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What are the side effects of velcade. VELCADE Side Effects: Comprehensive Guide to Bortezomib Injection Risks

by alexxlab

What are the most common side effects of VELCADE. How does bortezomib affect the nervous system. Can VELCADE cause heart problems. What precautions should patients take when receiving bortezomib injections. How does VELCADE impact blood pressure and platelet counts.

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Understanding VELCADE: A Powerful Multiple Myeloma Treatment

VELCADE, also known by its generic name bortezomib, is a potent medication used primarily in the treatment of multiple myeloma and mantle cell lymphoma. As an injectable proteasome inhibitor, it has shown significant efficacy in managing these hematological malignancies. However, like all powerful medications, it comes with a range of potential side effects that patients and healthcare providers must be aware of.

Nerve-Related Side Effects: Peripheral Neuropathy

One of the most significant concerns associated with VELCADE treatment is its impact on the nervous system. Peripheral neuropathy, a condition characterized by nerve damage, is a common side effect that requires careful monitoring.

Symptoms of VELCADE-Induced Peripheral Neuropathy

  • Muscle weakness
  • Tingling sensations
  • Burning pain
  • Numbness in hands and feet

Is peripheral neuropathy reversible? In many cases, the symptoms of peripheral neuropathy may improve or resolve after discontinuation or dose adjustment of VELCADE. However, in some instances, the nerve damage can be severe and potentially long-lasting.

Cardiovascular Concerns: Blood Pressure and Heart Function

VELCADE can have significant effects on the cardiovascular system, potentially causing or exacerbating existing heart conditions.

Blood Pressure Changes

Hypotension, or low blood pressure, is a known side effect of VELCADE. Patients may experience dizziness, lightheadedness, or fainting spells. Healthcare providers often need to adjust antihypertensive medications for patients undergoing VELCADE treatment.

Heart Rhythm Abnormalities and Heart Failure

Can VELCADE affect heart function? Yes, treatment with VELCADE has been associated with heart rhythm problems and may worsen existing heart failure. Patients with a history of heart disease or those at high risk require close monitoring during treatment.

Gastrointestinal Side Effects: Managing Digestive Distress

VELCADE can cause a range of gastrointestinal issues that may significantly impact a patient’s quality of life during treatment.

  • Nausea and vomiting
  • Diarrhea
  • Constipation

How can gastrointestinal side effects be managed? In cases of severe gastrointestinal distress, healthcare providers may recommend intravenous fluids to prevent dehydration and prescribe medications to alleviate symptoms. Dietary adjustments and proper hydration can also help manage these side effects.

Hematological Impacts: Focus on Platelet Counts

VELCADE can have a significant impact on blood cell production, particularly affecting platelet counts. Thrombocytopenia, or low platelet levels, is a common and potentially serious side effect of VELCADE treatment.

Signs of Low Platelet Counts

  • Easy bruising
  • Prolonged bleeding from cuts
  • Nosebleeds
  • Bleeding gums

What measures are taken to address thrombocytopenia? Healthcare providers closely monitor platelet levels during VELCADE treatment. In cases of severe thrombocytopenia, platelet transfusions may be necessary. Dose adjustments or treatment interruptions might also be considered to allow platelet counts to recover.

Pulmonary Complications: Monitoring Lung Function

VELCADE treatment has been associated with various lung problems, some of which can be severe or even life-threatening.

Respiratory Symptoms to Watch For

  • Persistent cough
  • Shortness of breath
  • Wheezing
  • Difficulty breathing

How are lung problems diagnosed and managed during VELCADE treatment? Patients experiencing respiratory symptoms undergo thorough evaluations, which may include chest X-rays, pulmonary function tests, and in some cases, high-resolution CT scans. Treatment may involve supportive care, corticosteroids, or in severe cases, discontinuation of VELCADE.

Neurological Concerns: Posterior Reversible Encephalopathy Syndrome (PRES)

Although rare, PRES is a serious neurological condition that has been reported in some patients receiving VELCADE. This condition affects the brain and can cause a range of concerning symptoms.

Symptoms of PRES

  • Seizures
  • High blood pressure
  • Severe headaches
  • Confusion
  • Visual disturbances or blindness

Is PRES reversible? As the name suggests, PRES is typically reversible if recognized and treated promptly. However, it requires immediate medical attention and usually necessitates discontinuation of VELCADE treatment. The safety of restarting VELCADE after a PRES episode remains uncertain.

Special Considerations and Precautions

While VELCADE is a powerful tool in the fight against multiple myeloma and mantle cell lymphoma, certain precautions must be taken to ensure patient safety.

Allergic Reactions

Patients with known allergies to bortezomib, boron, or mannitol should not receive VELCADE. Allergic reactions can be severe and potentially life-threatening.

Administration Route

Why is the route of administration important for VELCADE? VELCADE must never be administered intrathecally (into the spinal fluid) due to the risk of severe, potentially fatal side effects. It is typically given either intravenously or subcutaneously, with the latter route sometimes preferred in patients with pre-existing peripheral neuropathy.

Monitoring and Follow-up

Regular monitoring is crucial during VELCADE treatment. This includes:

  • Frequent blood tests to check platelet counts and other blood cell levels
  • Regular neurological examinations to assess for peripheral neuropathy
  • Cardiovascular monitoring, especially in patients with heart disease risk factors
  • Pulmonary function assessments if respiratory symptoms develop

How often should patients be monitored during VELCADE treatment? The frequency of monitoring depends on the individual patient’s risk factors and treatment response. Typically, blood tests are performed before each dose, while other assessments may be conducted at regular intervals or as symptoms warrant.

Managing Side Effects: A Collaborative Approach

Effective management of VELCADE side effects requires a collaborative effort between patients, caregivers, and healthcare providers. Open communication about new or worsening symptoms is crucial for timely intervention and optimal outcomes.

Strategies for Side Effect Management

  1. Dose modifications: Adjusting the VELCADE dose or schedule can often help mitigate side effects while maintaining treatment efficacy.
  2. Supportive medications: Anti-nausea drugs, pain relievers, and other supportive medications can help manage specific side effects.
  3. Lifestyle modifications: Proper nutrition, hydration, and gentle exercise (as tolerated) can help patients better cope with treatment side effects.
  4. Complementary therapies: Some patients find relief from side effects through acupuncture, massage, or other complementary approaches, although these should always be discussed with the healthcare team.

What role do patients play in managing VELCADE side effects? Patients are essential partners in their own care. By promptly reporting new symptoms, adhering to prescribed medications and monitoring schedules, and following lifestyle recommendations, patients can significantly contribute to the successful management of side effects and overall treatment outcomes.

Balancing Risks and Benefits: The VELCADE Decision

While the potential side effects of VELCADE may seem daunting, it’s important to consider them in the context of the drug’s proven efficacy in treating multiple myeloma and mantle cell lymphoma. For many patients, the benefits of VELCADE in controlling their cancer and potentially extending life outweigh the risks of side effects.

Factors Influencing Treatment Decisions

  • Stage and aggressiveness of the cancer
  • Patient’s overall health and pre-existing conditions
  • Previous treatments and their outcomes
  • Patient preferences and quality of life considerations

How do healthcare providers and patients decide if VELCADE is the right choice? The decision to use VELCADE is made through careful consideration of the individual patient’s circumstances, a thorough discussion of potential risks and benefits, and shared decision-making between the patient and their healthcare team.

Future Directions: Improving VELCADE Treatment

Research into improving the safety and efficacy of VELCADE continues, with several promising avenues being explored.

Ongoing Research Areas

  • Development of new proteasome inhibitors with improved side effect profiles
  • Combination therapies that may allow for lower VELCADE doses
  • Personalized medicine approaches to predict and prevent side effects
  • Novel delivery methods to reduce systemic exposure and side effects

What advancements can patients expect in VELCADE treatment? While it’s difficult to predict specific breakthroughs, ongoing research aims to enhance the therapeutic index of VELCADE and similar drugs, potentially leading to more effective and better-tolerated treatments for multiple myeloma and other hematological malignancies.

In conclusion, VELCADE (bortezomib) remains a critical component in the treatment arsenal against multiple myeloma and mantle cell lymphoma. While its side effects can be significant, careful monitoring, proactive management, and open communication between patients and healthcare providers can help maximize the benefits of this powerful medication while minimizing risks. As research continues, we can hope for even more refined and patient-friendly approaches to proteasome inhibitor therapy in the future.

VELCADE® (bortezomib) for Injection

It is not known if VELCADE is safe and effective in children.

Important Safety Information for VELCADE® (bortezomib) for Injection

What is the most important information I should know about VELCADE?



  • You should not receive VELCADE if you are allergic to bortezomib, boron, or mannitol.




  • VELCADE must not be administered into your spinal fluid (intrathecally) because of possible serious side effects that can lead to death.


What are the possible side effects of VELCADE?

VELCADE can cause serious side effects, including:


  • Nerve problems (peripheral neuropathy).

    VELCADE can cause damage to the nerves, a condition called peripheral neuropathy. Tell your healthcare provider if you get any new or worsening symptoms, including: muscle weakness, tingling, burning, pain, and loss of feeling in your hands and feet, any of which can be severe. Your doctor may change the dose and/or schedule of VELCADE or stop it altogether. If you have peripheral neuropathy before starting VELCADE, your doctor could consider giving you VELCADE subcutaneously.



  • Low blood pressure (hypotension).

    VELCADE can cause a drop in blood pressure. Tell your doctor if you have low blood pressure, feel dizzy, or feel as though you might faint. If you are taking drugs that lower blood pressure, your medications might need to be adjusted. If you are not drinking enough liquids, your doctor may need to administer IV fluids.



  • Heart problems.

    Treatment with VELCADE can cause or worsen heart rhythm problems and heart failure. Your doctor may closely monitor you if you have, or are at risk for, heart disease. Tell your doctor if you experience chest pressure or pain, palpitations, swelling of your ankles or feet, or shortness of breath.



  • Lung problems.

    There have been reports of lung disorders in people receiving VELCADE. Some of these events have been fatal. Tell your doctor if you experience any cough, shortness of breath, wheezing, or difficulty breathing.



  • Brain swelling (Posterior Reversible Encephalopathy Syndrome—PRES).

    There have been reports of a rare, reversible condition involving the brain, called PRES, in people treated with VELCADE. People with PRES can have seizures, high blood pressure, headaches, tiredness, confusion, blindness, or other vision problems. Treatment with VELCADE should be stopped in cases of PRES. It is not known whether restarting VELCADE therapy in patients previously experiencing this complication is safe.



  • Stomach and intestinal (gastrointestinal) problems.

    VELCADE treatment can cause nausea, vomiting, diarrhea, and constipation. If your symptoms are severe, your doctor may recommend IV fluids and/or medications.



  • Low platelet counts (thrombocytopenia).

    VELCADE can cause low levels of platelets (clot-forming cells). Your doctor may recommend a platelet transfusion or other supportive care. Tell your healthcare provider if you have any signs of low platelet counts, including bleeding and easy bruising.



  • Lowered white blood cells (neutropenia).

    VELCADE can cause low levels of neutrophils which are a type of white blood cell that help to fight infections. If your white blood cells become low, you can be at higher risk for infections. Tell your doctor if you develop a fever or believe you have an infection. You will have regular blood tests to check your cell counts during your treatment with VELCADE. If the number of these cells is very low, your doctor may change the dose and/or schedule of VELCADE.



  • Tumor Lysis Syndrome (TLS).

    TLS is caused by a fast breakdown of cancer cells. TLS can cause you to have kidney failure and the need for dialysis treatment and/or an abnormal heartbeat. Your healthcare provider may do blood tests to check for TLS.



  • Liver problems.

    If you have liver problems, it can be harder for your body to get rid of VELCADE. VELCADE has caused sudden liver failure in people who were taking many medications or had other serious medical conditions. Symptoms of liver problems include a yellow discoloration of the eyes and skin (jaundice) and pain in your right upper stomach-area. Your doctor will closely monitor you if you have liver disease. It is not known whether restarting VELCADE therapy in patients previously experiencing this complication is safe.



  • Hematologic disease (Thrombotic Microangiopathy, TMA).

    VELCADE can lead to the formation of blood clots in small blood vessels. These clots can result in low platelets, kidney damage, confusion, and an increased risk of bleeding, and may lead to death. Tell your doctor if you develop pinpoint-sized purple dots (petechiae), larger bruises, or if you see blood in your urine. Your doctor may stop treatment with VELCADE. It is not known whether restarting VELCADE therapy in patients previously experiencing this complication is safe.


The most commonly reported side effects in clinical studies include:



  • Nausea




  • Diarrhea




  • Low platelets (thrombocytopenia)




  • Decreased number of neutrophils, a type of white blood cell (neutropenia)




  • Nerve damage (peripheral neuropathy)




  • Fatigue




  • Nerve pain (neuralgia)




  • Low red blood cells (anemia)




  • Low white blood cells (leukopenia)




  • Constipation




  • Vomiting




  • Decreased number of lymphocytes, a type of white blood cell (lymphopenia)




  • Rash




  • Fever (pyrexia)




  • Lack of appetite (anorexia)


These are not all of the possible side effects with VELCADE. It is important to always contact your doctor if you experience any side effects while on VELCADE. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Before you take VELCADE, tell your healthcare provider about all of your medical conditions, including if you:



  • have liver disease or kidney disease. If you are on dialysis, your doctor will administer VELCADE after the dialysis procedure.




  • are taking medication for diabetes. VELCADE can affect your blood glucose levels. Your doctor may require close monitoring of your blood glucose levels and change the dose of your diabetes medicine while you are being treated with VELCADE.




  • develop a rash of any type or have skin pain while receiving VELCADE.




  • are pregnant or plan to become pregnant. VELCADE can harm your unborn baby.

    Females who are able to become pregnant:


    • Your healthcare provider will determine whether or not you are pregnant before you start treatment with VELCADE.


    • Females who are able to become pregnant must use effective birth control during treatment and for seven months after your last dose of VELCADE.


    Males with females partners who are able to become pregnant:


    • Males with female partners of reproductive potential must use effective contraception during treatment with VELCADE and for four months following the last dose of VELCADE.



  • Tell your healthcare provider right away if you or your partner become pregnant while you are receiving VELCADE or within seven months following the last dose.




  • VELCADE may have an effect on either male or female fertility.




  • are breastfeeding or plan to breastfeed. It is not known if VELCADE passes into breast milk, or if it affects an infant who is breastfed, or breast milk production. Do not breastfeed during treatment with VELCADE and for two months after your last dose of VELCADE.


Tell your healthcare provider about all the medicines you take, including prescription and over-the counter medicines, vitamins, and herbal supplements. VELCADE and other medicines may affect each other. Talk to your healthcare provider before starting any new medicines during treatment with VELCADE.

What should I avoid while taking VELCADE?

VELCADE may cause fatigue, dizziness, fainting (syncope), or lightheadedness when you sit or stand up. You should not drive or operate machinery if you experience any of these symptoms.

How is VELCADE administered?

VELCADE is prescribed by a doctor experienced in the use of medications to treat cancer. It is administered by a healthcare professional as an injection into your vein (intravenously, or IV) or under your skin (subcutaneously, or SC).

Velcade Injection: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

How to use Velcade Vial

This medication is given by injection into a vein or under the skin by a health care professional. If you are receiving this medication under the skin, make sure that the injection site is changed each time to lessen injury under the skin. Your doctor may direct you to receive this medication in a treatment cycle (for example, only on certain days each month). Carefully follow your doctor’s instructions. The dosage is based on your body size, medical condition, lab tests, and response to treatment.

To prevent dehydration, it is important to drink plenty of fluids while you are being treated with this drug. Consult your doctor or pharmacist if you have any questions.

Side Effects

Dizziness, lightheadedness, nausea, vomiting, loss of appetite, diarrhea, constipation, tiredness, weakness, or pain/redness at the injection site may occur. Nausea, vomiting, and diarrhea can be severe. In some cases, your doctor may prescribe medication to prevent or relieve nausea, vomiting, and diarrhea. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

People using this medication may have serious side effects. However, you have been prescribed this drug because your doctor has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk.

Bortezomib sometimes causes side effects due to the rapid destruction of cancer cells (tumor lysis syndrome). To lower your risk, your doctor may add a medication and tell you to drink plenty of fluids. Tell your doctor right away if you have symptoms such as: low back/side pain (flank pain), signs of kidney problems (such as painful urination, pink/bloody urine, change in the amount of urine), muscle spasms/weakness.

Tell your doctor right away if you have any serious side effects, including: tingling/numbness/pain/burning feeling of arms/legs, severe headache, mental/mood changes (such as confusion), signs of liver disease (such as nausea/vomiting that doesn’t stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine), symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).

Get medical help right away if you have any very serious side effects, including: chest pain, vision changes, seizures, weakness on one side of the body, trouble speaking, fainting, small red/purple/brown spots on your skin.

This medication can decrease blood cells, which can cause anemia, decrease your body’s ability to fight an infection, or cause easy bruising/bleeding. Tell your doctor right away if you develop any of the following symptoms: easy bleeding/bruising, black/tarry stools, vomit that looks like coffee grounds, signs of an infection (such as sore throat that doesn’t go away, fever, chills), unusual tiredness, pale skin.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Bortezomib can commonly cause a rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe reaction. Get medical help right away if you develop any rash.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as boron, mannitol), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: nerve problems (such as peripheral neuropathy), liver disease, kidney disease, dehydration, heart disease (such as heart failure), bleeding/blood disorders, current/recent infections, diabetes.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Bortezomib can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.

Tell your health care professional that you are using bortezomib before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using bortezomib. Bortezomib may harm an unborn baby. Your doctor should order a pregnancy test before you start this medication. Women using this medication should ask about reliable forms of birth control during treatment and for 7 months after the last dose. Men using this medication should ask about reliable forms of birth control during treatment and for 4 months after the last dose. If you or your partner becomes pregnant, talk to your doctor right away about the risks and benefits of this medication.

It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug and for 2 months after the last dose is not recommended. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Other medications can affect the removal of bortezomib from your body, which may affect how bortezomib works. Examples include rifamycins (such as rifabutin), St. John’s wort, drugs used to treat seizures (such as carbamazepine, phenytoin), among others.

Does Velcade Vial interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, fainting, or easy bleeding/bruising.

Lab and/or medical tests (such as complete blood count) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.

Not applicable. This medication is given in a clinic and will not be stored at home.

Images

Velcade 3.5 mg solution for injection

Color: colorlessShape: Imprint:

This medicine is a colorless, clear, vial

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

what you need to know – Drink-Drink

Introduction

If you have a certain type of blood cancer, your doctor may suggest Velcade (bortezomib) as a treatment option.

Velcade is a prescription drug used in adults with multiple myeloma or mantle cell lymphoma. Both of these cancers start in white blood cells.

This medicine comes as a powder that is mixed with a liquid to form a solution. It is injected under the skin or into a vein. You will receive doses of Velcade at your doctor’s office or clinic.

You can get Velcade as a long-term treatment. The length of your treatment may depend on the type of cancer you have and your specific treatment goals. Your doctor will determine how long you should take Velcade.

For more information about Velcade, including how to use it, see this detailed article. Like all medicines, Velcade can cause mild or serious side effects. Keep reading to find out more.

What are the most common side effects of Velcade?

Some people may experience mild or severe side effects during treatment with Velcade. Examples of some of the commonly reported side effects of Velcade include:

  • digestive problems such as nausea and vomiting*
  • fatigue (low energy)
  • low red blood cell, white blood cell, or platelet count
  • skin rash

    • 90 019 fever

What are the mild side effects of Velcade?

Velcade may cause mild side effects. Examples of mild side effects reported with Velcade include:

  • digestive problems such as nausea and vomiting*
  • skin rash
  • fever
  • fatigue (low energy)
  • decreased appetite 9 0020
  • insomnia ( sleep problems)†
  • dizziness
  • Headache
  • swelling of the arms or legs

In most cases, these side effects should be temporary. Some of them are easy to manage too. But if you have any symptoms that continue or bother you, talk to your doctor or pharmacist. And don’t stop using Velcade unless your doctor recommends it.

Velcade may cause mild side effects other than those listed above. See Velcade’s appointment for details.

After the Food and Drug Administration (FDA) approves a drug, it monitors the drug’s side effects. If you would like to notify the FDA of a side effect you had with Velcade, visit MedWatch.

What are the serious side effects of Velcade?

Some people who take Velcade may experience serious side effects. But these side effects are less common than mild side effects. However, it is important to be aware of the serious side effects that may occur so that you can start treatment right away. In rare cases, serious side effects can be fatal if left untreated.

Serious side effects reported with Velcade include:

  • neuropathy (nerve damage)*
  • low red blood cell, white blood cell, or platelet count
  • allergic reaction*
  • low blood pressure*
  • heart failure or others heart disease
  • lung problems such as pulmonary edema
  • tumor lysis syndrome (a condition that can occur when cancer cells die quickly and release their contents into the blood)
  • liver problems such as hepatitis
  • blood clotting conditions
  • posterior reversible encephalopathy syndrome causing brain swelling
  • infections such as bronchitis
  • mental side effects*
  • kidney problems such as kidney insufficiency
  • severe skin rash that can cause peeling of the skin
  • injection site reactions such as pain or swelling
  • severe digestive problems*

If you develop serious side effects while taking Velcade, contact your doctor immediately. If the side effects seem life-threatening or if you think you need a medical emergency, call 911 or your local emergency number right away.

Frequently Asked Questions About Velcade Side Effects

Get answers to some frequently asked questions about Velcade side effects.

How long do side effects from Velcade usually last?

The duration of your side effects (how long they last) may depend on several factors. These include your body’s reaction to the medication and the specific side effects you experience.

For example, if you experience injection site reactions such as pain or swelling, the reaction may go away a few days after you receive a dose of Velcade. But you may have these reactions with every injection you receive.

More serious side effects, such as liver or kidney problems, may not go away on their own. Your doctor may need to prescribe other medicines to treat these side effects.

If you are concerned about how long certain side effects will last, talk to your doctor or pharmacist. In some cases, your doctor may also recommend ways to alleviate your side effects so that they are not as bothersome.

Does Velcade cause any long-term side effects?

Yes, it is possible that Velcade may cause long-term side effects. But these side effects are usually rare. Examples of long-term side effects Velcade may cause include:

  • heart failure or other heart conditions
  • lung problems such as pulmonary edema
  • liver problems such as hepatitis
  • blood clotting conditions
  • kidney problems such as kidney failure

    • 9002 9

    Your doctor will follow up for side effects throughout the treatment with Velcade. If you develop any serious side effects, your doctor may reduce your dose. Or they may recommend that you stop taking Velcade and switch to another treatment.

    In some cases, your side effects may go away after you stop using Velcade. But in other cases, side effects may persist after treatment is stopped.

    If you have concerns about the long-term side effects of Velcade, talk to your doctor.

    Is hair loss a side effect of Velcade?

    No, hair loss was not a side effect reported by people taking Velcade alone in studies. However, hair loss may be caused by other cancer medicines you are taking with Velcade.

    Studies have reported hair loss in people taking Velcade with Rituxan (rituximab), Cytoxan (cyclophosphamide), Doxil (doxorubicin), and Rayos (prednisolone).

    Human hair loss in these studies was probably caused by cyclophosphamide or doxorubicin. These drugs are considered “cytotoxic,” meaning they kill cells. This is how they treat cancer, but they also cause hair loss.

    If you are concerned about hair loss during cancer treatment, talk to your doctor.

    Do the side effects of Velcade change depending on whether it is used for multiple myeloma or mantle cell lymphoma?

    Yes, your side effects may vary depending on whether you are using Velcade to treat multiple myeloma or mantle cell lymphoma. But in most cases, the side effects reported in Velcade’s studies were very similar in people with either of these conditions.

    Your side effects may also depend on other medicines you take with Velcade. Other drugs may increase the risk of certain side effects, such as infections, or may cause additional side effects, such as hair loss.

    Talk to your doctor or pharmacist if you have any questions about what side effects you may have with Velcade for your particular condition.

    Does Velcade cause any eye side effects?

    Yes, Velcade can cause eye side effects. These side effects were not common in studies, but they did occur in some people. Examples of eye side effects reported in studies include:

    • double vision
    • blurred vision
    • eye infection
    • eye irritation

    Other more serious eye related side effects have also been reported since Velcade was introduced to the market. These include blindness, optic neuropathy (damage to the optic nerve), and eyelid edema. These side effects did not appear in studies of the drug, so it is not clear how often they occurred and whether Velcade was the cause.

    If you experience any eye related side effects, be sure to tell your doctor. In some cases, they may be able to treat your eye side effects. In other, more serious cases, you may be asked to stop taking Velcade and switch to another cancer medicine.

    Side effects explained

    You may experience side effects from taking Velcade. Learn more about some of the side effects Velcade may cause below.

    Neuropathy

    Velcade may cause neuropathy (nerve damage) in some people. This was one of the most common side effects reported by people taking Velcade in studies.

    Neuropathy is a nerve disorder that causes numbness or weakness. Neuropathy often occurs in the arms or legs. Symptoms of neuropathy may include:

    • burning sensation on the skin
    • pain or weakness
    • numbness
    • pins and needles in your hands or feet
    What can help

    If you experience any of the above symptoms while taking Velcade, tell your doctor right away. Your doctor will also monitor your symptoms.

    If you experience neuropathy, your doctor may decrease your dose. Or they may recommend that you stop taking Velcade, either permanently or at least until your neuropathy improves.

    Psychiatric side effects

    Psychiatric side effects may develop when using Velcade. In studies, these side effects were rare.

    Examples of rare psychiatric side effects reported in Velcade’s studies include:

    • feeling excited
    • confusion
    • anxiety
    • suicidal thoughts or behavior
    • changes in your mental state condition, such as confusion or memory loss

    Mental side effects can lead to insomnia (trouble sleeping), which has been a common side effect of Velcade in studies.

    Before starting treatment with Velcade, be sure to tell your doctor about any mental illness you have or have had in the past. They may want to monitor you more closely during treatment.

    What can help

    If you develop mental side effects while taking Velcade, contact your doctor immediately. For some side effects, such as insomnia, your doctor may recommend medication to treat it.

    For other conditions, such as suicidal thoughts or behavior, your doctor may ask you to stop taking Velcade and switch to another treatment.

    Suicide Prevention

    If you think someone is at immediate risk of harming themselves or others:

    • Call 911 or your local emergency number help.
    • Stay with the person until help arrives.
    • Remove all weapons, knives, medicines and other items that could cause harm.
    • Listen, but don’t judge, argue, threaten or yell.

    If you or someone you know is thinking about suicide, get help from a crisis or suicide prevention hotline. Call the National Suicide Prevention Hotline at 800-273-8255.

    Digestive problems

    Digestive problems may occur during treatment with Velcade. These side effects were very common in studies of the drug. Examples of digestive issues include:

    • nausea
    • vomiting
    • diarrhea
    • constipation
    • abdominal pain

    In some cases, these side effects can be severe and cause dehydration. Be sure to tell your doctor if you have any digestive problems.

    What can help

    Your doctor will monitor you for symptoms of digestive problems throughout your treatment with Velcade. You may need to take medicines to treat these side effects, such as medicines for nausea or diarrhea. Your doctor or pharmacist can advise you on the best treatments for these conditions.

    In addition, digestive problems can lead to dehydration. To reduce this risk, be sure to drink plenty of fluids. You can stay hydrated by drinking water or sports drinks such as Gatorade.

    In cases of severe dehydration, you may need to have fluid given by vein by a healthcare professional. Your doctor will determine if your dehydration is severe enough to receive this treatment.

    Tell your doctor about any digestive problems you have during treatment. They may recommend ways to relieve these side effects.

    Low blood pressure

    Some people may develop low blood pressure during treatment with Velcade. This has been a fairly common side effect that has been reported by people using Velcade in research. In some cases, people have reported low blood pressure when changing positions, such as when getting up from a lying position.

    Low blood pressure can become serious if left untreated. For example, you may pass out if your blood pressure becomes too low.

    Your doctor will monitor you for symptoms of low blood pressure while you are being treated with Velcade. Examples of these symptoms include:

    • dizziness
    • fainting
    • blurred vision
    • cold or clammy skin
    What can help

    your doctor if you have a history of fainting. You should also talk to him about any other medications you are taking. If you are taking other drugs that can lower your blood pressure, you may be at a higher risk of developing low blood pressure while taking Velcade. In this case, your doctor may monitor your symptoms of low blood pressure more closely.

    Watch for symptoms of low blood pressure during treatment with Velcade. If you develop any symptoms, tell your doctor immediately. They may recommend increasing your fluid intake, changing the dose of other medicines you are taking, or adding another blood pressure medicine.

    Allergic reaction

    Like most medicines, Velcade can cause an allergic reaction in some people.

    Symptoms may be mild or severe and may include:

    • skin rash
    • itching
    • redness (temporary warmth, redness, or discoloration of the skin)
    • swelling under the skin, usually on the eyelids, lips, arms, or legs
    • swelling of the mouth, tongue, or throat that causes difficulty breathing
    What can help

    If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter oral antihistamine such as Benadryl (diphenhydramine) or a topical product such as hydrocortisone cream to relieve your symptoms.

    If your doctor confirms that you had a mild allergic reaction to Velcade, they will decide whether you should continue using it.

    If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms can be life threatening and require immediate medical attention.

    If your doctor confirms that you have had a serious allergic reaction to Velcade, he may ask you to switch to another treatment.

    Tracking side effects

    Consider keeping a record of any side effects you experience during your treatment with Velcade. You can then share this information with your doctor. This is especially helpful when you first start taking new medications or using a combination of treatments.

    Your side effect notes may include things like:

    • what dose of the drug you were taking when you had the side effect
    • How soon after starting this dose did you experience a side effect
    • What were your symptoms due to the side effect
    • How did it affect your daily activities
    • What other medications did you also take
    • Any other information you think important

    Taking notes and sharing them with your doctor will help him learn more about how the drug is affecting you. And your doctor can use this information to adjust your treatment plan if necessary.

    Velcade Warnings

    Velcade may not be right for you if you have certain medical conditions or other health conditions. Talk to your doctor about your medical history before taking Velcade. The list below includes factors to consider.

    Neuropathy. If you have a history of neuropathy (nerve damage), tell your doctor before starting treatment with Velcade. This drug may make your neuropathy worse. Your doctor may monitor your neuropathy symptoms more frequently to make sure your condition is not worsening.

    Allergic reaction. If you have had an allergic reaction to Velcade or any of its ingredients, you should not take Velcade. Ask your doctor which other medicines are best for you.

    Low blood pressure or fainting. Before using Velcade, tell your doctor if you have low blood pressure, any conditions that make you faint, become dehydrated, or are taking medicines that lower blood pressure. Velcade can also lower blood pressure, so taking it if you have any of these conditions could cause your blood pressure to drop too much. Your doctor may monitor you more frequently throughout your treatment with Velcade, or may recommend a different medicine for you.

    Heart failure or other heart conditions. Velcade may cause heart problems. If you already have a heart condition, such as heart failure, talk to your doctor before starting treatment with Velcade. This drug may make your condition worse. Your doctor may monitor you more closely during treatment to make sure your heart condition does not worsen.

    Lung condition. Velcade may cause lung problems such as pulmonary edema. If you already have a lung condition such as asthma, using Velcade may make it worse. If you have any lung conditions, talk to your doctor before starting treatment with Velcade. They may monitor you more closely for worsening lung problems during treatment.

    Liver condition. Velcade may cause liver problems such as hepatitis. If you already have liver disease, using Velcade may make it worse. Before starting treatment with Velcade, tell your doctor about any liver disease you have. Your doctor will likely monitor your liver symptoms during treatment. Or they may recommend another treatment option for you.

    Diabetes. If you have diabetes and are taking any oral medications to treat your condition, tell your doctor before starting treatment with Velcade. Velcade may change the way your diabetes medications work, which can cause high or low blood sugar levels. Your doctor will likely ask you to monitor your blood sugar more frequently during treatment with Velcade.

    Alcohol use and Velcade

    It is not known whether it is safe to drink alcohol during treatment with Velcade.

    Both Velcade and alcohol can cause low blood pressure, which can be dangerous and lead to fainting. Velcade and alcohol can also cause nausea or vomiting. Thus, drinking alcohol with Velcade may exacerbate these side effects.

    If you drink alcohol, talk to your doctor about how much (if any) it is safe for you to drink while on Velcade.

    Pregnancy and breast-feeding while using Velcade

    See below for information on using Velcade while pregnant or breast-feeding.

    pregnancy

    You should not use Velcade if you are pregnant or planning to become pregnant. This is due to the fact that Velcade can harm the fetus.

    During treatment with Velcade and for at least 7 months after stopping treatment, women* who may become pregnant should use birth control to prevent pregnancy. In addition, men* who have a sexual partner who may become pregnant must use birth control while taking Velcade and for at least 4 months after stopping treatment.

    If you are pregnant or planning to become pregnant, talk to your doctor about the best treatment plan for you.

    Breast-feeding

    Breast-feeding is not recommended during treatment with Velcade or for at least 2 months after stopping treatment. This is because it is not known if Velcade can pass into breast milk or what effect it might have on a breastfed baby.

    If you are breastfeeding or planning to breastfeed, talk to your doctor about your options.

    What to ask your doctor

    You may experience side effects from taking Velcade. In some cases, your side effects may be mild and may go away on their own. However, more serious side effects are possible.

    Before starting treatment with Velcade, talk to your doctor about the risk of side effects from the drug. Some questions you might want to ask include:

    • What is the best way to treat the side effects that Velcade can cause?
    • Will my other medical conditions increase my risk of side effects from Velcade?
    • How do I monitor for serious side effects while on Velcade treatment?
    • How do I know if my side effects from Velcade are serious?
    • What should I do if I get pregnant while taking Velcade?

    Ask a pharmacist

    Q:

    If I take other medicines with Velcade for cancer, am I at higher risk of side effects?

    Anonymous

    A:

    In most cases, the side effects of Velcade are expected to be the same regardless of whether the drug is used with other cancer treatments.

    But in Velcade’s studies, some side effects were more common when the drug was given with other cancer treatments than when it was used on its own. Examples include low white blood cell count and low platelet count.

    If you are using Velcade along with other cancer medicines, talk to your doctor about the risk of side effects. They can tell you what to expect when using Velcade with other cancer treatments.

    Amber Watson, PharmD Answers represent the opinions of our medical experts. All content is for informational purposes only and should not be considered medical advice.

    Registration data: Drink-Drink has made every effort to ensure that all information is accurate, complete and up to date. However, this article should not be used as a substitute for the knowledge and experience of a licensed healthcare professional. You should always check with your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or side effects. The absence of warnings or other information for a given medicinal product does not mean that the drug or combination of drugs is safe, effective, or suitable for all patients or for all specific uses.

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    Important safety information

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