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Velcade

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

Medically reviewed on Jan 30, 2018

What is Velcade?

See also: Pomalyst

Velcade (bortezomib) interferes with the growth of some cancer cells and keeps them from spreading in your body.

Velcade is used to treat multiple myeloma and mantle cell lymphoma.

Velcade is sometimes given after other cancer medications have been tried without successful treatment.

Important Information

Velcade may cause a serious viral infection of the brain that can lead to disability or death. Call your doctor right away if you have any change in your mental state, decreased vision, or problems with speech or walking. These symptoms may start gradually and get worse quickly.

Velcade can lower blood cells that help your body fight infections and help your blood to clot. You may get an infection or bleed more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, chills, body aches).

Before taking this medicine

You should not be treated with Velcade if you are allergic to bortezomib, mannitol, or boron.

To make sure Velcade is safe for you, tell your doctor if you have ever had:

  • nerve problems such as numbness, tingling, or burning pain;

  • diabetes;

  • liver disease;

  • kidney disease, or if you are on dialysis;

  • a low level of platelets or white or red blood cells;

  • heart disease, congestive heart failure;

  • lung disease or breathing problems;

  • herpes or shingles (herpes zoster);

  • high or low blood pressure; or

  • if you are dehydrated.

You may need to have a negative pregnancy test before starting this treatment.

Bortezomib can harm an unborn baby. Do not use Velcade if you are pregnant. Use effective birth control to prevent pregnancy, whether you are a man or a woman. The use of this medicine by either parent may cause birth defects.

Keep using birth control for at least 2 months after your last dose of Velcade. Tell your doctor right away if a pregnancy occurs while either the mother or the father is using this medicine.

Velcade may affect fertility (ability to have children) in both men and women. However, it is important to use birth control to prevent pregnancy because bortezomib may harm the baby if a pregnancy does occur.

It is not known whether bortezomib passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine and for at least 2 months after your last dose.

How is Velcade given?

Velcade is injected into a vein through an IV.

You will receive this injection in a clinic or hospital setting. A doctor, nurse, or other healthcare provider will give you this injection.

You may be given medication to prevent nausea or vomiting while you are receiving Velcade.

Velcade can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.

Your liver function and nerve function may also need to be checked.

Velcade dosing information

Usual Adult Dose for Lymphoma:

DOSAGE IN PREVIOUSLY UNTREATED MANTLE CELL LYMPHOMA:
1.3 mg/m2 as a bolus IV injection twice weekly in combination with IV rituximab, cyclophosphamide, doxorubicin, and oral prednisone for two weeks (days 1, 4, 8, and 11) followed by a ten day rest period (days 12 through 21)

Comments:
-The three week period is considered a treatment cycle.
-A minimum of 72 hours should elapse between consecutive doses of Velcade.
-For patients with a response first documented at cycle 6, two additional cycles (for a total of 8 cycles) are recommended.

FOR USE IN THE TREATMENT OF RELAPSED MANTLE CELL LYMPHOMA:
-Usual dose: 1.3 mg/m2 as a bolus IV injection or subcutaneously twice weekly for two weeks (days 1, 4, 8, and 11) followed by a ten day rest period (days 12 through 21). Therapy extending beyond 8 cycles may be administered by the standard schedule or may be given once weekly for 4 weeks (days 1, 8, 15, and 22), followed by a 13-day rest (days 23 through 35).

Uses: For the treatment of mantle cell lymphoma

Usual Adult Dose for Multiple Myeloma:

FOR USE IN THE TREATMENT OF PREVIOUSLY UNTREATED MULTIPLE MYELOMA:
-Usual dose: 1.3 mg/m2 administered as a 3 to 5 second bolus IV injection or subcutaneously in combination with oral melphalan and oral prednisone for nine 6-week treatment cycles:
-In cycles 1 through 4, Velcade is administered twice weekly (days 1, 4, 8, 11, 22, 25, 29, and 32). In cycles 5 through 9, Velcade is administered once weekly (days 1, 8, 22, and 29).

Comments:
-At least 72 hours should elapse between consecutive doses of Velcade.

FOR USE IN THE TREATMENT OF RELAPSED MULTIPLE MYELOMA:
-Usual dose: 1.3 mg/m2 as a bolus intravenous injection or subcutaneously twice weekly for two weeks (days 1, 4, 8, and 11) followed by a ten day rest period (days 12 through 21). Therapy extending beyond 8 cycles may be administered by the standard schedule or may be given once weekly for 4 weeks (days 1, 8, 15, and 22), followed by a 13-day rest (days 23 through 35).

Comments:
-Velcade may be administered alone or in combination with dexamethasone.
-The three week period is considered a treatment cycle.
-A minimum of 72 hours should elapse between consecutive doses of Velcade.
-Patients with multiple myeloma who have previously responded to treatment with Velcade (either alone or in combination) and who have relapsed at least 6 months after their prior therapy may be started on the last tolerated dose.

Use: For the treatment of multiple myeloma (who had previously responded to treatment with this drug and who have relapsed at least 6 months after completing treatment)

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Call your doctor for instructions if you will miss an appointment for your Velcade injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving Velcade?

Avoid becoming dehydrated if you have any vomiting or diarrhea. Talk with your doctor about how best to keep yourself hydrated.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Bortezomib can pass into body fluids (urine, feces, vomit). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Velcade side effects

Get emergency medical help if you have signs of an allergic reaction to Velcade: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Velcade may cause a serious viral infection of the brain that can lead to disability or death. Call your doctor right away if you have a severe headache, buzzing in your ears, vision problems, weakness, confusion, thinking problems, or a seizure (convulsions).

Also call your doctor at once if you have:

  • new or worsening nerve problems such as numbness, burning, pain, weakness, or tingly feeling;

  • a light-headed feeling, like you might pass out;

  • severe or ongoing nausea, vomiting, diarrhea, or constipation;

  • fever with shortness of breath or trouble breathing;

  • dehydration symptoms - feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;

  • low blood cell counts - fever, chills, tiredness, flu-like symptoms, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath;

  • liver problems - right-sided stomach pain, or jaundice (yellowing of the skin or eyes);

  • signs of congestive heart failure - shortness of breath (even with mild exertion), swelling in your lower legs, rapid weight gain, cough with mucus, fast heartbeats, sleep problems; or

  • signs of tumor cell breakdown - muscle cramps, tiredness, fast or slow heart rate, fluttering in your chest, decreased urination, tingling around your mouth.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common Velcade side effects may include:

  • numbness or tingly feeling;

  • loss of appetite, nausea, vomiting;

  • diarrhea, constipation;

  • fever, chills, cold or flu symptoms;

  • rash; or

  • feeling tired.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Velcade?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Many drugs can interact with bortezomib. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Velcade only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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