stethoscope How is bortezomib given? If you have any questions about your treatment, speak to your medical team. They are the best people to ask if you have questions Bortezomib is usually given as an injection under the skin about your individual situation. The information in this publication is (subcutaneous), but can also be given intravenously (into the vein). not meant to replace their advice. Bortezomib is most often given with the steroid . It can also be given in other combinations, such as with the drug (known as VCD), or the immunomodulatory drug (IMiD) thalidomide (VTD). The exact dose of bortezomib, and how long you will have it for, depends on a number of factors, including: We’re here for everything

Your height and weight a diagnosis of myeloma brings

HeightWeight Get in touch to find out more about how we can support you

Whether you are receiving treatment in Call the Myeloma Infoline on a once-weekly or twice-weekly schedule 0800 980 3332

Schedule Bortezomib Email Ask the Nurse at [email protected] ® What treatment combination you are receiving (Velcade ) Visit our website at myeloma.org.uk Other information about bortezomib Treatment Guide

You should not drink or take green tea supplements Myeloma UK while being treated with bortezomib because they can 22 Logie Mill, Beaverbank Business Park, interfere with the way bortezomib works. Avoid Green Tea Edinburgh EH7 4HG Published by: Myeloma UK 0131 557 3332 Publication date: January 2019 You should also avoid having vitamin C in large doses as it Last updated: January 2019 [email protected] can interfere with treatment with bortezomib. Review date: January 2022 Registered Charity No: SC026116 Avoid Vitamin Alcohol intake should be strictly limited whilst taking bortezomib because it can exacerbate side effects such as dizziness and fatigue. We appreciate your feedback Avoid Alcohol Please fill in a short online survey about our patient information at myeloma.org.uk/pifeedback or email any comments to [email protected] For a list of references used to develop our resources, visit myeloma.org.uk/references Velcade

What is bortezomib? Possible side effects Peripheral Low blood Low blood pressure of bortezomib neuropathy counts () Bortezomib, also known as ® Bortezomib has a number of is damage Bortezomib may cause a decrease Bortezomib can cause a drop in Velcade , is a inhibitor possible side effects which can to the nerves in hands, feet, arms in the number of red blood cells, blood pressure which can make drug used in the treatment of vary considerably from patient to or legs. It tends to come on quite white blood cells and platelets in you feel dizzy, lightheaded or like patient. It is important to report any quickly after starting treatment and your blood. This can cause anaemia you are about to faint. If you are on myeloma. side effects to your doctor or nurse can produce painful/uncomfortable and fatigue, as well as making you treatment to help lower your blood as soon as possible so they can be burning, tingling and prickling more susceptible to infection and pressure, you may need to have treated or managed promptly. sensations. It can be the most increasing your risk of bleeding. its dose reduced or stopped whilst significant and problematic side If necessary, you can be given you are on bortezomib. Keeping Often the best way to manage effect of bortezomib. supportive treatment to help with well hydrated can help to prevent the side effects associated with these side effects and to boost your hypotension, especially during the bortezomib is to lower the dose For most patients, symptoms will How does it work? blood cell counts. time bortezomib is administered. small protein tags small protein tags and/or change the schedule of improve or disappear after the dose bortezomib e.g. from twice-weekly and/or frequency of administration If you feel dizzy or lightheaded Bortezomib works by blocking to once-weekly. of bortezomib is reduced. However, Gastrointestinal when taking bortezomib, you the actions of . in some cases, bortezomib may should not operate machinery or You may also benefit from a disturbances Proteasomes are large molecules need to be temporarily stopped drive a car. temporary pause in treatment found in all cells of the body, or discontinued. If you have severe Bortezomib can cause diarrhoea, for a few weeks. This should not and they are involved in the peripheral neuropathy, you may not constipation, nausea and vomiting. protein tagged breakdown of damaged or protein tagged affect the activity of the myeloma for recycling for recycling be able to have other treatments While usually mild and manageable, Fatigue and it does not mean that your unwanted proteins. Bortezomib in the future that are also known to these side effects can become proteasome temporarily blocks their function, proteasome myeloma will suddenly progress. problematic in some cases. cause it. Fatigue usually resolves shortly protein stopping them from breaking protein Unfortunately, if side effects remain Maintaining a good fluid intake fragments fragments after treatment has finished. There down unwanted proteins. This problematic, it may be necessary Pain and discomfort can be and a balanced diet is important. are a number of medical and non- causes proteins to build up to to stop treatment altogether and alleviated by gentle massage, warm Your doctor can prescribe specific medical ways to help manage proteasome inhibitors block the toxic levels, killing the cell. proteasome inhibitors block the consider other options. baths, heat/cold packs, and specific treatment to help prevent or control proteasome causing proteins to proteasome causing proteins to fatigue. For example, treatment for build up build up nerve painkilling drugs, such as these side effects. Myeloma cells rely more pregabalin and gabapentin. anaemia may reduce fatigue if it is heavily on proteasomes than caused by low red blood cell counts. drug drug normal healthy cells; they are Skin Increasing your levels of activity and therefore much more sensitive rashes having complementary therapies to bortezomib. such as aromatherapy or massage Some myeloma patients taking may also help. bortezomib can develop a skin rash, which may be itchy and need treatment with antihistamines and/or steroid creams. If this is particularly problematic, it may be necessary to stop Figure 1: Mechanism of action of proteasome inhibitors treatment temporarily or restart at a lower dose. stethoscope How is bortezomib given? If you have any questions about your treatment, speak to your medical team. They are the best people to ask if you have questions Bortezomib is usually given as an injection under the skin about your individual situation. The information in this publication is (subcutaneous), but can also be given intravenously (into the vein). not meant to replace their advice. Bortezomib is most often given with the steroid dexamethasone. It can also be given in other combinations, such as with the chemotherapy drug cyclophosphamide (known as VCD), or the immunomodulatory drug (IMiD) thalidomide (VTD). The exact dose of bortezomib, and how long you will have it for, depends on a number of factors, including: We’re here for everything

Your height and weight a diagnosis of myeloma brings

HeightWeight Get in touch to find out more about how we can support you

Whether you are receiving treatment in Call the Myeloma Infoline on a once-weekly or twice-weekly schedule 0800 980 3332

Schedule Bortezomib Email Ask the Nurse at [email protected] ® What treatment combination you are receiving (Velcade ) Visit our website at myeloma.org.uk Other information about bortezomib Treatment Guide

You should not drink green tea or take green tea supplements Myeloma UK while being treated with bortezomib because they can 22 Logie Mill, Beaverbank Business Park, interfere with the way bortezomib works. Avoid Green Tea Edinburgh EH7 4HG Published by: Myeloma UK 0131 557 3332 Publication date: January 2019 You should also avoid having vitamin C in large doses as it Last updated: January 2019 [email protected] can interfere with treatment with bortezomib. Review date: January 2022 Registered Charity No: SC026116 Avoid Vitamin Alcohol intake should be strictly limited whilst taking bortezomib because it can exacerbate side effects such as dizziness and fatigue. We appreciate your feedback Avoid Alcohol Please fill in a short online survey about our patient information at myeloma.org.uk/pifeedback or email any comments to [email protected] For a list of references used to develop our resources, visit myeloma.org.uk/references Velcade

What is bortezomib? Possible side effects Peripheral Low blood Low blood pressure of bortezomib neuropathy counts (hypotension) Bortezomib, also known as ® Bortezomib has a number of Peripheral neuropathy is damage Bortezomib may cause a decrease Bortezomib can cause a drop in Velcade , is a possible side effects which can to the nerves in hands, feet, arms in the number of red blood cells, blood pressure which can make drug used in the treatment of vary considerably from patient to or legs. It tends to come on quite white blood cells and platelets in you feel dizzy, lightheaded or like patient. It is important to report any quickly after starting treatment and your blood. This can cause anaemia you are about to faint. If you are on myeloma. side effects to your doctor or nurse can produce painful/uncomfortable and fatigue, as well as making you treatment to help lower your blood as soon as possible so they can be burning, tingling and prickling more susceptible to infection and pressure, you may need to have treated or managed promptly. sensations. It can be the most increasing your risk of bleeding. its dose reduced or stopped whilst significant and problematic side If necessary, you can be given you are on bortezomib. Keeping Often the best way to manage effect of bortezomib. supportive treatment to help with well hydrated can help to prevent the side effects associated with these side effects and to boost your hypotension, especially during the bortezomib is to lower the dose For most patients, symptoms will How does it work? blood cell counts. time bortezomib is administered. small protein tags small protein tags and/or change the schedule of improve or disappear after the dose bortezomib e.g. from twice-weekly and/or frequency of administration If you feel dizzy or lightheaded Bortezomib works by blocking to once-weekly. of bortezomib is reduced. However, Gastrointestinal when taking bortezomib, you the actions of proteasomes. in some cases, bortezomib may should not operate machinery or You may also benefit from a disturbances Proteasomes are large molecules need to be temporarily stopped drive a car. temporary pause in treatment found in all cells of the body, or discontinued. If you have severe Bortezomib can cause diarrhoea, for a few weeks. This should not and they are involved in the peripheral neuropathy, you may not constipation, nausea and vomiting. protein tagged breakdown of damaged or protein tagged affect the activity of the myeloma for recycling for recycling be able to have other treatments While usually mild and manageable, Fatigue and it does not mean that your unwanted proteins. Bortezomib in the future that are also known to these side effects can become proteasome temporarily blocks their function, proteasome myeloma will suddenly progress. problematic in some cases. cause it. Fatigue usually resolves shortly protein stopping them from breaking protein Unfortunately, if side effects remain Maintaining a good fluid intake fragments fragments after treatment has finished. There down unwanted proteins. This problematic, it may be necessary Pain and discomfort can be and a balanced diet is important. are a number of medical and non- causes proteins to build up to to stop treatment altogether and alleviated by gentle massage, warm Your doctor can prescribe specific medical ways to help manage proteasome inhibitors block the toxic levels, killing the cell. proteasome inhibitors block the consider other options. baths, heat/cold packs, and specific treatment to help prevent or control proteasome causing proteins to proteasome causing proteins to fatigue. For example, treatment for build up build up nerve painkilling drugs, such as these side effects. Myeloma cells rely more pregabalin and gabapentin. anaemia may reduce fatigue if it is heavily on proteasomes than caused by low red blood cell counts. drug drug normal healthy cells; they are Skin Increasing your levels of activity and therefore much more sensitive rashes having complementary therapies to bortezomib. such as aromatherapy or massage Some myeloma patients taking may also help. bortezomib can develop a skin rash, which may be itchy and need treatment with antihistamines and/or steroid creams. If this is particularly problematic, it may be necessary to stop Figure 1: Mechanism of action of proteasome inhibitors treatment temporarily or restart at a lower dose. Velcade

What is bortezomib? Possible side effects Peripheral Low blood Low blood pressure of bortezomib neuropathy counts (hypotension) Bortezomib, also known as ® Bortezomib has a number of Peripheral neuropathy is damage Bortezomib may cause a decrease Bortezomib can cause a drop in Velcade , is a proteasome inhibitor possible side effects which can to the nerves in hands, feet, arms in the number of red blood cells, blood pressure which can make drug used in the treatment of vary considerably from patient to or legs. It tends to come on quite white blood cells and platelets in you feel dizzy, lightheaded or like patient. It is important to report any quickly after starting treatment and your blood. This can cause anaemia you are about to faint. If you are on myeloma. side effects to your doctor or nurse can produce painful/uncomfortable and fatigue, as well as making you treatment to help lower your blood as soon as possible so they can be burning, tingling and prickling more susceptible to infection and pressure, you may need to have treated or managed promptly. sensations. It can be the most increasing your risk of bleeding. its dose reduced or stopped whilst significant and problematic side If necessary, you can be given you are on bortezomib. Keeping Often the best way to manage effect of bortezomib. supportive treatment to help with well hydrated can help to prevent the side effects associated with these side effects and to boost your hypotension, especially during the bortezomib is to lower the dose For most patients, symptoms will How does it work? blood cell counts. time bortezomib is administered. small protein tags small protein tags and/or change the schedule of improve or disappear after the dose bortezomib e.g. from twice-weekly and/or frequency of administration If you feel dizzy or lightheaded Bortezomib works by blocking to once-weekly. of bortezomib is reduced. However, Gastrointestinal when taking bortezomib, you the actions of proteasomes. in some cases, bortezomib may should not operate machinery or You may also benefit from a disturbances Proteasomes are large molecules need to be temporarily stopped drive a car. temporary pause in treatment found in all cells of the body, or discontinued. If you have severe Bortezomib can cause diarrhoea, for a few weeks. This should not and they are involved in the peripheral neuropathy, you may not constipation, nausea and vomiting. protein tagged breakdown of damaged or protein tagged affect the activity of the myeloma for recycling for recycling be able to have other treatments While usually mild and manageable, Fatigue and it does not mean that your unwanted proteins. Bortezomib in the future that are also known to these side effects can become proteasome temporarily blocks their function, proteasome myeloma will suddenly progress. problematic in some cases. cause it. Fatigue usually resolves shortly protein stopping them from breaking protein Unfortunately, if side effects remain Maintaining a good fluid intake fragments fragments after treatment has finished. There down unwanted proteins. This problematic, it may be necessary Pain and discomfort can be and a balanced diet is important. are a number of medical and non- causes proteins to build up to to stop treatment altogether and alleviated by gentle massage, warm Your doctor can prescribe specific medical ways to help manage proteasome inhibitors block the toxic levels, killing the cell. proteasome inhibitors block the consider other options. baths, heat/cold packs, and specific treatment to help prevent or control proteasome causing proteins to proteasome causing proteins to fatigue. For example, treatment for build up build up nerve painkilling drugs, such as these side effects. Myeloma cells rely more pregabalin and gabapentin. anaemia may reduce fatigue if it is heavily on proteasomes than caused by low red blood cell counts. drug drug normal healthy cells; they are Skin Increasing your levels of activity and therefore much more sensitive rashes having complementary therapies to bortezomib. such as aromatherapy or massage Some myeloma patients taking may also help. bortezomib can develop a skin rash, which may be itchy and need treatment with antihistamines and/or steroid creams. If this is particularly problematic, it may be necessary to stop Figure 1: Mechanism of action of proteasome inhibitors treatment temporarily or restart at a lower dose. stethoscope How is bortezomib given? If you have any questions about your treatment, speak to your medical team. They are the best people to ask if you have questions Bortezomib is usually given as an injection under the skin about your individual situation. The information in this publication is (subcutaneous), but can also be given intravenously (into the vein). not meant to replace their advice. Bortezomib is most often given with the steroid dexamethasone. It can also be given in other combinations, such as with the chemotherapy drug cyclophosphamide (known as VCD), or the immunomodulatory drug (IMiD) thalidomide (VTD). The exact dose of bortezomib, and how long you will have it for, depends on a number of factors, including: We’re here for everything

Your height and weight a diagnosis of myeloma brings

HeightWeight Get in touch to find out more about how we can support you

Whether you are receiving treatment in Call the Myeloma Infoline on a once-weekly or twice-weekly schedule 0800 980 3332

Schedule Bortezomib Email Ask the Nurse at [email protected] ® What treatment combination you are receiving (Velcade ) Visit our website at myeloma.org.uk Other information about bortezomib Treatment Guide

You should not drink green tea or take green tea supplements Myeloma UK while being treated with bortezomib because they can 22 Logie Mill, Beaverbank Business Park, interfere with the way bortezomib works. Avoid Green Tea Edinburgh EH7 4HG Published by: Myeloma UK 0131 557 3332 Publication date: January 2019 You should also avoid having vitamin C in large doses as it Last updated: January 2019 [email protected] can interfere with treatment with bortezomib. Review date: January 2022 Registered Charity No: SC026116 Avoid Vitamin Alcohol intake should be strictly limited whilst taking bortezomib because it can exacerbate side effects such as dizziness and fatigue. We appreciate your feedback Avoid Alcohol Please fill in a short online survey about our patient information at myeloma.org.uk/pifeedback or email any comments to [email protected] For a list of references used to develop our resources, visit myeloma.org.uk/references