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Drug Interactions between belimumab and bortezomib

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

bortezomib belimumab

Applies to: bortezomib and belimumab

MONITOR: Concomitant use of belimumab and biologic therapies, including B-cell targeted therapies with immunosuppressant effects may lead to an increase in the rate of severe adverse events and serious infections. In a double-blind, randomized, placebo-controlled, phase 3 trial in adults with systemic lupus erythematosus (SLE) receiving belimumab, the addition of rituximab was associated with serious adverse events in 22.2% and serious infections in 9% of patients, compared to 13.9% and 2.8% of patients, respectively, in the placebo add-on group. Clinical data for other B-cell targeted therapies are unavailable.

MANAGEMENT: According to the manufacturer of belimumab, available data do not support the coadministration of belimumab with rituximab in patients with SLE. Caution and monitoring for adverse reactions, particularly infections, is advised if concomitant use of belimumab with other biologic therapies with immunosuppressant effects, particularly B-cell targeted therapies including but not limited to ocrelizumab, ofatumumab, or obinutuzumab. Some authorities advise against their concomitant use.

References (4)
  1. (2023) "Product Information. Benlysta (belimumab)." GlaxoSmithKline, SUPPL-79
  2. (2023) "Product Information. Benlysta (belimumab)." GlaxoSmithKline Australia Pty Ltd, 16.0
  3. (2023) "Product Information. Benlysta (belimumab)." GlaxoSmithKline UK Ltd
  4. (2024) "Product Information. Benlysta (belimumab)." GlaxoSmithKline Inc, 279901

Drug and food interactions

Moderate

bortezomib food

Applies to: bortezomib

GENERALLY AVOID: Data from in vitro and animal (mice) studies suggest that green tea may antagonize the cytotoxic effects of bortezomib. Polyphenols in green tea such as (-)-epigallocatechin gallate (EGCG) have been shown to block the proteasome inhibitory action of bortezomib in multiple myeloma and glioblastoma cancer cell lines. The mechanism appears to involve a direct chemical reaction between the boronic acid moiety of bortezomib and the 1,2-benzenediol groups present in certain polyphenols leading to inactivation of bortezomib. However, one group of investigators reported that no antagonism of bortezomib was observed in preclinical in vivo experiments where EGCG plasma concentrations are commensurate with dietary or supplemental intake.

MANAGEMENT: Until more data are available, it may be advisable to avoid or limit consumption of green tea and green tea products during treatment with bortezomib. The interaction has not been demonstrated for other, non-boronic acid proteasome inhibitors.

References (3)
  1. Bannerman B, Xu L, Jones M, et al. (2011) "Preclinical evaluation of the antitumor activity of bortezomib in combination with vitamin C or with epigallocatechin gallate, a component of green tea." Cancer Chemother Pharmacol, 68, p. 1145-54
  2. Golden EB, Lam PY, Kardosh A, et al. (2009) "Green tea polyphenols block the anticancer effects of bortezomib and other boronic acid–based proteasome inhibitors." Blood, 113, p. 5927-37
  3. Jia L, Liu FT (2013) "Why bortezomib cannot go with 'green'?" Cancer Biol Med, 10, p. 206-13

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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