Bortezomib, Injection

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KEY POINTS

• This medicine is given by IV or subcutaneous injection to treat multiple myeloma or mantle cell lymphoma.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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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 or subcutaneous injection (shot just under the skin) to treat:
• Multiple myeloma
• Mantle cell lymphoma

It may be given to people who have already been treated with 2 other types of chemotherapy and have not shown improvement.

This medicine may be used to treat other conditions as determined by your healthcare 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
• Diabetes
• Heart disease, heart failure, or pulmonary hypertension
• Herpes zoster
• Liver or kidney disease
• Low blood pressure
• Lung disease
• 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 these injections. This medicine is usually given 2 times a week for 2 weeks, followed by 10 days without an injection. It may also be given once a week for 4 weeks followed by 13 days without an injection. Keep all appointments for treatment.

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.

Follow your healthcare provider’s instruction for how much water you should drink while receiving this medicine. 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.

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, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

If you have diabetes: 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 cannot 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 stomach pain; swelling in the legs or feet; severe headache; vision problems; confusion; seizures; changes in your thoughts or moods.

Other: Loss of appetite; lightheadedness; dizziness; headache; trouble sleeping; cough; bone or back pain; diarrhea; constipation; nausea; vomiting; stomach pain; trouble swallowing; tiredness; nervousness; 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 blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antibiotics such as clarithromycin (Biaxin) and telithromycin (Ketek)
• Antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Monistat, Oravig), and voriconazole (Vfend)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), oxcarbazepine (Trileptal), phenobarbital, phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Aspirin and other salicylates
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), pindolol, and sotalol (Betapace, Sorine)
• Calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Diabetes medicines such as glipizide (Glucotrol), glyburide (Glynase), insulin, metformin (Fortamet, Glucophage, Riomet), 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)
• HIV medicines such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Invirase)
• Hydralazine
• Medicines to raise white blood cell counts such as filgrastim (Neupogen), pegfilgrastim (Neulasta), and sargramostim (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 (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Propranolol (Hemangeol, Inderal, InnoPran)
• Rifabutin (Mycobutin), rifampin (Rifadin), and rifapentine (Priftin)
• 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.

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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.