Bortezomib (Velcade)

From - A Hematology Oncology Wiki
Jump to: navigation, search

General information

Class/mechanism: Reversible inhibitor of the 26S proteasome, interfering with degradation of ubiquitinated proteins. This disrupts normal homeostatic mechansims, leading to cell death.[1][2][3]
Route: IV, SC
Extravasation: irritant

  • Use antiviral prophylaxis (such as with acyclovir (Zovirax) 400 mg PO daily or valacyclovir (Valtrex) 250-500 mg PO daily) to decrease risk of reactivating herpes zoster in patients treated with Bortezomib (Velcade)[4]

For conciseness and simplicity, currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, Medscape, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]

Diseases for which it is used

Notable side effects

Patient drug information

History of changes in FDA indication

  • 5/13/2003: FDA approved "for the treatment of multiple myeloma patients who have received at least two prior therapies and have demonstrated disease progression on the last therapy."
  • 3/25/2005: FDA approved "for the treatment of multiple myeloma patients who have received at least 1 prior therapy."
  • 12/8/2006: FDA approved "for the treatment of patients with mantle cell lymphoma who have received at least one prior therapy."
  • 6/23/2008: FDA approved "for the treatment of patients with multiple myeloma" (previously was only approved for patients who had received prior therapy).
  • 10/8/2014: FDA approved for "treatment of patients with mantle cell lymphoma" (including first-line therapy for untreated patients; previously was only approved for patients who had received at least one prior treatment).

Also known as

  • Code names: LDP 341, MLN341, PS-341
  • Brand names: Biocure, Borater, Bortecad, Bortemib, Bortenat, Bortetrust, Bortrac, Borvex, Borviz, Botepar, Bromadene, Egybort, Mibor, Myezom, Norvelzo, Ortez, Velcade, Zomib, Zuricade


  1. 1.0 1.1 1.2 Bortezomib (Velcade) package insert
  2. Bortezomib (Velcade) package insert (locally hosted backup)
  3. Velcade manufacturer's website
  4. Vickrey E, Allen S, Mehta J, Singhal S. Acyclovir to prevent reactivation of varicella zoster virus (herpes zoster) in multiple myeloma patients receiving bortezomib therapy. Cancer. 2009 Jan 1;115(1):229-32. link to original article PubMed
  5. Broyl A, Corthals SL, Jongen JL, van der Holt B, Kuiper R, de Knegt Y, van Duin M, el Jarari L, Bertsch U, Lokhorst HM, Durie BG, Goldschmidt H, Sonneveld P. Mechanisms of peripheral neuropathy associated with bortezomib and vincristine in patients with newly diagnosed multiple myeloma: a prospective analysis of data from the HOVON-65/GMMG-HD4 trial. Lancet Oncol. 2010 Nov;11(11):1057-65. Epub 2010 Sep 21. link to original article contains verified protocol PubMed
  6. Bortezomib (Velcade) patient drug information (Chemocare)
  7. Bortezomib (Velcade) patient drug information (UpToDate)