Bortezomib is used on its own or together with other medicines to treat certain types of cancer such as multiple myeloma (bone marrow cancer) and mantle cell lymphoma (cancer that affects the lymph nodes).
It is used for those who have not been previously treated for multiple myeloma or mantle cell lymphoma, or for those who have received one or more prior treatments and whose cancer is still progressing.
Your doctor or nurse will administer the injection for you.
Bortezomib injection is to be given intravenously (into the vein). It is delivered directly into the bloodstream via the blood vessel.
It may also be injected subcutaneously (into the fatty layer under the skin, usually in the thigh or abdomen area).
The dose, route and schedule of administration of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.
This medicine is not to be given intrathecally (into the spinal cord).
Ensure that you keep all appointments with your doctor so that you do not miss any doses. Your doctor also needs to regularly monitor your response to Bortezomib.
If you miss an appointment or miss an injection, alert your doctor or nurse. A replacement appointment or injection should be given as soon as possible.
Alert your doctor if you have the following conditions:
- lung or breathing problems
- heart problems
- ever had an allergic reaction (rashes, breathlessness, swollen eyes) to boron
as this medicine may not be suitable for you.
Do not use this medicine if you are pregnant. If you become pregnant while being treated with this medicine, alert your doctor immediately. Bortezomib may cause harm to your unborn child.
Do not breastfeed while you are being treated with this medicine.
Inform your doctor if you have the following conditions:
- blood disorders e.g. low level of platelets, red or white blood cells
- bleeding problems
- low blood pressure
- history fainting, dizziness, or light-headedness
- history of numbness, tingling, or pain the hands or feet
- fits or seizures
- heart diseases e.g. heart failure
- liver disease e.g. hepatitis
- kidney disease
It is important that you do not get pregnant or father a child while you are being treated with Bortezomib. You and your partner must use proven birth control methods during the treatment and for 3 months after stopping the treatment. You may wish to discuss birth control methods with your doctor or pharmacist.
If you are going for an operation, including minor surgery and dental work, inform your doctor or dentist that you are using Bortezomib.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy tests may be done routinely to check the appropriateness of the treatment.
- Your doctor may also need to do blood tests, chest x-ray, lung, liver and kidney function tests. Your doctor will advise you about how often you need to have these tests.
Bortezomib may cause drowsiness, dizziness or blurred vision. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: nausea, vomiting, diarrhoea, constipation, stomach pain, altered taste, decreased appetite, dry mouth, tiredness, headache, pain in the muscle, joint, or bone, difficulty sleeping, weight loss, swelling of hands or legs and injection site reactions.
This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.
This medicine will cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Alert your doctor if you have a fever, or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Alert your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Some side effects may be serious, although they are not common. Alert your doctor quickly if you experience:
- rashes, breathlessness, swollen eyes
- irregular heartbeat
- muscle cramps or weakness
- fainting or passing out
- numbness, burning or prickling sensation in the feet or hands.
- seizures or fits
- difficulty in breathing, shortness of breath
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicine to treat TB (infection known as tuberculosis) e.g. rifampicin, isoniazid
- medicines to treat fungal infection e.g. ketoconazole
- medicines for HIV infection e.g. ritonavir
- medicines for fits or seizures e.g. phenytoin, carbamazepine, phenobarbital
- medicine for irregular heartbeat e.g. amiodarone
- medicines for diabetes
- St. John’s wort (herbal supplement)
This list does not include all medicines that may interact with Bortezomib.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Limit your intake of vitamin C supplements. Avoid taking foods or beverages that are rich in vitamin C particularly 12 hours before and after treatment.
Avoid excessive consumption (more than 1 litre a day) of grapefruit juice.
Avoid green tea and its extracts.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
Store below 25°C. However, if room temperature is more than 25°C, keep it in the fridge. Do not freeze it otherwise it will become less effective.
Protect from light. Light may cause the medication to lose some of its effectiveness.
Do not use this medicine if it becomes cloudy or if it has changed in colour.