If you have a certain type of blood cancer, your doctor might suggest Velcade (bortezomib) as a treatment option for you.

Velcade is a prescription medication used in adults with either multiple myeloma or mantle cell lymphoma. These are both cancers that occur in your white blood cells.

This medication comes as a powder that’s mixed with liquid to form a solution. It’s given as an injection under your skin or into a vein. You’ll receive your Velcade doses at your doctor’s office or in a clinic.

You might receive Velcade as a long-term treatment. How long your treatment lasts may depend on the type of cancer you have and your specific treatment goals. Your doctor will determine the length of time you should take Velcade.

For more information about Velcade, including details about its uses, see this in-depth article. Like other drugs, Velcade can cause mild or serious side effects. Keep reading to learn more.

Some people may experience mild or serious side effects during their Velcade treatment. Examples of a few of Velcade’s commonly reported side effects include:

* To learn more about this side effect, see “Side effects explained” below.

Velcade may cause mild side effects. Examples of mild side effects that have been reported with Velcade include:

* To learn more about this side effect, see “Side effects explained” below.
† To learn more about this side effect, see “psychiatric disorders” under “Side effects explained” below.

In most cases, these side effects should be temporary. Some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And do not stop using Velcade unless your doctor recommends it.

Velcade may cause mild side effects other than the ones listed above. See Velcade’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Velcade, visit MedWatch.

Some people taking Velcade may experience serious side effects. But these side effects are more rare than mild side effects. Even so, it’s important to be aware of serious side effects that may occur so that you can get treatment for them right away. In rare cases, serious side effects can be fatal if not treated.

Serious side effects that have been reported with Velcade include:

If you develop serious side effects while taking Velcade, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see “Side effects explained” below.

Get answers to some frequently asked questions about Velcade’s side effects.

How long do side effects from Velcade typically last?

The duration of your side effects (how long they last) may depend on several factors. These include your body’s reaction to the medication and which specific side effects you’re experiencing.

For example, if you experience injection site reactions such as pain or swelling, the reaction may go away a few days after you get your Velcade dose. But you might have these reactions with each injection you receive.

More serious side effects, such as liver or kidney problems, may not go away on their own. Your doctor may need to prescribe other medications to treat these side effects.

If you’re concerned about how long specific side effects will last, talk with your doctor or pharmacist. In some cases, your doctor may also be able to recommend ways to help relieve your side effects, so they’re not as bothersome.

Does Velcade cause any long-term side effects?

Yes, it’s possible that Velcade can cause long-term side effects. But these side effects are usually rare. Examples of long-term side effects that Velcade may cause include:

Your doctor will monitor you for side effects throughout your Velcade treatment. If you develop any serious side effects, your doctor may decrease the dose. Or they may recommend you stop taking Velcade and switch to a different treatment.

In some cases, your side effects may go away after you stop using Velcade. But in other cases, the side effects may continue after you’ve stopped treatment.

If you have concerns about long-term side effects with Velcade, talk with your doctor.

Is hair loss a side effect of Velcade?

No, hair loss was not a side effect reported by people taking Velcade by itself in studies. However, hair loss may be caused by other cancer medications that you take with Velcade.

In studies, hair loss was reported by people using Velcade with Rituxan (rituximab), Cytoxan (cyclophosphamide), Doxil (doxorubicin), and Rayos (prednisone).

The hair loss experienced by people in these studies was likely caused by cyclophosphamide or doxorubicin. These drugs are considered “cytotoxic,” which means they work by killing cells. This is how they work to treat cancer, but they also cause hair loss.

If you’re concerned about hair loss during your cancer treatment, talk with your doctor.

Do Velcade’s side effects vary depending on whether it’s used for multiple myeloma or mantle cell lymphoma?

Yes, it’s possible that your side effects may vary depending on whether you’re using Velcade for multiple myeloma or mantle cell lymphoma. But in most cases, side effects reported in studies of Velcade were very similar for people with either of these conditions.

Your side effects may also depend on other medications you may be taking with Velcade. Other drugs may raise your risk for certain side effects, such as infections, or they may cause additional side effects, such as hair loss.

If you have questions about which side effects could occur when taking Velcade for your specific condition, talk with your doctor or pharmacist.

Does Velcade cause any eye-related side effects?

Yes, Velcade may cause eye-related side effects. These side effects weren’t common in studies, but they did occur in some people. Examples of eye-related side effects that were reported in studies include:

Other, more serious eye-related side effects were also reported after Velcade was released onto the market. They include blindness, optic neuropathy (damage to your optic nerve), and swelling of your eyelid. These side effects didn’t occur in studies of the drug, so it’s unclear how often they’ve happened or if Velcade was the cause.

If you experience any eye-related side effects, be sure to tell your doctor. In some cases, they may be able to treat your eye side effects. In other, more serious cases, they may have you stop taking Velcade and switch to a different medication to treat your cancer.

You may experience side effects from taking Velcade. Below, learn more about some of the side effects Velcade may cause.

Neuropathy

Velcade may cause neuropathy (nerve damage) in some people. This was one of the more common side effects reported by people taking Velcade in studies.

Neuropathy is a nerve condition that causes numbness or weakness. Often, neuropathy occurs in your hands or feet. Symptoms of neuropathy may include:

  • burning sensation on your skin
  • pain or weakness
  • numbness
  • pins and needles in your hands or feet

What might help

If you experience any of the above symptoms during your Velcade treatment, tell your doctor right away. Your doctor will also monitor you for symptoms.

If you do experience neuropathy, your doctor may decrease your dose. Or they may recommend that you stop taking Velcade, either permanently or at least until your neuropathy improves.

Psychiatric side effects

It’s possible to develop psychiatric side effects while using Velcade. In studies, these side effects were rare.

Examples of rare psychiatric side effects reported in studies of Velcade include:

  • feeling agitated
  • confusion
  • anxiety
  • suicidal thoughts or behaviors
  • changes in your mental status, such as confusion or memory loss

Psychiatric side effects can lead to insomnia (trouble sleeping), which was a common side effect of Velcade in studies.

Before you start treatment with Velcade, be sure to tell your doctor about any psychiatric conditions you currently have or have had in the past. They may want to monitor you more closely during your treatment.

What might help

If you develop psychiatric side effects during your Velcade treatment, talk with your doctor right away. For some side effects, such as insomnia, your doctor may be able to recommend medications to treat it.

For other conditions, such as suicidal thoughts or behaviors, your doctor may have you stop taking Velcade and switch to another treatment.

SUICIDE PREVENTION

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Digestive problems

Digestive problems are possible during treatment with Velcade. These side effects were very common in studies of the drug. Examples of digestive problems include:

  • nausea
  • vomiting
  • diarrhea
  • constipation
  • abdominal (belly) pain

In some cases, these side effects can be severe and cause you to become dehydrated. Be sure to tell your doctor if you have any digestive issues.

What might help

Your doctor will monitor you for symptoms of digestive problems throughout your treatment with Velcade. You may need to take medications to treat these side effects, such as medication for nausea or diarrhea. Your doctor or pharmacist can advise you on the best treatments for these conditions.

In addition, your digestive problems may cause you to become dehydrated. To lower this risk, be sure to drink plenty of fluids. You can stay hydrated by drinking water or sports drinks such as Gatorade.

In cases of severe dehydration, you may need to receive fluids into your vein from a healthcare professional. Your doctor will determine if your dehydration is severe enough to receive this treatment.

During your treatment, tell your doctor about any digestive issues that you experience. They can recommend ways to help relieve these side effects.

Low blood pressure

Some people may develop low blood pressure during their Velcade treatment. This was a fairly common side effect reported by people using Velcade in studies. In some cases, people reported low blood pressure when changing positions, such as when getting up from lying down.

Low blood pressure can become serious if it’s not treated. For example, you could faint if your blood pressure gets too low.

Throughout your Velcade treatment, your doctor will monitor you for symptoms of low blood pressure. Examples of these symptoms include:

  • dizziness
  • fainting
  • blurry vision
  • cold or clammy skin

What might help

Before you start Velcade treatment, tell your doctor if you have a history of fainting. You should also talk with them about any other medications you’re taking. If you take other drugs that may lower your blood pressure, you may have a higher risk of developing low blood pressure during your Velcade treatment. In this case, your doctor may monitor you more closely for symptoms of low blood pressure.

During your Velcade treatment, watch for symptoms of low blood pressure. If you do develop any symptoms, tell your doctor right away. They may recommend increasing your fluid intake, changing your dose of other medications you take, or adding another medication to raise your blood pressure.

Allergic reaction

Like most drugs, Velcade can cause an allergic reaction in some people.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter oral antihistamine, such as Benadryl (diphenhydramine), or a topical product, such as hydrocortisone cream, to manage your symptoms.

If your doctor confirms you had a mild allergic reaction to Velcade, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Velcade, they may have you switch to a different treatment.

Keeping track of side effects

During your Velcade treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of drug you were taking when you had the side effect
  • how soon after starting that dose you had the side effect
  • what your symptoms were from the side effect
  • how it affected your daily activities
  • what other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help your doctor learn more about how the drug affects you. And your doctor can use this information to adjust your treatment plan if needed.

Velcade may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Velcade. The list below includes factors to consider.

Neuropathy. If you have a history of neuropathy (nerve damage), tell your doctor before you start treatment with Velcade. This drug may make your neuropathy worse. Your doctor may monitor you more often for symptoms of neuropathy to make sure your condition isn’t getting worse.

Allergic reaction. If you’ve had an allergic reaction to Velcade or any of its ingredients, you should not take Velcade. Ask your doctor what other medications are better options for you.

Low blood pressure or fainting. Before using Velcade, tell your doctor if you have low blood pressure, any conditions that cause you to faint, are dehydrated, or take medications that lower your blood pressure. Velcade can also lower your blood pressure, so taking it if you have any of these conditions may decrease your blood pressure too much. Your doctor may monitor you more often throughout your treatment with Velcade, or they may recommend a different medication for you.

Heart failure or other heart conditions. Velcade may cause heart problems. If you already have a heart condition, such as heart failure, talk with your doctor before starting Velcade treatment. This drug could worsen your condition. Your doctor may monitor you more closely during treatment to make sure your heart condition isn’t getting worse.

Lung conditions. Velcade can cause lung problems, such as swelling in your lungs. If you already have a lung condition, such as asthma, using Velcade could make it worse. If you have any lung conditions, talk with your doctor before you start treatment with Velcade. They may monitor you more closely for worsening lung problems during your treatment.

Liver conditions. Velcade may cause liver problems, such as hepatitis. If you already have a liver condition, using Velcade could make it worse. Before starting treatment with Velcade, tell your doctor about any liver conditions you have. Your doctor will likely monitor you for symptoms of your liver condition during your treatment. Or they may recommend a different treatment option for you.

Diabetes. If you have diabetes and are taking any medications by mouth to treat your condition, tell your doctor before starting Velcade treatment. Velcade may change the way your diabetes medications work, which can cause high or low blood sugar. Your doctor will likely have you monitor your blood sugar more often during Velcade treatment.

Alcohol use and Velcade

It’s not known if it’s safe to drink alcohol during Velcade treatment.

Both Velcade and alcohol can cause low blood pressure, which may be dangerous and result in fainting. Velcade and alcohol can both also cause nausea or vomiting. So drinking alcohol with Velcade may make these side effects worse.

If you drink alcohol, talk with your doctor about how much (if any) may be safe for you to drink during your Velcade treatment.

Pregnancy and breastfeeding while using Velcade


See below for information about using Velcade during pregnancy or while breastfeeding.

Pregnancy

You should not use Velcade if you’re pregnant or planning to become pregnant. This is because Velcade can cause harm to a fetus.

During your Velcade treatment and for at least 7 months after stopping treatment, females* who can become pregnant should use birth control to prevent pregnancy. In addition, males* with a sexual partner who can become pregnant should use birth control while using Velcade and for at least 4 months after stopping treatment.

If you’re pregnant or planning to become pregnant, talk with your doctor about the best treatment plan for you.

* In this article, we use the terms “female” and “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Breastfeeding

Breastfeeding is not recommended during Velcade treatment or for at least 2 months after stopping treatment. This is because it’s not known if Velcade may pass into breast milk or what effects it may have on a breastfed child.

If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.

You may experience side effects from taking Velcade. In some cases, your side effects may be mild and may go away on their own. However, more serious side effects are possible.

Before you start treatment with Velcade, talk to your doctor about your risk of side effects from the drug. Some questions that you may want to ask include:

  • What’s the best way to treat side effects that Velcade may cause?
  • Will my other medical conditions increase my risk of side effects from Velcade?
  • How should I monitor myself for serious side effects during my Velcade treatment?
  • How will I know if my side effects from Velcade are serious?
  • What should I do if I become pregnant while taking Velcade?

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.