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Velcade (Generic Bortezomib)

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Why is this medication prescribed?

Velcade (bortezomib) is a medication used to treat certain types of cancer, particularly multiple myeloma and mantle cell lymphoma. It belongs to a class of drugs known as proteasome inhibitors, which work by interfering with the normal activity of proteasomes in cells. Proteasomes are structures within cells that break down proteins, and by inhibiting their function, Velcade can disrupt the growth and survival of cancer cells.

How should this medicine be used?

Here are some general guidelines for the use of Velcade:

  • Administration: Velcade is usually administered by injection (subcutaneously or intravenously) under the skin or into a vein. The specific method of administration may depend on the type of cancer being treated and the individual patient.
  • Dosage: The dosage and schedule of Velcade can vary based on the type of cancer being treated and the overall health of the patient. Your healthcare provider will determine the appropriate dose and schedule for you.
  • Frequency: Velcade is often given in cycles, with periods of treatment followed by rest. The cycle length and the number of cycles will depend on the specific treatment plan prescribed by your doctor.
  • Monitoring: During treatment with Velcade, your healthcare team will monitor your response to the medication and assess for any potential side effects. They may conduct regular blood tests and other evaluations to ensure the treatment is effective and well-tolerated.
  • Precautions: It’s important to follow your healthcare provider’s instructions carefully. Inform your doctor about any other medications or supplements you are taking, as they may interact with Velcade. Your healthcare team will also monitor for potential side effects, and it’s essential to communicate any symptoms or concerns promptly.
  • Storage: Velcade should be stored as directed by your healthcare provider or pharmacist. It is typically stored in a refrigerator, and it’s important to follow the storage instructions to maintain its effectiveness.

Always consult with your healthcare provider for personalized information and guidance regarding the use of Velcade in your specific case. They will consider your medical history, overall health, and the type and stage of cancer you are being treated for when determining the appropriate treatment plan.

Other uses for this medicine

Some off-label uses of Velcade may include:

  • Amyloidosis: Velcade may be used in the treatment of amyloidosis, a condition where abnormal proteins build up in tissues and organs.
  • Waldenström’s macroglobulinemia: This is a type of non-Hodgkin lymphoma, and Velcade may be considered in some cases.
  • Chronic Lymphocytic Leukemia (CLL): In certain situations, Velcade may be used for CLL, particularly in combination with other medications.

What special precautions should I follow?

Regarding special precautions for Velcade, here are some important considerations:

  • Peripheral Neuropathy: Velcade can cause peripheral neuropathy, a condition that affects the nerves in the extremities. It may lead to symptoms such as tingling, numbness, and pain in the hands and feet. Patients should report any unusual sensations to their healthcare provider promptly.
  • Blood Counts: Velcade can affect blood cell counts, including white blood cells, red blood cells, and platelets. Regular blood tests are typically conducted to monitor these counts during treatment.
  • Liver and Kidney Function: Velcade is metabolized by the liver and excreted by the kidneys. Patients with pre-existing liver or kidney conditions may require dose adjustments, and regular monitoring of liver and kidney function is important.
  • Pregnancy and Breastfeeding: Pregnant or breastfeeding individuals should inform their healthcare provider, as the effects of Velcade on pregnancy and breastfeeding are not well-established. The potential risks and benefits should be carefully discussed.
  • Drug Interactions: Inform your healthcare provider about all medications, including over-the-counter drugs and supplements, that you are taking. Some medications may interact with Velcade, affecting its effectiveness or increasing the risk of side effects.
  • Heart Conditions: Velcade may cause or worsen heart rhythm problems. Patients with a history of heart conditions should be closely monitored during treatment.

Always follow your healthcare provider’s instructions and report any concerns or side effects promptly. Individual circumstances can vary, and your healthcare team will tailor the treatment plan to your specific needs and medical history.

What special dietary instructions should I follow?

Regarding dietary instructions for Velcade, there are no specific dietary restrictions associated with the medication. However, maintaining a well-balanced and nutritious diet is generally important for overall health, especially during cancer treatment. If you have any concerns about your diet or nutritional needs, consult with your healthcare provider or a registered dietitian.

What should I do if I forget a dose?

If you forget a dose of Velcade, it’s crucial to contact your healthcare provider as soon as possible. They will provide guidance on whether the missed dose should be administered, rescheduled, or if any adjustments to the treatment plan are necessary. Do not try to make up for a missed dose without consulting your healthcare team, as they will consider your overall treatment schedule and response to therapy when advising on the next steps.

What side effects can this medication cause?

Velcade (bortezomib) can cause various side effects, and their severity can vary from person to person. It’s important to note that not everyone will experience these side effects, and some individuals may experience side effects that are not listed here. Always consult with your healthcare provider for personalized information about potential side effects. Common side effects of Velcade include:

  • Peripheral Neuropathy: Tingling, numbness, or pain in the hands and feet. Regular monitoring and reporting of symptoms to your healthcare provider are important.
  • Gastrointestinal Issues: Nausea, vomiting, diarrhea, and constipation.
  • Fatigue: Feeling tired or weak is a common side effect.
  • Low Blood Cell Counts: Velcade can affect bone marrow function, leading to low white blood cell counts (increasing the risk of infection), low red blood cell counts (resulting in anemia), and low platelet counts (increasing the risk of bleeding). Regular blood tests will monitor these counts.
  • Fever: Some individuals may experience fever as a side effect.
  • Low Blood Pressure: Velcade can cause a drop in blood pressure, leading to dizziness or fainting.
  • Respiratory Issues: Cough, shortness of breath, or other respiratory symptoms.
  • Skin Reactions: Rash or itching.
  • Liver and Kidney Issues: Elevated liver enzymes and changes in kidney function may occur.
  • Heart Rhythm Problems: Velcade may cause or worsen heart rhythm problems, and cardiac function is monitored during treatment.
  • Lung Toxicity: Rarely, Velcade has been associated with lung toxicity, which may cause cough or difficulty breathing.
  • Reactivation of Herpes Zoster (Shingles): Velcade may increase the risk of reactivating the herpes zoster virus, leading to shingles.

It’s essential to communicate any side effects or concerns promptly to your healthcare provider. They can provide guidance on managing side effects and may adjust the treatment plan if needed. In some cases, side effects may require dose modifications or temporary discontinuation of Velcade. Additionally, supportive medications or interventions may be prescribed to alleviate specific symptoms.

Always follow your healthcare provider’s instructions and attend regular check-ups during treatment to monitor your response and manage any potential side effects.

What should I know about storage and disposal of this medication?

Storage and disposal information for Velcade (bortezomib):


  • Refrigeration: Velcade is typically stored in the refrigerator. Follow the specific storage instructions provided by your healthcare provider or pharmacist.
  • Protect from Light: Some formulations of Velcade may be light-sensitive. Keep the medication in its original packaging and protect it from light as directed.
  • Do Not Freeze: Do not freeze Velcade unless otherwise instructed.


  • Follow Local Guidelines: Dispose of Velcade according to local guidelines for the disposal of hazardous waste or medications. Check with your healthcare provider or pharmacist for specific instructions.
  • Return to Pharmacy: Some pharmacies and healthcare facilities have programs for the safe disposal of unused medications. Inquire if they can assist with the disposal of Velcade.
  • Do Not Flush: Do not flush Velcade down the toilet or pour it down the drain unless specifically instructed to do so.

In case of emergency/overdose

In case of emergency or overdose, seek immediate medical attention. Contact your local poison control center or go to the nearest emergency room. Be prepared to provide information about the medication, dosage, and any symptoms experienced.

What other information should I know?

  • Medical History: Inform your healthcare provider of your complete medical history, including any pre-existing conditions, allergies, or medications you are currently taking.
  • Follow Instructions: Take Velcade exactly as prescribed by your healthcare provider. Do not change the dose or schedule without consulting them.
  • Regular Monitoring: Attend all scheduled medical appointments and follow-up visits for regular monitoring of your response to Velcade and potential side effects.
  • Communication: Report any new or worsening symptoms, side effects, or concerns to your healthcare provider promptly.
  • Interactions: Be aware of potential drug interactions. Inform your healthcare provider of all medications, including over-the-counter drugs and supplements, that you are taking.
  • Pregnancy/Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss this with your healthcare provider. The risks and benefits of Velcade during pregnancy and breastfeeding should be carefully evaluated.

Always follow your healthcare provider’s instructions and ask questions if there is anything you do not understand. They are your best resource for information tailored to your specific medical situation.

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