Bortezomib

Generic Name: bortezomib (bor-TEZ-oh-mib)
Brand Name: Velcade

Bortezomib is used for:

Treating certain types of cancer (eg, mantle cell lymphoma, multiple myeloma). It may also be used for other conditions as determined by your doctor.

Bortezomib is an antineoplastic (cancer chemotherapy) medicine. It works by blocking certain proteins within the cancer cell, causing the cell to die. This helps to slow the growth and spread of the cancer.

Do NOT use bortezomib if:

  • you are allergic to any ingredient in bortezomib, or to boron or mannitol
  • you are taking carbamazepine, efavirenz, enzalutamide, hydantoins (eg, phenytoin), oxcarbazepine, phenobarbital, primidone, rifamycins (eg, rifampin), or St. John's wort

Contact your doctor or health care provider right away if any of these apply to you.

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Before using bortezomib:

Some medical conditions may interact with bortezomib. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of liver problems, a low white blood cell count, low blood platelets, peripheral neuropathy (numbness, pain, or burning sensations in the hands or feet) or other nerve problems, heart problems (eg, congestive heart failure), low blood pressure, diabetes, lung problems, or herpes infection (eg, genital herpes, shingles, cold sores)
  • if you are dehydrated, are on dialysis, or have a history of fainting

Some MEDICINES MAY INTERACT with bortezomib. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Diabetes medicines (eg, glyburide, metformin) because the risk of high or low blood sugar may be increased
  • Alpha-blockers (eg, terazosin), medicines for high blood pressure, or any other medicines that may lower your blood pressure because the risk of low blood pressure and fainting may be increased. Ask your doctor or pharmacist if you are unsure if any of your medicines may lower your blood pressure
  • Azole antifungals (eg, itraconazole, ketoconazole) or protease inhibitors (eg, ritonavir) because they may increase the risk of bortezomib's side effects
  • Carbamazepine, efavirenz, enzalutamide, hydantoins (eg, phenytoin), oxcarbazepine, phenobarbital, primidone, rifamycins (eg, rifampin), or St. John's wort because they may decrease bortezomib's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if bortezomib may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use bortezomib:

Use bortezomib as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Drinking extra fluids while you are taking bortezomib is recommended. Check with your doctor for instructions.
  • Bortezomib is usually given as an injection into a vein or under the skin at your doctor's office, hospital, or clinic. Bortezomib is not intended to be injected into the spinal cord. Contact your health care provider if you have any questions.
  • Do not use bortezomib if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • If bortezomib is given under the skin in the thigh or stomach area, be sure to rotate injection sites. New injections should be given at least 1 inch from an old site. Do NOT inject into areas where the skin is tender, bruised, red, or hard.
  • Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • It is very important that each dose is given at the scheduled time. If you miss a dose of bortezomib, contact your doctor right away to establish a new dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use bortezomib.

Important safety information:

  • Bortezomib may cause dizziness, fatigue, fainting, or vision changes. These effects may be worse if you take it with alcohol or certain medicines. Use bortezomib with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Bortezomib may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Bortezomib may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
  • Use caution with sharp objects like safety razors or nail cutters and avoid activities such as contact sports to lower your chance of getting cut, bruised, or injured.
  • Bortezomib may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
  • Contact your doctor if you experience new or worsening nerve problems (eg, tingling, numbness, pain, or burning in the feet or hands; weakness in the arms or legs). Your dose may need to be changed.
  • A serious and possibly fatal condition called tumor lysis syndrome (TLS) has been reported in certain patients taking bortezomib. Contact your doctor right away if you develop symptoms, such as fast or irregular heartbeat; fainting; decreased urination; muscle weakness or cramps; nausea, vomiting, diarrhea, or loss of appetite; or sluggishness. Discuss any questions or concerns with your doctor.
  • Carry an ID card at all times that says you take bortezomib.
  • If vomiting or diarrhea occurs, you will need to take care not to become dehydrated. Contact your doctor for instructions. Contact your doctor right away if you experience dizziness, light-headedness, or fainting.
  • Diabetes patients - Bortezomib may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Women who may become pregnant should avoid becoming pregnant while being treated with bortezomib. Be sure to use effective birth control while using bortezomib. If you have questions about effective birth control, talk with your doctor.
  • Lab tests, including complete blood cell counts, may be performed while you use bortezomib. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Bortezomib should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Bortezomib may cause harm to the fetus. Do not become pregnant while you are using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using bortezomib while you are pregnant. It is not known if bortezomib is found in breast milk. Do not breast-feed while using bortezomib.

Possible side effects of bortezomib:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; headache; loss of appetite; mild stomach pain; nausea; redness at the injection site; stomach upset; taste changes; tiredness; trouble sleeping; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); bloody or black, tarry stools; blurred vision, vision loss, or other vision changes; change in the amount of urine produced; changes in thinking or strength; chest pain; confusion; decreased balance or coordination; dry mouth or eyes; fainting; fast, slow, or irregular heartbeat; memory problems; mental, mood, or behavior changes (eg, agitation, depression, suicidal thoughts); new or worsening nerve problems (eg, burning, numbness, pain, or tingling in the hands or feet; weakness in the arms or legs); one-sided weakness; seizures; severe or persistent diarrhea, vomiting, constipation, or stomach pain; severe or persistent headache or dizziness; severe or persistent muscle pain, cramping, or weakness; severe or persistent tiredness or weakness; shortness of breath; signs of an infection (chills, cough, fever, persistent sore throat); sluggishness; slurred speech; sudden weight gain; swelling or pain in the hands, ankles, feet, or legs; symptoms of liver problems (eg, yellowing of the skin or eyes; dark urine; pale stools; severe or persistent nausea or loss of appetite); trouble walking or talking; unusual bruising or bleeding; vomit that looks like coffee grounds.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; severe or persistent dizziness; unusual bruising or bleeding.

Proper storage of bortezomib:

Bortezomib is usually handled and stored by a health care provider. If you are using bortezomib at home, store bortezomib as directed by your pharmacist or health care provider. Keep bortezomib out of the reach of children and away from pets.

General information:

  • If you have any questions about bortezomib, please talk with your doctor, pharmacist, or other health care provider.
  • Bortezomib is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take bortezomib or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about bortezomib. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to bortezomib. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using bortezomib.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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