Bortezomib/Ascorbic Acid (Vitamin C)
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
If vitamin C is taken too close to your bortezomib dose, it can prevent bortezomib from being absorbed by your cancer cells.
What might happen:
Your bortezomib might not work as well.
What you should do about this interaction:
Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Do not start taking vitamin C supplements without discussing them with your oncologist. Your oncologist may instruct you to take vitamin C at a specific time of day. Follow these instructions closely.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Zou W, Yue P, Lin N, He M, Zhou Z, Lonial S, Khuri FR, Wang B, Sun SY. Vitamin C inactivates the proteasome inhibitor PS-341 in human cancer cells. Clin Cancer Res 2006 Jan 1;12(1):273-80.
2.Llobet D, Eritja N, Encinas M, Sorolla A, Yeramian A, Schoenenberger JA, Llombart-Cussac A, Marti RM, Matias-Guiu X, Dolcet X. Antioxidants block proteasome inhibitor function in endometrial carcinoma cells. Anticancer Drugs 2008 Feb;19(2):115-24.
3.Fernandez Y, Miller TP, Denoyelle C, Esteban JA, Tang WH, Bengston AL, Soengas MS. Chemical blockage of the proteasome inhibitory function of bortezomib: impact on tumor cell death. J Biol Chem 2006 Jan 13; 281(2):1107-18.
4.Bannerman B, Xu L, Jones M, Tsu C, Yu J, Hales P, Monbaliu J, Fleming P, Dick L, Manfredi M, Claiborne C, Bolen J, Kupperman E, Berger A. 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 2011 Nov;68(5):1145-54.
5.Catley L, Anderson KC. Velcade and vitamin C: too much of a good thing?. Clin Cancer Res 2006 Jan 1;12(1):3-4.
6.Perrone G, Hideshima T, Ikeda H, Okawa Y, Calabrese E, Gorgun G, Santo L, Cirstea D, Raje N, Chauhan D, Baccarani M, Cavo M, Anderson KC. Ascorbic acid inhibits antitumor activity of bortezomib in vivo. Leukemia 2009 Sep; 23(9):1679-86.
7.Nakano A, Abe M, Oda A, Amou H, Hiasa M, Nakamura S, Miki H, Harada T, Fujii S, Kagawa K, Takeuchi K, Watanabe T, Ozaki S, Matsumoto T. Delayed treatment with vitamin C and N-acetyl-L-cysteine protects Schwann cells without compromising the anti-myeloma activity of bortezomib. Int J Hematol 2011 Jun;93(6):727-35.
8.Sharma M, Khan H, Thall PF, Orlowski RZ, Bassett RL Jr, Shah N, Bashir Q, Parmar S, Wang M, Shah JJ, Hosing CM, Popat UR, Giralt SA, Champlin RE, Qazilbash MH. A randomized phase 2 trial of a preparative regimen of bortezomib, high-dose melphalan, arsenic trioxide, and ascorbic acid. Cancer 2012 May 1;118(9):2507-15.
9.Berenson JR, Yellin O, Woytowitz D, Flam MS, Cartmell A, Patel R, Duvivier H, Nassir Y, Eades B, Abaya CD, Hilger J, Swift RA. Bortezomib, ascorbic acid and melphalan (BAM) therapy for patients with newly diagnosed multiple myeloma: an effective and well-tolerated frontline regimen. Eur J Haematol 2009 Jun;82(6):433-9.