Uses

What is bortezomib used for?

Bortezomib is commonly used to treat blood cancers, including multiple myeloma and mantle cell lymphoma

Bortezomib may also be used for other conditions as determined by your healthcare provider.

How does bortezomib work (mechanism of action)?

Bortezomib is a type of medicine called a proteasome inhibitor. It works by blocking cancer cells from being able to break down protein. The buildup of protein in the cell causes the cell to die.

How is bortezomib supplied (dosage forms)?

Bortezomib is available in an injectable form that is given by a healthcare provider.

How should I store bortezomib?

Bortezomib is usually given by a healthcare provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of bortezomib?

The most common side effects of bortezomib are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Stomach issues, including diarrhea, constipation, nausea, and vomiting (see below)
  • Blood disorders (see below)
  • Nerve problems (see below)
  • Tiredness
  • Rash
  • Fever
  • Loss of appetite

You should also tell your healthcare provider right away if you have a skin rash or injection site reactions, such as pain or discoloration near the injection site, after receiving your bortezomib dose. These are additional side effects that can happen with bortezomib.

There may be other side effects of bortezomib that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of bortezomib?

While less common, the most serious side effects of bortezomib are described below, along with what to do if they happen.

Severe Allergic Reactions. Bortezomib may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Nerve Problems. Nerves are the fibers that carry sensations from your body to the brain. Damage to these nerves, called peripheral neuropathy, can happen in people who are using bortezomib. Stop using bortezomib and call your healthcare provider if you develop pain, burning, tingling, numbness, or weakness in your arms, hands, legs, or feet.

Low Blood Pressure (Hypotension). Bortezomib may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.

  • Dizziness, feeling lightheaded, or fainting
  • Confusion
  • Feeling weak or tired
  • Muscle cramps

Heart Failure. Bortezomib may increase your risk of heart failure. Heart failure happened in people who had heart problems before using bortezomib as well as those who did not. Heart failure can be dangerous and even life-threatening. Tell your healthcare provider right away if you have any of the following symptoms of heart failure.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs
  • Unusually fast weight gain
  • Unusual tiredness

Breathing Problems. Bortezomib may cause slow or shallow breathing and shortness of breath. Tell your healthcare provider if you develop severe sleepiness or trouble breathing while using bortezomib. Bortezomib may also cause pneumonia or your blood pressure in your lungs to get higher than normal, also called pulmonary hypertension. Get emergency help if you have any of the following symptoms.

  • Changes in the color of your skin, including bluish color to your lips and fingernails
  • Confusion
  • Shortness of breath
  • Feeling dizzy, lightheaded, or fainting
  • Changes in your heart rate or rhythm, such as a fast, slow, pounding, or skipping heartbeat
  • Slow or shallow breathing
  • Excessive sleepiness or trouble staying awake

Lung Inflammation. Bortezomib can cause inflammation in your lungs, also called interstitial lung disease or pneumonitis. This can be serious or even life-threatening. Tell your healthcare provider if you have trouble breathing. You may also have a cough and/or fever. 

Posterior Reversible Encephalopathy Syndrome (PRES). People using bortezomib may develop a rare brain condition called PRES. PRES involves swelling in your brain that is very serious and can lead to death. Call your healthcare provider right away if you develop any of the following symptoms of PRES.

  • Seizures
  • Headache
  • Extreme tiredness
  • Confusion
  • Blindness or vision problems
  • Thinking, memory, or personality changes
  • High blood pressure

Stomach Issues. Bortezomib can cause stomach issues, including diarrhea, constipation, nausea, and vomiting. If you are given medicine to prevent or treat diarrhea, nausea, or other stomach issues, take it exactly as your healthcare provider tells you. Call your healthcare provider right away if you have any of the following.

  • Severe diarrhea
  • Diarrhea that does not go away
  • Diarrhea with weakness, dizziness, or fever
  • Severe nausea or vomiting
  • Severe constipation

Blood Disorders. Bortezomib can cause blood disorders, such as low platelet levels (thrombocytopenia), low neutrophil levels (neutropenia), low red blood cell levels (anemia), and low white blood cell levels (leukopenia). Get help right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Tumor Lysis Syndrome. Bortezomib can cause a rapid amount of cells to die. This can lead to a condition called tumor lysis syndrome. This can be a serious condition. It is important to drink plenty of water while using bortezomib and to keep all of your appointments for blood work so your healthcare provider can see how your body is responding to bortezomib. Tell your healthcare provider right away if you have any of the following signs of tumor lysis syndrome while using bortezomib.

  • Nausea and vomiting
  • Weakness
  • Swelling or fluid retention
  • Shortness of breath
  • Muscle cramps
  • Seizures

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using bortezomib. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Blood Clots. Bortezomib may cause blood clots in your small blood vessels, which could lead to a condition called thrombotic microangiopathy. These blood clots can cause damage to your kidneys, brain, or other organs, which can be serious and even life-threatening. Get emergency help right away if you have any of the following signs of blood clots.

  • Fever
  • Bruising
  • Nosebleeds
  • Tiredness
  • Decreased urination (pee)

Warnings & Precautions

Who should not use bortezomib?

Allergies to Ingredients. People who are allergic to any of the following should not use bortezomib.

  • Bortezomib
  • Velcade
  • Boron
  • Mannitol
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in bortezomib.

What should I know about bortezomib before using it?

Bortezomib is usually given by a healthcare provider in a hospital or clinic.

Bortezomib can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how bortezomib affects you.

You should drink plenty of fluids while using bortezomib. This is because bortezomib may cause nausea, vomiting, and diarrhea, which can lead to dehydration. Be sure to tell your healthcare provider if you have any nausea, vomiting, diarrhea, or other side effects while using bortezomib.

What should I tell my healthcare provider before using bortezomib?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if bortezomib is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Heart problems, including a previous heart attack or heart failure
  • Liver problems

Diabetes. If you have diabetes, you may need to check your blood sugar more often. Talk with your healthcare provider about how often to check your blood sugar and let them know right away if you have any changes in your usual blood sugar levels. 

Cold Sores or Herpes Infection. If you have cold sores or genital herpes, talk with your healthcare provider. You may need to take medicine to prevent these infections while you are using bortezomib.

Pregnancy. Bortezomib may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. You must not be pregnant before starting bortezomib. If you can become pregnant, use effective birth control while using bortezomib and for seven months after your last dose. If you are assigned male at birth and have a partner that can become pregnant, use effective birth control during treatment with bortezomib and for four months after your last dose. 

Breastfeeding. Do not use bortezomib while you are breastfeeding and do not breastfeed for two months after your last dose of bortezomib. It is not known if bortezomib passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.

Infertility. Bortezomib may cause fertility problems. Talk with your healthcare professional if this is a concern for you. 

Other Medicines and Supplements. Bortezomib may interact with other medicines and supplements. Before using bortezomib, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Interactions

Does bortezomib interact with foods or drinks?

There are no known interactions between bortezomib and foods or drinks.

It is unknown if drinking alcohol will affect bortezomib.

Does bortezomib interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

 In particular, make sure that you discuss if you are taking any of the following before using bortezomib.

  • Ketoconazole, a medicine used to treat fungal infections
  • Rifampin, a medicine commonly used to treat an infection called tuberculosis

Many other medicines may alter the blood levels of bortezomib. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with bortezomib. Always check with your healthcare provider.

Does Bortezomib (Velcade) interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much bortezomib?

If you or someone else has used too much bortezomib, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of bortezomib?

Bortezomib is usually given by a healthcare provider in a hospital, clinic, or infusion center. Your healthcare provider will make sure you are receiving bortezomib as scheduled. If you miss an appointment to get your bortezomib dose, call to make another appointment as soon as possible.

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