VELCADE SIDE EFFECTS

Velcade is given as an injection through a needle placed into a vein.

You will receive this injection in a clinic or hospital setting. A doctor, nurse, or other healthcare provider will give you this injection.

Velcade is usually injected 2 times a week for 2 weeks, followed by 10 days without an injection. Velcade may also be given once a week for 4 weeks followed by 13 days without an injection. Follow your doctor's instructions about your individual dosing schedule.

Velcade can lower blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled appointments.
What happens if I miss a dose?

Call your doctor for instructions if you will miss an appointment for your Velcade injection.
What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine.

Overdose may cause weakness, bruising or bleeding, pinpoint red spots on your skin, and fainting.
What should I avoid while receiving Velcade?

Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.

Avoid becoming dehydrated if you have any vomiting or diarrhea. Symptoms of dehydration include dizziness, dry mouth, fainting, or hot and dry skin. Talk with your doctor about how best to keep yourself hydrated.

Velcade can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Dizziness may be more likely to occur when rising from a sitting or lying position. Get up slowly to keep from falling.


Get emergency medical help if you have any of these signs of an allergic reaction to Velcade: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

new or worsening nerve problems such as numbness, burning, pain, weakness, or tingly feeling;

feeling like you might pass out;

dry cough and trouble breathing;

severe headache, vision problems, confusion, and/or seizure (convulsions);

black, bloody, or tarry stools, vomit that looks like blood or coffee grounds;

severe constipation;

easy bruising or bleeding, unusual weakness;

fever, chills, body aches, flu symptoms;

feeling short of breath, even with mild exertion;

fast or slow heart rate, weak pulse, lower back pain, blood in your urine;

urinating less than usual or not at all;

muscle weakness, tightness, or contraction, overactive reflexes; or

nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious Velcade side effects may include:

mild nausea, vomiting, upset stomach;

diarrhea, constipation;

headache, blurred vision, dizziness;

muscle pain, bone or joint pain;

sleep problems (insomnia);

mild rash or itching; or

skin irritation where the medicine was injected.

VELCADE SIDE EFFECTS IN NUMBERS:

Feeling sick affects just over 6 in 10 people (60%) but is usually well controlled with anti sickness drugs
Fatigue affects about 1 in 2 people taking this drug (50%)
Loss of appetite affects about 4 in 10 people (40%)
Diarrhoea affects around 6 out of 10 people (58%) – it is usually mild but tell your doctor or nurse as you can have medicines to stop it
Increased risk of getting an infection due to a drop in the number of white blood cells – you may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should urgently contact your hospital if you think you have an infection
About 1 in 10 people (10%) get shingles (herpes zoster virus) you may have to take an anti viral drug to prevent this
Bruising and bleeding due to a drop in platelets occurs in 4 out of 10 people (40%) – low platelets may also cause nosebleeds or bleeding gums after brushing teeth so if you see blood in your stool or vomit or have lots of tiny red spots or bruises on arms or legs (petechiae), contact your hospital straight away
Tiredness and breathlessness due to a drop in red blood cells (anaemia) affects about 3 out of 10 people (30%) – you may need a blood transfusion to treat anaemia
Numbness, tingling or a burning sensation in fingers and toes affects 3 out of 10 people (30%) – tell your doctor if you have a change in feeling in your hands or feet as they may need to lower your dose
A high temperature (fever) for a few hours after having the drug affects about 1 in 3 people (33%)
Headaches affect about 1 in 4 people (25%)
Skin changes – about 1 out of 4 people (25%) have a rash or very red, dry, itchy skin
Taste changes affect just over 1 in 10 people (13%)
Indigestion affects 1 in 10 people (10%)
Constipation – if you have constipation tell your hospital doctor straight away
Breathless and a cough affect about 1 in 4 people (25%)
Low blood pressure (hypotension) affects just over 1 in 10 people (12%) – this can make you feel lightheaded or dizzy
Blurred vision – about 1 in 10 people (11%) have this but it is usually mild
Pain in your muscles, bones or tummy (abdomen)
Loss of fertility – you may not be able to get pregnant or father a child after treatment with this drug.
It is important to talk to your doctor about your fertility before starting treatment
We don’t know whether bortezomib can harm a developing baby – so talk to your doctor about contraception before having treatment if there is any chance you or your partner could become pregnant

Occasional side effects
Some people may have one or more of the following side effects
Flu like symptoms
Swelling of ankles and legs due to a build up of fluid (oedema) affects 1 in 20 people (5%) but is usually mild
Hiccups
Changes in mood – you may feel anxious or low
Dehydration – drink plenty of fluids (around 2 litres a day) to prevent dehydration

Rare side effects
Few people may have some of the following effects:
Heart problems, including chest pain, affect fewer than 1 in 100 people (1%) - contact your doctor as soon as possible if you have chest pain
Mild changes in how your liver works - this is unlikely to cause symptoms, and your liver will almost certainly go back to normal after the treatment ends
Kidney problems may cause difficulty or pain passing urine, needing to pass urine often or blood in your urine - tell your doctor if you have any of these problems.

Important points to rememberNot everyone will get these side effects. A side effect may get worse through your course of treatment, or more side effects may develop as the course goes on. The side effects depend on
How many times you've had the drug before

Your general health

The amount of the drug you have (the dose)
Other drugs you are having
Some side effects are inconvenient or upsetting but not damaging to your health.
Some side effects are serious medical conditions and need treating. Where we tell you to contact your doctor, it is because
Your side effect may need treating
Your drug dose may need reducing to try to prevent the side effect.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements, alternative therapies and over the counter remedies – some drugs can react together. A study in mice published in 2009 found that green tea may stop bortezomib (velcade) from working properly, so the authors of the study strongly recommend that people taking bortezomib do not drink green tea or take any green tea preparations.
Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them.

Immunisations:

You should not have immunisations with live vaccines while you are having treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your treatment.
It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.