Bortezomib, Injection bor-TEZ-oh-mib

What are other names for this medicine?

Type of medicine: antineoplastic (anticancer); chemotherapy

Generic and brand names: bortezomib, injection; Velcade Injection

What is this medicine used for?

This medicine is given by IV injection (a shot directly into a vein) to treat a type of cancer called multiple myeloma. It is given to people who have already been treated with 2 other types of chemotherapy and have not shown improvement. It may be used for other conditions as determined by your health care provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• heart disease
• herpes zoster
• liver or kidney disease
• low blood pressure
• peripheral neuropathy (numbness, tingling, pain, or burning feelings in your feet or hands)
• problems with dehydration

Tell your healthcare provider if you are taking medicine to treat high blood pressure or diabetes.

This medicine may make you sterile (unable to have children) whether you are a man or a woman. If you plan to have children someday, talk with your healthcare provider before you start treatment.

Females of childbearing age: This medicine is not given during pregnancy because it may harm the baby. Tell your healthcare provider if you are pregnant or plan to become pregnant. Use an effective method of birth control while receiving this medicine. If you need advice about birth control, ask your healthcare provider. Do not breast-feed while receiving this treatment.

How do I use it?

Your healthcare provider will give you an IV injection twice a week for 2 weeks, followed by a 10 day rest period.

What should I watch out for?

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.

You may have lightheadedness, dizziness, drowsiness, and blurred vision. Do not drive or operate machinery until you are fully alert and can see clearly.

This medicine may cause a flare up of shingles or cold sores. Contact your healthcare provider right away if you have these symptoms.

This medicine can cause nausea, vomiting, diarrhea, and constipation. The nausea, vomiting, and diarrhea can cause dehydration (loss of too much water from your body). Be careful in hot weather to avoid activities that cause you to sweat heavily. Also avoid drinking large amounts of caffeine (in cola drinks, coffee, and tea) which can cause dehydration by making you urinate more. Drink more water while receiving this medicine.

You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Diabetics: This medicine may affect your blood sugar level and change the amount of diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you are unable to reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reactions (hives, itching, rash, tightness in your chest, swelling of your lips, tongue or throat, trouble breathing)

Serious (report these to your healthcare provider right away): High fever; muscle weakness or cramps; numbness, tingling, pain, or burning feelings in the feet and hands; fast heartbeat; unusual bruising or bleeding; white patches in the mouth; severe constipation with abdominal pain.

Other: Loss of appetite; lightheadedness; dizziness; headache; trouble sleeping; cough; swelling in the legs or feet; bone or back pain; diarrhea; constipation; nausea; vomiting; stomach pain; trouble swallowing; tiredness; nervousness; blurred vision; stuffy nose.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• angiotensin receptor II blockers such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• antifungals such as fluconazole (Diflucan), ketoconazole (Nizoral), and miconazole aspirin and other salicylates
• anti-HIV medicines such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Invirase)
• antiseizure medicines such as carbamazepine (Tegretol), oxcarbazepine (Trileptal), phenobarbital, phenytoin (Dilantin), and primidone (Mysoline)
• beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), pindolol, propranolol (Inderal LA), and sotalol (Betapace)
• calcium channel blockers such as diltiazem (Cardizem, felodipine, isradipine (DynaCirc CR), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera-HS, Isoptin SR, Verelan, Tiazac)
• diabetes medicines such as glipizide (Glucotrol, Glucotrol XL), glyburide (DiaBeta, Glynase PresTab), insulin, metformin (Glucophage), pioglitazone (Actos), repaglinide (Prandin), and rosiglitazone (Avandia)
• diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• hydralazine
• medicines to increase the number of blood cells such as filgrastim (G-CSF, Neupogen), pegfilgrastim (Neulasta), and sargramostim/GM-CSF (Leukine),
• medicines to treat or prevent blood clots such as abciximab (ReoPro), argatroban, bivalirudin (Angiomax), clopidogrel (Plavix), dipyridamole (Persantine), eptifibatide (Integrilin), lepirudin (Refludan), tirofiban (Aggrastat), and warfarin (Coumadin)
• nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• rifabutin (Mycobutin) and rifampin (Rifadin, Rifater, Rifamate)
• St. John’s wort

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.