Velcade® (bortezomib)

VELCADE® (bortezomib) for Injection is an antineoplastic agent available for injection into a vein (intravenously or IV) or under the skin (subcutaneously). VELCADE must not be administered into the spinal fluid (intrathecally). It has been approved by the FDA for the treatment of myeloma. For information about VELCADE, call Millennium at 1-866-VELCADE or the IMF Infoline at (800) 452-CURE (800-452-2873).

General Information

Understanding Velcade as a Subcutaneous (SQ) injection videos

What You Need to Know About VELCADE as a Subcutaneous (SQ) Injection 
Frequently Asked Questions About VELCADE as Subcutaneous (SQ) Injection

Patients personifying progress: Mary Ming-Mosely 

Two months ago, I started on VELCADE subcutaneous. It’s just a shot. I don’t have to wait for an IV. It’s just in-and-out. VELCADE has kept me going and feeling well enough to live my life. 

VELCADE® Treatment Approaches

A Report of Findings from the Nurse Leadership Board Roundtable Meeting

The VELCADE® website  

Information for patients and clinicans on indications and usage. 

Patient Assistance

VELCADE® downloadable resources 

As someone living with multiple myeloma or relapsed mantle cell lymphoma—or as someone caring for a person with one of these diseases—you may have many questions about the disease and its treatment. Our dedicated case managers at 1-866-VELCADE(835-2233), option 2 can provide you and your loved ones with day-to-day and long-term support.

VELCADE Reimbursement Assistance Program 

Program is available to patients, physicians, and caregivers to provide assistance regarding reimbursement issues related to the use of VELCADE® (bortezomib) for Injection. 

Possible Side Effects

Peripheral neuropathy

Peripheral neuropathy (PN) is a serious condition in which treatment affects nerves in the hands, feet, legs, and/or arms. Symptoms of PN include numbness, tingling, or even pain in the hands, feet, legs, and/or arms. Some patients may have experienced PN from the effects of the monoclonal protein itself and/or from previous treatments for myeloma. If you begin taking Velcade with this pre-existing condition, it is especially important that you pay particular attention to the extent of your discomfort, so that you can rapidly report a worsening of your condition to your doctor. If detected and managed appropriately, the neuropathy is often reversible.

Subcutaneous (SQ) Velcade causes significantly less PN than IV Velcade. Patients who received SQ Velcade in the Intergroupe Francophone du Myélome (IFM) trial in which it was compared to IV Velcade had an incidence of PN of any severity of 38%, while those who received IV Velcade had a 53% incidence of any grade of PN. Only 6% of the patients who received SQ Velcade had PN of Grade 3 or 4 (on a scale where 1 is the lowest and 4 the highest grade), while 16% of the IV patients had Grade 3 or 4 PN. SQ Velcade may also have reduced side effects on the gastrointestinal system (nausea, constipation/diarrhea).

Fatigue

Fatigue is a common side effect associated with Velcade therapy. Although fatigue is generally not severe, caution is advised if you are operating machinery, including automobiles. Please see the IMF publication Understanding Fatigue for further information on this debilitating side effect and how to manage it.

Nausea

Nausea may occur while taking Velcade and may be associated with dizziness, light-headedness, or fainting if it leads to dehydration. Medical treatment may be required for dehydration.

Diarrhea

Diarrhea may occur while taking Velcade. Dizziness, light-headedness, or fainting may occur due to dehydration caused by either excessive or persistent diarrhea.

Decreased platelet levels

Myeloma patients taking Velcade often experience a condition called thrombocytopenia – a lowered level of platelets in the blood. Platelets help blood to clot; fewer platelets can lead to bruising, bleeding, and slower healing. The platelet level falls with treatment but, after the required interval between doses, should return to the baseline level by the beginning of the next cycle.

Low blood pressure (hypotension)

A drop in blood pressure may occur after receiving Velcade. If you have a history of fainting or low blood pressure or are taking medication that can cause low blood pressure (such as antihypertensive medication, that is, medication to treat high blood pressure), it is important that you tell your doctor about your condi-tion before you begin receiving Velcade. Dizziness, especially when it occurs after rapidly sitting up or standing from a lying-down position, may be a sign of low  blood pressure.

Other side effects of Velcade 

Other side effects may occur with Velcade and include headache, insomnia, occa-sional rash, fever, cough, back pain, and muscle cramps. Velcade has been shown to increase the incidence of Herpes Zoster virus (also known as “shingles”), a painful itchy rash usually located on one side of the body. Patients with myeloma have a higher risk for developing shingles because myeloma compromises the immune response. Please discuss with your doctor taking an anti-viral medication to reduce your risk for this condition, and remember to discuss ANY changes in your health with a doctor or nurse on your healthcare team.