Bortezomib (Generic Name)

Other Names: Velcade™

About This Drug

Bortezomib is used to treat cancer. It is given intravenously (IV) or  by injection 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 oncologist.

Possible Side Effects (More Common)

  • Effects on the nerves called peripheral neuropathy. You may feel numbness or tingling in your hands and feet. It may be difficult for you to button your clothes, open jars, or walk normally. The effect on the nerves may get worse with additional doses of the drug. These effects get better in some people after the drug is stopped but it may not get better in some people.  Be careful when cooking, walking, and handling sharp objects and hot liquids.
  • Dizziness or light-headedness
  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. It may increase your risk for infection, fatigue, and bleeding.
  • Weakness
  • Nausea and vomiting
  • Changes in bowel movements. Some patients get diarrhea, while others have constipation.
  • Indigestion
  • Cough
  • Bone pain
  • Muscle cramps
  • Changes in the way some foods and drinks taste
  • Decreased appetite
  • Abdominal pain
  • Skin rash or acne

Possible Side Effects (Less Common)

  • Fever
  • Swelling (fluid retention) in the legs, ankles, and/or feet
  • Fatigue
  • Headache
  • Feeling anxious
  • Trouble sleeping

Sexual Problems and Reproductive Concerns

  • In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. 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 receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may experience signs of menopause like vaginal dryness or itching.
    • 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.
    • Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred. 
    • Breast feeding warning: Women are advised not to breast feed during treatment because this drug could enter the breast milk and seriously harm a breast feeding infant.

Treating Side Effects

  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
  • Do not drive or operate machinery if you feel dizzy, light-headed, or faint, or if you have blurred vision. If you feel dizzy when you first stand up after lying down, sit upright for a few minutes before standing.
  • Be especially careful when walking, cooking, or handling sharp objects or hot liquids.
  • Take your temperature as your nurse tells you, and whenever you feel warm (feverish).
  • Ask your doctor or nurse about medicine that is available to help prevent or lessen nausea, vomiting, diarrhea, pain, itching, or acne.
  • Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry.
  • Let your doctor or nurse know if you are having trouble sleeping

Food and Drug Interactions

There are no known interactions of bortezomib with food. This drug may interact with other medicine. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs, and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly 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 advice.

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Unusual bleeding or bruising
  • Fainting
  • Lightheadedness or dizziness
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than 3 times in 1 day

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

  • Pain, tingling, burning, numbness, or a pins-and-needles feeling in your hands or feet or around your mouth or throat
  • Difficulty walking or changes in the way you walk
  • Clumsiness in buttoning clothes, opening jars, or doing other routine activities
  • Pain, nausea, or vomiting not helped by prescribed medicine
  • No bowel movement for 3 days or if you feel uncomfortable
  • Swelling (fluid retention) in your legs, feet, or ankles
  • Headache not helped by prescribed medicine
  • Persistent loss of appetite or rapid weight loss (more than 5 pounds in 1 week)
  • Diarrhea of 5 or 6 stools in 1 day or diarrhea with weakness
  • Extreme weakness that interferes with normal activities
  • Extreme fatigue that interferes with normal activities

Revised September 2012

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