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This information is about bortezomib, which is commonly known as Velcade®. It is currently used to treat people with multiple myeloma|. Velcade may also be used to treat other types of cancer as part of a research trial|.
Velcade® is a new type of anti-cancer drug called a proteosome inhibitor.
Proteosomes are a group of enzymes found in all cells in the body. They play an important role in controlling cell function and growth. By interfering with how proteosomes work, Velcade may cause cancer cells to die and may stop the cancer from growing. Cancer cells are more sensitive to the effects of Velcade than normal cells are.
In the UK, Velcade is currently used to treat multiple myeloma. It is given to people who have already been treated with at least one other type of chemotherapy and have already had, or are unsuitable for, a bone marrow transplant, but whose myeloma has continued to develop.
Velcade is given by injection into a vein (intravenously) through a fine tube (cannula). It may be given through a central line|, which is inserted under the skin into a vein near your collarbone. Alternatively it may be given through a PICC line|, which is inserted into a vein in the crook of your arm.
Velcade is usually given as four doses over a three-week period. The doses are given on the first and fourth day of the first two weeks, followed by a 10-day rest period. This completes one cycle of treatment. You can have up to eight cycles of treatment over six months.
Each person’s reaction to any drug is different. Some people have very few side effects while others may experience more. The side effects described below won't affect everyone being treated with Velcade.
We have outlined the most common side effects, but haven't included those that are rare and therefore unlikely to affect you. If you notice any effects that aren't listed here, discuss them with your nurse or doctor.
It's important that you drink plenty of fluids (2-3 litres a day) while having treatment with Velcade.
This is due to the effect of Velcade on the nerves and is known as peripheral neuropathy|. You may also notice that you have difficulty buttoning clothes or doing fiddly tasks. Let your doctor know about any changes. It's important to tell your doctor if you get pain in your hands or feet as the dose of Velcade may need to be reduced to prevent further problems. If symptoms are more severe, Velcade may be stopped for a time until they improve.
Fatigue| is a possible side effect of this treatment. Try to balance periods of rest with gentle exercise such as walking when you feel able.
This can usually be controlled with anti-sickness (anti-emetic)| drugs.
A dietitian or specialist nurse at your hospital can give advice on how to boost your appetite|, cope with taste changes| and maintain your weight. Taste changes usually get better once treatment is over.
This can usually be controlled with medicines, but let your doctor know if it's severe or continues. It's important to drink plenty of fluids if you have diarrhoea|.
This may be relieved by drinking plenty of fluids, eating a high-fibre diet and taking gentle exercise. If constipation| is severe or continues for more than three days, tell your doctor as you may need additional treatment.
This may occur within a few hours of treatment with Velcade, but it doesn't usually last long. Your doctor may prescribe medicines to reduce these effects.
Let your doctor know if you have headaches, so they can advise you on what can help.
Velcade can temporarily reduce the number of white blood cells in your body. This can make you more prone to infection|.
Contact your doctor or the hospital straight away if:
Velcade can reduce the production of platelets, which help the blood clot. Tell your doctor if you have unexplained bleeding or bruising.
You may become anaemic while having treatment with Velcade. This may make you feel tired and breathless. It can be treated with a blood transfusion.
You may feel dizzy or light-headed if you stand up quickly. This is caused by a temporary drop in blood pressure. Let your doctor know if you have dizziness or feel light-headed, as you may need additional treatment to help. Drinking plenty of fluids and moving slowly when getting up from a lying or sitting position can help.
Your doctor can prescribe medicine to help with these, if they occur.
Velcade can cause temporary breathlessness. Contact your doctor if you feel breathless.
Velcade may cause eye pain or blurred vision. Let your doctor know if this affects you.
In some people, Velcade may cause lowered mood (depression|), feelings ofanxiety| or difficulty sleeping. Talk to your doctor if this happens to you.
It's important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they're not mentioned above.
Velcade may affect your ability to drive. Don't drive if you experience dizziness, blurred vision or excessive tiredness. Seek advice from you doctor if you have any concerns.
It's not advisable to become pregnant or father a child while having Velcade, as it may harm the developing baby. It’s important to use effective contraception while having this drug, and for at least a few months afterwards. You can discuss this with your doctor.
It’s not known whether biological therapies can be present in semen or vaginal fluids. To protect your partner it’s safest to either avoid sex or use a barrier form of contraception for about 48 hours after treatment.
This section has been compiled using information from a number of reliable sources, including:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.