pharmacologic Classification: proteasome inhibitors

Indications

High Alert

Action

Therapeutic Effects:

Pharmacokinetics

Absorption: IV administration results in complete bioavailability.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: Mostly metabolized by the liver via the CYP2C19, CYP3A4, and CYP1A2 isoenzymes, and to a lesser extent by the CYP2D6 and CYP2C9 isoenzymes; excretion pathway unknown.

Half-life: 9–15 hr.

Time/Action Profile

ROUTEONSETPEAKDURATION
IVunknown38 days*unknown

*Median time to response based on clinical parameters.

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypotension, HF.

Derm: STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS.

EENT: blurred vision, diplopia.

GI: anorexia, constipation, diarrhea, nausea, vomiting, LIVER FAILURE.

Hemat: anemia, neutropenia, thrombocytopenia, BLEEDING, THROMBOTIC THROMBOCYTOPENIC PURPURA/HEMOLYTIC UREMIC SYNDROME.

Neuro: fatigue, malaise, peripheral neuropathy, weakness, dizziness, POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME (PRES), syncope.

Resp: pneumonia.
Misc: fever, tumor lysis syndrome.

Interactions

Drug-Drug:

Route/Dosage

see Calculator

Previously Untreated Multiple Myeloma

Hepatic Impairment

Previously Untreated Mantle Cell Lymphoma

Hepatic Impairment

Relapsed Multiple Myeloma and Mantle Cell Lymphoma

Hepatic Impairment

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Velcade