bortezomib mannitol boronic ester at a glance
Medicine class
Proteasome inhibitor used as systemic anticancer treatment.
Main licensed uses
Multiple myeloma and, in a specified combination, mantle cell lymphoma.
Administration
Injection under the skin or into a vein; it must never be injected into the spinal canal.
Key monitoring issue
Report new or worsening numbness, tingling, burning pain or weakness promptly.
What is bortezomib mannitol boronic ester used for?
Licensed adult uses include:
Progressive multiple myeloma after previous therapy, alone or with pegylated liposomal doxorubicin or dexamethasone, where stem-cell transplantation has occurred or is unsuitable.
Previously untreated multiple myeloma in people unsuitable for high-dose chemotherapy with stem-cell transplantation, combined with melphalan and prednisone.
Induction treatment of previously untreated multiple myeloma before high-dose chemotherapy and stem-cell transplantation, combined with dexamethasone, with or without thalidomide.
Previously untreated mantle cell lymphoma where stem-cell transplantation is unsuitable, combined with rituximab, cyclophosphamide, doxorubicin and prednisone.
How does bortezomib mannitol boronic ester work?
Proteasomes normally break down selected proteins inside cells. Bortezomib reversibly blocks the 26S proteasome, disrupting protein control and survival signals so susceptible cancer cells stop dividing and undergo cell death.
bortezomib mannitol boronic ester preparations and strengths
Injection
Route: Parenteral
Strengths: 1 mg, 2.5 mg, 2.5 mg/mL, 3.5 mg
How to take bortezomib mannitol boronic ester
Bortezomib is prepared and usually administered by an experienced healthcare professional, either under the skin of the abdomen or thigh or into a vein. Subcutaneous sites should be rotated. Some NHS services permit home administration of prepared syringes after assessment, training and ongoing review.
Do not inject into sore, inflamed, hardened or damaged skin.
Do not self-administer unless your specialist service has trained and authorised you.
If trained for home use, follow the service’s storage, handling, sharps-disposal and symptom-check instructions.
Use only the route shown on the treatment plan. Never inject bortezomib into the spinal canal.
bortezomib mannitol boronic ester side effects
Common or expected effects
- Nausea, vomiting, diarrhoea or constipation
- Tiredness, fever, headache or reduced appetite
- Numbness, tingling, burning pain or weakness from peripheral neuropathy
- Low platelets, red cells or white cells, causing bruising, anaemia or increased infection risk
- Dizziness or a fall in blood pressure on standing
- Rash, muscle pain or injection-site reactions
- Shingles reactivation
Get urgent medical advice
- Fever, shivering or other signs of infection
- Unexpected or persistent bleeding
- New or rapidly worsening neuropathy or weakness
- Severe constipation, abdominal swelling or vomiting suggesting ileus
- Breathlessness, chest tightness, ankle swelling, fainting or altered heartbeat
- Seizure, severe headache, confusion or sudden visual disturbance
- Muscle cramps, weakness, confusion or breathlessness that may indicate tumour lysis syndrome
bortezomib mannitol boronic ester in pregnancy
Pregnancy should be avoided because human data are limited and fetal harm is possible. Product documents differ: the powder product specifies contraception for eight months after treatment for women and five months for men, while the solution product specifies three months for both. Follow instructions for the exact product and combination prescribed. Thalidomide-containing treatment has additional strict pregnancy-prevention requirements. Discuss fertility preservation before treatment where relevant.
bortezomib mannitol boronic ester while breastfeeding
Breastfeeding should stop during treatment because transfer into human milk is unknown and serious effects in an infant are possible. Ask the specialist team when it may safely restart.
bortezomib mannitol boronic ester interactions
Give the cancer team a complete list of prescribed, non-prescribed and herbal products. Important examples include:
Potent CYP3A4 inhibitors, including ketoconazole and ritonavir
They can increase bortezomib exposure, so closer monitoring may be required.
Strong CYP3A4 inducers, including rifampicin, carbamazepine, phenytoin and phenobarbital
They can reduce bortezomib exposure and potentially reduce its effect; combined use is not recommended by the product information.
Common questions about bortezomib mannitol boronic ester
Answers are fully visible for fast scanning and source review.
Is bortezomib mannitol boronic ester the same as bortezomib?
It is the form named in the product composition; bortezomib is the clinically active proteasome inhibitor.
Can bortezomib be given at home?
Some NHS services allow trained, assessed patients or carers to administer prepared subcutaneous syringes at home. This requires ongoing specialist review.
Can bortezomib neuropathy continue after treatment?
It can persist in some people, although symptoms may improve. Discuss ongoing symptoms with the specialist team.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.