bortezomib
Other Name: Velcade®
For treating patients with multiple myeloma and certain types of lymphomas.
Tell your doctor and pharmacist if you have/had significant medical condition(s), especially if you have / had:
Kidney, liver, lung or heart problems
High or low blood pressure
Bleeding problems
Problems with nerves in hands and feet (numbness or tingling), or
any allergies.
Remember to:
- Tell your health care team about all of the other medications you are taking.
- Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding
If there is ANY chance that you or your partner may become pregnant, you and your partner together must:
Use 2 effective forms of birth control at the same time while taking this drug: Keep using birth control until 3 months after the last dose. Discuss with your healthcare team.
Do not breastfeed while taking this drug.
Tell your doctor right away if you or your partner becomes pregnant.
This medication may affect fertility (ability to get pregnant).
This drug is injected under the skin, or given into a vein over a few seconds.
Talk to your health care team about your treatment schedule.
A minimum gap of 72 hours between doses is required to avoid severe side effects.
If you miss your treatment appointment, talk to your health care team to find out what to do.
Do not eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. They may increase side effects.
This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.
Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.
For mild aches and pain or fever:
- If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever.
- You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you.
- Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding. Talk to your health care team before you start or stop these medications.
- Talk to your health care team or go to the closest emergency room right away if you have a fever. See the Fever pamphlet for more information.
- If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever.
If you are taking antidiabetic or steroid medications by mouth, monitor your blood sugar regularly since bortezomib may cause changes in your blood sugar levels.
Green tea and vitamin C supplements have been shown to affect how bortezomib works. Avoid green tea and any drinks or foods that contain green tea during your entire bortezomib treatment. Talk with your cancer health care team before taking any vitamin C supplements.
Exercise caution when driving or operating dangerous machinery while you are taking this drug as it can cause tiredness, dizziness, fainting or blurred vision.
Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.
The following table lists side effects that you may have when getting bortezomib. The table is set up to list the most common side effects first and the least common last.
It is unlikely that you will have all of the side effects listed and you may have some that are not listed. Read over the side effect table so that you know what to look for and when to get help. Keep this paper during your treatment so that you can refer to it if you need to.
Very Common Side Effects (50 or more out of 100 people) | |
Side effects and what to do | When to contact health care team |
Fatigue What to look for?
What to do?
Ask your health care team for the Fatigue pamphlet for more information. | Talk to your health care team if it does not improve or if it is severe |
Diarrhea What to look for?
What to do? If you have diarrhea:
| Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day) |
Nausea and vomiting (Generally mild) What to look for?
What to do? To help prevent nausea:
| Talk to your health care team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if severe |
Common Side Effects (25 to 49 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Constipation (May be severe) What to look for?
What to do? To help prevent constipation:
To help treat constipation:
Ask your health care team for the Constipation Pamphlet for more information. | Talk to your health care team if it does not improve or if it is severe |
Neuropathy (Tingling, numb toes or fingers) (May be severe) What to look for?
What to do?
In rare cases, it may continue long after treatment ends. If you continue to have bothersome symptoms, talk to your health care team for advice. | Talk to your health care team, especially if you have trouble doing tasks like doing up buttons, writing, moving, severe pain or numbness |
Fever, chills, shivering (less common) What to look for?
What to do?
| Talk to your health care team if it does not improve or if it is severe |
Low neutrophils (white blood cells) in the blood (neutropenia) (May be severe) When neutrophils are low, you are at risk of getting an infection more easily. Ask your health care team for the Neutropenia (Low white blood cell count) pamphlet for more information. What to look for?
You have a fever if your temperature taken in your mouth (oral temperature) is:
What to do? If your health care team has told you that you have low neutrophils:
If you have a fever: If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away. | If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you MUST get emergency medical help right away. |
Low platelets in the blood (May be severe) When your platelets are low, you are at risk for bleeding and bruising. Ask your health care team for the Low Platelet Count pamphlet for more information. What to look for?
What to do? If your health care team has told you that you have low platelets:
If you have signs of bleeding:
If you have bleeding that does not stop or is severe (very heavy), you must get emergency medical help right away. | Talk to your health care team if you have any signs of bleeding. If you have bleeding that doesn’t stop or is severe (very heavy), you MUST get emergency help right away. |
Low appetite What to look for?
Ask your health care team for the Loss of Appetite pamphlet for more information. | Talk to your health care team if it does not improve or if it is severe |
Headache; mild joint, muscle pain or cramps What to look for?
What to do?
Ask your health care team for the Pain pamphlet for more information. | Talk to your health care team if it does not improve or if it is severe |
Cough and feeling short of breath (May be severe) What to look for?
What to do?
| Talk to your health care team. If you are not able to talk to your health care team for advice, and you have a fever or severe symptoms, you MUST get emergency medical help right away |
Less Common Side Effects (10 to 24 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Rash; dry, itchy skin (May be severe) What to look for?
What to do? To prevent and treat dry skin:
Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away. | Talk to your health care team if no improvement or if severe |
Trouble Sleeping Your medications may cause trouble sleeping. It may get better once your body gets used to the medication or when your treatment ends. What to look for?
What to do? Talk to your health care team if it does not improve or if it is severe | Talk to your health care team if it does not improve or if it is severe |
Mild swelling (May be severe) What to look for?
What to do?
| Talk to your health care team if it does not improve or if it is severe |
Pains or cramps in the belly What to look for?
| Talk to your health care team if it does not improve or if it is severe |
Low blood pressure (may be severe); Dizziness What to look for?
What to do?
| Talk to your health care team if it does not improve or if it is severe |
Too much or too little salt in your body What to look for?
What to do? Get emergency medical help right away for severe symptoms. | Get emergency medical help right away for severe symptoms |
Eye problems What to look for?
What to do?
| Talk to your health care team as soon as possible |
Heartburn; stomach upset; bloating What to look for?
What to do?
| Talk to your health care team if it does not improve or if it is severe |
Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:
Irregular heartbeat, fainting, or swelling in legs/ankles/belly
Suggest Pain or swelling or hardened vein in your arms or legs
Sudden loss of vision, speech, or the use of your limb(s) or chest pain, shortness of breath), or pain in belly or limb
Severe headache, seizures, confusion
Swollen face, lip or tongue, chest or throat tightness
Severe/sudden belly pain or stomach area, bloating, severe constipation
Tender right side of belly, yellowish skin or eyes, dark urine
Increased pain in centre of belly and may extend to the back, appetite or weight loss
Symptoms of gout such as joint pains; lower back pain, body swelling, passing little or no urine, or recent unusual weight gain
Who do I contact if I have questions or need help?My cancer health care provider is: ______________________________________________ During the day I should contact:________________________________________________ Evenings, weekends and holidays:______________________________________________
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Other Notes:
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For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.