Find out what bortezomib is, how you have it and other important information about taking bortezomib.
Bortezomib is also called by its brand name Velcade. It is a treatment for myeloma and mantle cell lymphoma.
You can have bortezomib on its own. Or with other cancer drugs such as:
- liposomal doxorubicin
- steroids (prednisolone or dexamethasone)
How it works
Bortezomib is a type of cancer treatment drug called a proteasome inhibitor.
Proteasomes are in cells. They help to break down proteins that the cell doesn't need. Bortezomib blocks the proteasomes so the proteins build up inside the cell. The cell then dies.
How you have it
You have bortezomib either as an injection under your skin (subcutaneously) into your leg or tummy (abdomen). Or as an injection into your bloodstream (intravenously).
Into your bloodstream
You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.
You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.
When you have it
You can have bortezomib on its own if you have already had treatment for myeloma.
You usually have bortezomib twice a week, for 2 weeks. Then you have a break of 10 days. This 3 week period is called a cycle of treatment.
The length of your treatment cycle might be different. Your doctor will discuss this with you.
After 4 cycles of treatment you might have a blood or urine test. This is to check the levels of a protein called serum M.
Serum M is made by myeloma cells. So if the bortezomib is working, the serum M levels go down.
You have a further 2 cycles of treament if all signs of the myeloma disappear. Or you have 8 cycles if the myeloma does not completely disappear.
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
Other medicines, foods and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
A study published in 2009 found that green tea may stop bortezomib from working properly. The research team of this study recommended that people taking bortezomib do not drink green tea or take any green tea preparations.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for at least 3 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Don’t breastfeed during this treatment because the drug may come through into your breast milk.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and shingles vaccine (Zostavax).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine (as an injection)
- be in contact with other people who've had live vaccines as injections
Avoid close contact with people who’ve recently had live vaccines taken by mouth (oral vaccines) such as oral polio or the typhoid vaccine.
This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So, avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.
You should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.