Bortezomib (Generic Name)

Other Names: Velcade™

About This Drug

Bortezomib is used to treat cancer. It is given in the vein (IV) or by a shot under the skin (subcutaneously). If given every 3 days, it should be given no earlier than 72 hours from your last dose unless directed differently by your cancer doctor.

Possible Side Effects (More Common)

  • Effects on the nerves are called peripheral neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped but it does not get better in all people.
  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Feeling dizzy
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours or many hours after your treatment and may last up to 72 hours. Medicines are available to stop or lessen these side effects.
  • Constipation (not able to move bowels)
  • Loose bowel movements (diarrhea) that may last for a few days
  • Stomach pain
  • Viral infections.  Your doctor may prescribe a medicine to prevent certain viral infections while you are getting treated with bortezomib.  
  • Weakness
  • Cough
  • Muscle cramps
  • Decreased appetite (decreased hunger)
  • Changes in the way food and drinks taste
  • Skin rash
  • In patients who take medicine for high blood sugar (diabetes), bortezomib may cause high or low blood sugars.  Your doctor may tell you to check your blood sugar more often, and may change the dose of your diabetes medicine.

Possible Side Effects (Less Common)

  • Fever
  • Swelling of your legs, ankles and/or feet
  • Tiredness
  • Headache
  • Depression, feeling nervous (anxiety), or other mood changes
  • Trouble sleeping
  • Changes in the tissue of the heart. Some changes may happen that can cause your heart to have less ability to pump blood. Your heart function will be checked as needed.
  • Changes in your liver function.  Your doctor will check your liver function as needed. 

Treating Side Effects

  • If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids.
  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements you should drink more fluids so that you do not become dehydrated (lack water in the body due to losing too much fluid).
  • If you are dizzy, get up slowly after sitting or lying.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • Ask your doctor or nurse about medicine that is available to help stop or lessen nausea, vomiting, loose stools, constipation (not able to move bowels), or pain.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • Your doctor may prescribe a medicine to prevent certain viral infections while you are getting treated with bortezomib.  
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • Let your doctor or nurse know if you are having trouble sleeping.

Special Instructions

When you tell a doctor or nurse your health history, always tell them that you have received bortezomib.

Food and Drug Interactions

There are no known interactions of bortezomib with food.  This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Easy bleeding or bruising
  • Fainting
  • Feeling dizzy or lightheaded
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or lightheadedness
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin.

Call your doctor or nurse as soon as possible if you have any of these symptoms:

  • Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions
  • Pain that is not relieved by prescribed medicine
  • Nausea that is not relieved by prescribed medicines
  • No bowel movement for 3 days or you feel uncomfortable
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Headache that does not go away
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Extreme weakness that interferes with normal activities
  • Fatigue that interferes with your daily activities

Sexual Problems and Reproduction Concerns

  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
  • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.
  • Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
    • In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
    • Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Revised November 2014

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