Package Leaflet: Information for the User
Bortezomib Farmoz 3.5 mg powder for solution for injection EFG
Read all of this leaflet carefully before you start using this medicine because it contains important information for you.
Keep this leaflet, you may need to read it again.
Contents of the pack
This medicine contains the active substance bortezomib, a "proteasome inhibitor". Proteasomes play an important role in controlling cell function and growth. Bortezomib can destroy cancer cells by interfering with their function.
Bortezomib is used to treat multiple myeloma (a type of bone marrow cancer) in patients over 18 years of age:
Bortezomib is used to treat mantle cell lymphoma (a type of cancer that affects the lymph nodes) in patients over 18 years of age in combination with the medicines rituximab, cyclophosphamide, doxorubicin, and prednisone, in patients whose disease has not been previously treated and for those patients who are not considered suitable for a stem cell transplant.
Do not use Bortezomib Farmoz
Warnings and precautions
Tell your doctor if you have:
You will need to have regular blood tests before and during treatment with bortezomib to check your blood cell count regularly.
You must tell your doctor if you have mantle cell lymphoma and are given rituximab with bortezomib:
Before starting treatment with bortezomib, you should read the package leaflets of all the medicines you need to take with bortezomib to find out about the information related to these medicines. When using thalidomide, special attention should be paid to pregnancy testing and prevention measures (see Pregnancy and Breastfeeding in this section).
Children and adolescents
Bortezomib should not be used in children and adolescents because it is not known how it will affect them.
Other medicines and Bortezomib Farmoz
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.
In particular, tell your doctor if you are using medicines that contain any of the following active substances:
Pregnancy and breastfeeding
Do not use bortezomib if you are pregnant unless it is clearly necessary.
Both men and women using bortezomib must use effective contraception during and up to 3 months after treatment. If, despite these measures, you become pregnant, inform your doctor immediately.
Do not breastfeed while using bortezomib. Ask your doctor when it is safe to restart breastfeeding after finishing your treatment.
Thalidomide causes birth defects and fetal death. When bortezomib is given with thalidomide, you should follow the thalidomide pregnancy prevention program (see the thalidomide package leaflet).
Driving and using machines
Bortezomib may cause fatigue, dizziness, fainting, or blurred vision. Do not drive or use tools or machines if you experience these side effects; even if you do not experience them, you should still be cautious.
Your doctor will tell you the dose of bortezomib according to your height and weight (body surface area). The usual starting dose of bortezomib is 1.3 mg/m2 of body surface area twice a week.
Your doctor may change the dose and the total number of treatment cycles depending on your response to treatment, the occurrence of certain side effects, and your underlying condition (e.g., liver problems).
Progressive multiple myeloma
When bortezomib is given alone, you will receive 4 doses of bortezomib by intravenous or subcutaneous injection on days 1, 4, 8, and 11, followed by a 10-day "rest" period without treatment. This 21-day period (3 weeks) is one treatment cycle. You may receive up to 8 cycles (24 weeks).
You may also receive bortezomib with the medicines doxorubicin liposomal pegylated or dexamethasone.
When bortezomib is given with doxorubicin liposomal pegylated, you will receive bortezomib by intravenous or subcutaneous injection in a 21-day treatment cycle, and doxorubicin liposomal pegylated 30 mg/m2 will be given on day 4 of the bortezomib 21-day treatment cycle by intravenous infusion after the bortezomib injection.
You may receive up to 8 cycles (24 weeks).
When bortezomib is given with dexamethasone, you will receive bortezomib by intravenous or subcutaneous injection in a 21-day treatment cycle, and dexamethasone 20 mg will be given orally on days 1, 2, 4, 5, 8, 9, 11, and 12 of the bortezomib 21-day treatment cycle.
You may receive up to 8 cycles (24 weeks).
Previously untreated multiple myeloma
If you have not been previously treated for multiple myeloma and are not a candidatefor a stem cell transplant, you will receive bortezomib with the medicines melphalan and prednisone.
In this case, the duration of one treatment cycle is 42 days (6 weeks). You will receive 9 cycles (54 weeks).
Melphalan (9 mg/m2) and prednisone (60 mg/m2) are given orally during the first 4 days of each cycle.
If you have not received previous treatment for multiple myeloma and are a candidatefor a stem cell transplant, you will receive bortezomib by intravenous or subcutaneous injection with the medicines dexamethasone, or dexamethasone and thalidomide, as induction treatment.
When bortezomib is given with dexamethasone, you will receive bortezomib by intravenous or subcutaneous injection in a 21-day treatment cycle, and dexamethasone will be given orally at a dose of 40 mg on days 1, 2, 3, 4, 8, 9, 10, and 11 of the bortezomib 21-day treatment cycle.
You will receive 4 cycles (12 weeks).
When bortezomib is given with thalidomide and dexamethasone, the duration of one treatment cycle is 28 days (4 weeks).
Dexamethasone 40 mg is given orally on days 1, 2, 3, 4, 8, 9, 10, and 11 of the bortezomib 28-day treatment cycle, and thalidomide is given orally once daily at a dose of 50 mg up to day 14 of the first cycle, and if tolerated, the thalidomide dose may be increased to 100 mg from day 15 to 28, and from the second cycle onwards, it may be further increased to 200 mg daily. You may receive up to 6 cycles (24 weeks).
Previously untreated mantle cell lymphoma
If you have not been previously treated for mantle cell lymphoma, you will receive bortezomib by intravenous or subcutaneous injection with the medicines rituximab, cyclophosphamide, doxorubicin, and prednisone. Bortezomib is given by intravenous or subcutaneous injection on days 1, 4, 8, and 11, followed by a "rest" period without treatment. The duration of one treatment cycle is 21 days (3 weeks). You may receive up to 8 cycles (24 weeks).
The following medicines are given by intravenous infusion on day 1 of the bortezomib 21-day treatment cycle:
Rituximab at a dose of 375 mg/m2, cyclophosphamide at a dose of 750 mg/m2, and doxorubicin at a dose of 50 mg/m2.
Prednisone is given orally at a dose of 100 mg/m2 on days 1, 2, 3, 4, and 5 of the bortezomib treatment cycle.
How bortezomib is given
This medicine is given by intravenous or subcutaneous injection. You will be given bortezomib by a healthcare professional experienced in the use of cytotoxic medicines. The bortezomib powder must be dissolved before administration. This will be done by a healthcare professional. The reconstituted solution is then injected into a vein or under the skin. The injection into a vein is rapid, lasting between 3 and 5 seconds. The injection under the skin is given into the thighs or abdomen.
If you receive more bortezomib than you should
This medicine will be given to you by your doctor or nurse, so it is unlikely that you will receive too much. In the unlikely event of an overdose, your doctor will monitor you for side effects.
In case of overdose or accidental ingestion, contact your doctor or pharmacist immediately or call the Toxicology Information Service, telephone 91 562 04 20, stating the medicine and the amount taken.
Like all medicines, this medicine can cause adverse effects, although not all people suffer from them. Some of these effects can be serious.
If you are administered bortezomib for multiple myeloma or mantle cell lymphoma, report immediately to your doctor if you observe any of the following symptoms:
Treatment with bortezomib can very frequently cause a decrease in the number of red and white blood cells and platelets in the blood. Therefore, you will need to have regular blood tests before and during treatment with bortezomib, to regularly check the count of your blood cells. You may experience a reduction in the number of:
If you are administered bortezomib for the treatment of multiple myeloma, the adverse effects you may experience are included below:
Very Common Adverse Effects (may affect more than 1 in 10 people)
Common Adverse Effects (may affect up to 1 in 10 people)
Uncommon Adverse Effects (may affect up to 1 in 100 people)
If you are administered bortezomib along with other medicines for the treatment of mantle cell lymphoma, the adverse effects you may experience are included below:
Very Common Adverse Effects (may affect more than 1 in 10 people)
Common Adverse Effects (may affect up to 1 in 10 people)
Uncommon Adverse Effects (may affect up to 1 in 100 people)
sufficient amount of oxygen. Some of these are difficulty breathing, shortness of breath, shortness of breath without exercise, breathing that can become shallow, difficult, or stop, rapid breathing
Rare Adverse Effects (may affect up to 1 in 1,000 people)
Reporting of Adverse Effects
If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect that does not appear in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiration date that appears on the vial and on the packaging after CAD.
Keep the vial in the outer packaging to protect it from light.
The reconstituted solution should be used immediately after preparation.
If the reconstituted solution is not used immediately, the storage times after reconstitution and the conditions before use are the responsibility of the user.
However, the reconstituted solution is stable for 8 hours at 25°C stored in the original vial and/or a syringe, the total storage time of the reconstituted medicine should not exceed 8 hours before administration. Keep the reconstituted solution protected from light.
Bortezomib Farmoz is exclusively for single use. The disposal of unused medicine and all materials that have come into contact with it will be carried out in accordance with local regulations.
Composition of Bortezomib Farmoz
Reconstitution for intravenous administration:
After reconstitution, 1 ml of the solution for intravenous injection contains 1 mg of bortezomib.
Reconstitution for subcutaneous administration:
After reconstitution, 1 ml of the solution for subcutaneous injection contains 2.5 mg of bortezomib.
Appearance of the Product and Container Contents
Bortezomib Farmoz powder for solution for injection is a white or off-white paste or powder.
Each container of Bortezomib Farmoz 3.5 mg powder for solution for injection contains a 20 ml glass vial with a stopper.
Marketing Authorization Holder and Manufacturer
Marketing Authorization Holder
Farmoz - Sociedade Técnico Medicinal, S.A
Rua da Tapada Grande, nº2
Abrunheira, 2710-089 Sintra
Portugal
Manufacturers
Oncotec Pharma Produktion GmbHAm Pharmapark
06861 Dessau-Roßlau
Germany
O
Tecnimede – Sociedade Técnico-Medicinal S.A.
Quinta da Cerca, Caixaria
2565-187 Dois Portos
Portugal
Local Representative of the Marketing Authorization Holder:
Tecnimede España Industria Farmacéutica, S.A.
Avda. Bruselas, 13
28108 Alcobendas (Madrid) Spain.
Date of Last Revision of this Prospectus:
June 2022
Detailed information on this medicinal product is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/
This information is intended only for healthcare professionals:
Note: bortezomib is a cytotoxic agent. Therefore, caution should be exercised during handling and preparation. The use of gloves and other protective clothing is recommended to prevent skin contact.
SINCE BORTEZOMIB FARMOZ DOES NOT CONTAIN PRESERVATIVES, IT IS ADVISED TO STRICTLY FOLLOW AN ASEPTIC TECHNIQUE DURING ITS HANDLING.
The concentration of the resulting solution will be 1 mg/ml. The solution should be colorless and transparent, with a final pH of 4 to 7. It is not necessary to check the pH of the solution.
It is necessary to protect the reconstituted product from light.
Bortezomib Farmoz 3.5 mg powder for solution for injection SHOULD ONLY BE ADMINISTERED INTRAVENOUSLY OR SUBCUTANEOUSLY. Do not administer by other routes. Intrathecal administration has caused death.
A vial is for single use and the remaining solution should be discarded.
The disposal of unused medicinal products and all materials that have come into contact with them will be carried out in accordance with local regulations.
This information is intended only for healthcare professionals:
Only the 3.5 mg vial can be administered subcutaneously, as described below.
Note: bortezomib is a cytotoxic agent. Therefore, caution should be exercised during handling and preparation. The use of gloves and other protective clothing is recommended to prevent skin contact.
SINCE BORTEZOMIB FARMOZ DOES NOT CONTAIN PRESERVATIVES, IT IS ADVISED TO STRICTLY FOLLOW AN ASEPTIC TECHNIQUE DURING ITS HANDLING.
The concentration of the resulting solution will be 2.5 mg/ml. The solution should be colorless and transparent, with a final pH of 4 to 7. It is not necessary to check the pH of the solution.
It is necessary to protect the reconstituted product from light.
Bortezomib Farmoz 3.5 mg powder for solution for injection SHOULD ONLY BE ADMINISTERED INTRAVENOUSLY OR SUBCUTANEOUSLY. Do not administer by other routes. Intrathecal administration has caused death.
A vial is for single use and the remaining solution should be discarded.
The disposal of unused medicinal products and all materials that have come into contact with them will be carried out in accordance with local regulations.