Drug General Information (ID: DDISOJ5H2R)
Drug Name			Ascorbic acid		Drug Info		Bortezomib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Vitamins				Antineoplastics
Structure

Mechanism of Ascorbic acid-Bortezomib Interaction (Severity Level: Moderate)
Attenuated pharmacological effects (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Ascorbic acid				Bortezomib
Mechanism		Decrease the antitumor effects of bortezomib				Bortezomib
Key Mechanism Factor 1
		Factor Name		Pharmacodynamics
		Factor Description		Reduced pharmacological effects leading to insufficient efficacy and/or treatment failure.
Mechanism Description		Attenuated pharmacological effects of  Ascorbic acid when combined with Bortezomib

Recommended Action
Management		Until more data are available, it may be advisable to avoid taking supplements containing ascorbic acid during bortezomib therapy, or at least on bortezomib treatment days.

References
1	Zou W, Yue P, Lin N, et al. "Vitamin C inactivates the proteasome inhibitor PS-341 in human cancer cells." Clin Cancer Res 12 (2006): 273-80
2	Bannerman B, Xi L, Jones M, et al "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 (2011): 1145-54
3	Catley L, Anderson KC "Velcade and vitamin C: too much of a good thing?" Clin Cancer Res 12 (2006): 3-4