Bortezomib (Injection)

Introduction

Bortezomib (bor-TEZ-oh-mib)

Treats multiple myeloma and mantle cell lymphoma.

Brand Name(s)

Velcade

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you use medicine to treat HIV or AIDS (such as didanosine, indinavir, lamivudine, nelfinavir, ritonavir, saquinavir, stavudine, zidovudine, Combivir®, Crixivan®, Epivir®, Fortovase®, Invirase®, Kaletra®, Norvir®, or Viracept®), medicine to treat infection (such as clarithromycin, telithromycin, Biaxin®, or Ketek®), medicine to treat a fungus infection (such as itraconazole, ketoconazole, Nizoral®, or Sporanox®), or medicine to treat depression (such as nefazodone or Serzone®).
• Make sure your doctor knows if you also use St John's wort, medicine to treat tuberculosis (such as rifampin, Rifadin®, Rimactane®), or medicine to treat seizures (such as carbamazepine, phenytoin, Tegretol®, or Dilantin®).
• Tell your doctor if you have used any medicine that might cause nerve problems.

Warnings While Using This Medicine

• Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
• Make sure your doctor knows if you are breastfeeding or if you have liver disease, heart disease, congestive heart failure, low blood pressure, or a history of fainting. Tell your doctor if you have diabetes, herpes virus infection, lung disease, or nerve problems.
• Tell your doctor right away if you have burning, numbness, tingling, or painful sensations in your arms, hands, legs, or feet. These could be symptoms of peripheral neuropathy.
• This medicine can lower your blood pressure too much and cause you to feel lightheaded or dizzy. This is more likely to happen if you use medicines that affect you blood pressure or are dehydrated. Stand or sit up slowly if you are dizzy.
• This medicine may cause serious heart problems. Tell your doctor right away if you have chest pain, trouble breathing, uneven heartbeat, or swelling of the feet, ankles, or legs.
• This medicine may make you dizzy, drowsy, or tired. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you.
• This medicine may increase your chance of having a brain condition called reversible posterior leukoencephalopathy syndrome (RPLS). Check with your doctor right away if you have headaches, seizures, extreme drowsiness, confusion, or problems with vision.
• Cancer medicines can cause nausea and/or vomiting in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these side effects.
• This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.
• This medicine may cause a serious reaction called tumor lysis syndrome (TLS). Call your doctor right away if you have a change in how much or how often you urinate; joint pain, stiffness, or swelling; lower back, side, or stomach pain; swelling of the feet or lower legs; or unusual tiredness or weakness.
• If you are diabetic and you take an oral antidiabetic medicine, you should check your blood sugar level often and report any unusual changes to your doctor.
• Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash
• Change in how much or how often you urinate or painful or difficult urination
• Chest pain or fast, slow, or uneven heartbeat
• Confusion or seizures
• Dark-colored urine or pale stools
• Fever, chills, cough, runny or stuffy nose, sore throat, and body aches
• Lightheadedness, dizziness, or fainting
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet
• Severe diarrhea, nausea, and vomiting or stomach pain
• Sudden or severe headache, or problems with vision, speech, or walking
• Swelling in your face, arms, legs, ankles, or feet
• Trouble breathing
• Unusual bleeding, bruising, tiredness, or weakness
• Yellowing of your skin or the whites of your eyes

If you notice these less serious side effects, talk with your doctor:

• Loss of appetite
• Mild diarrhea, constipation, nausea, or vomiting
• Mild headache
• Mild skin rash or itching
• Pain, itching, burning, swelling, or a lump under your skin where the needle is placed

When This Medicine Should Not Be Used

How to Use This Medicine

Injectable

• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given through a needle placed in one of your veins.
• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine.
• You may also receive medicines to help prevent nausea, vomiting, or diarrhea. Ask your doctor if you should drink extra water while you use this medicine. This could help you avoid feeling dizzy or lightheaded.

If a dose is missed:

• This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088