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bortenat-2mg

PRODUCT DETAILS

Trade name : Bortenat
Active component : Bortezomib
Strength of the component : 2mg vial
Manufactured by : Natco pharma
Pack : 2mg Bortezomib containing vial in a carton
Dosage form : lyophilized powder
Category : Anti-cancer drug; proteasome inhibitor

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Bortezomib is a drug sold under the brand name of Bortenat 2mg which belongs to anti-neoplastic medicine, the main ingredient which is used as bortenat, which is available in the form of lyophilized powder Bortenat 2mg is a prime benign proteasome inhibitor; proteasome is a biological structure that clefts the proteins Pharmacological grouped as: anti-neoplastic agent or proteasome inhibitor The drug is an prescription drug given under the supervision of pharmacist

PHARMACOKINETICS

Absorption:
The Bortenat 2mg peak plasma level occurs as 509ng/ml
Distribution:
The Bortenat 2mg has nearly 83% of human plasma protein binding.
Metabolism:
Primarily metabolic pathway of Bortenat 2mg is occurs by deboronation to form 2-deboronated metabolites which are inactive as 26S proteasome inhibitors. In liver Bortenat 2mg is metabolized with the help of cytochrome P 450 enzymes 3A4, 2C19, & 1A2 by oxidation
Elimination:
The half life period of Bortenat 2mg occurs at 9 to 15 hours In single dose IV;

In adults:
Multiple myeloma:
Previously untreated multiple myeloma In the therapy: Bortenat dose 1.3mg/m2 should be given as 3 to 5 seconds via IV bolus or subcutaneous by interacting with tablet melphalan and prednisolone for nine 6 weeks treatment cycles Bortenat is taken for two times weekly, (day 1, 4, 8, 11, 22, 25, 29 and 32) for Cycles 1 over 4 Bortenat is taken once a week (day 1, 8, 22, and 29) for Cycles 5 over 9 Duration of Bortenat is 72 hours
In Relapse stage:
The usual dose of Bortenat is 1.3mg/m2 should be given via IV bolus or subcutaneous as two times for two weeks (day1, 4, 8, and 11) followed by a ten day rest course (day 12 through 21) Schedule of Treatment increased above 8 cycles may be taken once weekly for 4 weeks (day 1, 8, 15, and 22), followed by 13 day rest (day 23 over 35)
Important points:
Bortenat administrated alone or combination with dexamethasone therapy cycle require of Three week course
Mantle cell lymphoma:
The usual dose of Bortenat for untreated mantle cell lymphoma is; Bortenat 1.3mg/m2 given as IV bolus given as two times weekly by concomitant with rituximab, cyclophospahmide, doxorubicin and tablet prednisolone for 2 weeks (day I, IV, VIII & XI) followed by rest period of 10 day (day II through 21). In Relapse stage: The regular dose of Bortenat is 1.3mg/m2 administered as IV bolus or subcutaneous 2 times for two weeks (day I, IV, VIII & XI) followed by 10 day rest period (day II through 21) The treatment followed for above 8 cycles may be taken for once weekly for 4 weeks (day 1, 8, 15 & 22), followed by rest of 13 day (days 23 through 35) Lyophilized powder form is Bortenat ; which is reconstituted by using 0.9% normal saline (NS) NaCl. Reconstituted the Bortenat 2mg in 2ml of 0.9% NS The route of administration is IV bolus Intrathecal not use for administration

MECHANISM OF ACTION

The drug Bortenat is a type of chymotrypsin like activity which is in form of unstable prohibitor of the 26S proteasome in human cells. The 26S proteasome is a group of protein that reduces the agglutinated proteins The various proteins are weakens by proteasome enzymes that make difficult to tumor cells persistence like cyclins, tumor suppressors, BCL-2 & cyclin dependent kinase inhibitors The functioning site of proteasome has Postglutamyl peptide hydrolysis activity Chymotrypsin like Trypsin like Prevention of these degenerations, sensitizes cells to apoptosis and cell arrest and leads to cell lysis

PRECAUTION & WARNING

While taking Bortenat 2mg some adverse effects occurs care should be taken in the conditions like Cardiac toxicity Pulmonary toxicity like Acute Respiratory Distress Syndrome, pneumonitis, interstitial pneumonia, lung infiltration. Posterior reversible encephalopathy syndrome-stop the Bortenat 2mg therapy Bortenat 2mg leads to peripheral neuropathy like burning sensation, hyperesthesia, hypoesthesia, paresthesia, neuropathic pain Manage postural Hypotension by altering the antihypertensive agents, hydration, and administration of mineralocorticoids or sympathomimetics Gastrointestinal toxicity-fluid or electrolyte replacements have to take Thrombocytopenia and neutropenia Tumor lysis syndrome Hepatic toxicity Embryo fetal toxicity

DRUG INTERACTION

Avoid interaction with st. Johns wort to decrease the exposure of Bortenat 2mg while concomitant with CYP3A4 inhibitors: there is a chance of getting Bortenat 2mg toxicity; so to reduce the dose of Bortenat 2mg Interaction with Strong CYP3A4 inducers: decrease the exposure of Bortenat 2mg while concomitant with melphalan-prednisone or dexamethasone alone No clinical effect on Bortenat 2mg exposure.

CONTRAINDICATION

Bortenat 2mg is administer through IV bolus or subcutaneous; whereas intrathecal administration is contraindicated to the patients who are receiving Bortezomib Hypersensitivity reaction occurs in patients who are contraindicated to Bortenat 2mg, boron, boric acid or glycine

MISSED DOSE

Bortenat 2mg is not a normal medicine used as anti-cancer drug; it is not to be self-medicated If a dose failed to take should consult with medical oncologist and followed the dosing schedules Avoid self administered Follow the advice given by physician and do not missed the cycles for course of therapy

SIDE EFFECTS

Most common side effects occurred after administration of Bortenat 2mg includes; Burning, crawling, itching, numbness, prickling ; Chest pain ; Black tarry stools; Bleeding gums ; Blood in urine ; Blurred vision ; Body aches, dizziness, faintness, nerve pain, painful urination, pale skin, runny nose, sore throat, stuffy nose, swollen glands, sunken eyes, ulcer, dry mouth, Cough producing mucus, ear congestion, loss of voice

Belching, bone pain, difficulty with moving & bowel movements, cold and shivering, loss of appetite, loss of taste, muscle cramps, muscle pain, stomach discomfort. Vomiting, loss of weight discomfort, increased sensitivity of pain & touch, irregular breathing, heart beats, swelling of peripheral organs, thickening of bronchial secretions

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