bortezomib

Velcade (bortezomib) can cause new or worsening nerve problems in your arms, hands, legs, and feet (peripheral neuropathy). In clinical studies, there were fewer people who experienced nerve problems when injections were given under the skin than IV. Let your provider know if you experience numbness, pain, burning, a feeling of "pins and needles," tremors, problems with balance, or weakness in your arms or legs. You might need a change in your dose or have your injections spaced out more. Nerve problems are generally reversible or improved after adjusting the dose of Velcade (bortezomib).

Velcade (bortezomib) can cause new or worsening heart failure and affect how well your heart pumps blood through your body. If you have heart problems, your provider will monitor you more regularly while you receive Velcade (bortezomib) treatment to make sure it doesn’t get worse. Tell your provider if you have shortness of breath that usually worsens with activity or while lying flat, swelling of your legs or feet, sudden weight gain, fatigue, or dizziness. These can be signs of heart failure.

Rare, but serious, lung problems, including inflammation of the lungs and pneumonia, have happened in people receiving Velcade (bortezomib). Let your provider know if you have difficulty breathing, cough, or fatigue during your treatment.

Rare cases of a brain condition called posterior reversible encephalopathy syndrome (PRES) have happened with people receiving Velcade (bortezomib). Get medical help right away if you experience sudden severe headaches, sudden confusion, sudden vision loss or other vision changes, behavioral changes, or seizures. If you’re diagnosed with PRES, you’ll need to stop this medication.

Velcade (bortezomib) can cause your white blood cell and platelet counts to be low. When the number of these cells are lower than normal, you’re at risk of developing infections and bleeding or bruising. Your provider will closely monitor your blood counts through routine lab work while you’re receiving Velcade (bortezomib). Let your provider know as soon as possible if you experience fevers, chills, or bleeding and bruising that doesn’t stop or go away, because you might need to stop this medication.

Treatment with Velcade (bortezomib) can cause a serious reaction called tumor lysis syndrome (TLS). TLS is when many cancer cells die quickly and break down in your body. This causes a rapid release of the cells’ contents like uric acid, potassium, and phosphorus into your blood. High levels of uric acid and electrolytes in your body can cause serious kidney damage and abnormal heart rhythms. You’re at higher risk if you have a large number of cancer cells in your body or if your tumor is large. Your provider will monitor you more closely if you have a higher risk for TLS. Tell your provider right away if you’re urinating less than usual or have dark urine, muscle cramps, or a racing heartbeat.

Liver damage has occurred in some people receiving Velcade (bortezomib) in combination with other medications that can cause liver injury. This can happen to anyone, but be sure to tell your provider if you have liver problems before starting this medication. Let your provider know right away if you experience tiredness, loss of appetite, nausea or vomiting, dark urine, right-side stomach pain, or yellowing of the eyes or skin, as these can be signs of liver problems.

Though rare, some people receiving Velcade (bortezomib) have experienced serious blood clots in the smallest blood vessels, including those in the brain and kidney. Let your provider know right away if you have problems thinking, confusion, dizziness, changes in how you urinate, or dark urine. You might have to stop treatment with Velcade (bortezomib) while your provider figures out the cause.