Bortezomib is a cancer medicine called a proteasome inhibitor. It is given by a health care professional, usually into a vein or under the skin. It can help slow or stop the growth of certain blood cancers.
Brand Name(s)
- US: Boruzu; Velcade
- Canada: ACT Bortezomib; Bortezomib SDZ; PMS-Bortezomib; TARO-Bortezomib; Velcade
Warning(s)
This drug can cause serious side effects. Know when to call your care team right away, and tell every provider you see that you are taking bortezomib.
- Allergic reactions: Rash, hives, itching, swelling of the face or throat, trouble breathing, or peeling skin need urgent care.
- Infections and low blood counts: Fever, chills, sore throat, cough, mouth sores, pain when urinating, or a wound that does not heal can be signs of infection. You may bruise or bleed more easily.
- Shingles (herpes zoster) can reactivate: Pain, tingling, or a blistering rash with fever or muscle aches. Your doctor may give medicine to help prevent this.
- Nerve damage (peripheral neuropathy): Numbness, tingling, burning, pain, or weakness in hands or feet; trouble sensing heat or cold.
- Heart problems (Rare): New or worse shortness of breath, swelling of legs or arms, fast or irregular heartbeat, or sudden weight gain can be signs of heart failure.
- Lung problems (Rare): New or worse cough, trouble breathing, or fever.
- Liver problems (Rare): Dark urine, yellow skin or eyes, right‑side belly pain, very tired, light‑colored stools, nausea or vomiting.
- Tumor Lysis Syndrome (TLS): Fast or abnormal heartbeat, fainting, muscle cramps or weakness, trouble passing urine, severe nausea, vomiting, diarrhea, or feeling very sluggish.
- Blood pressure and blood sugar changes: Severe headache, dizziness, fainting, or vision changes; unusual thirst, frequent urination, shaking, sweating, or fast heartbeat.
- Injection site reactions: Pain, redness, or swelling where the shot is given.
Before or while you take bortezomib:
- Tell all of your health care providers you take this drug, including dentists and pharmacists.
- Many medicines interact with bortezomib, including some used for HIV, infections, and seizures. Do not start, stop, or change medicines unless your care team says it is safe.
- Green tea and some green tea extracts may make bortezomib work less well. Ask your care team before using them.
- You may feel dizzy or sleepy. Avoid driving or tasks that need you to be alert until you know how this drug affects you. Rise slowly to prevent lightheadedness.
- You have a higher risk for infection. Wash your hands often and try to avoid people who are sick.
- If you have diabetes, your blood sugar may change. Monitor it as directed by your care team.
- Pregnancy and breastfeeding: Bortezomib may harm an unborn baby. A pregnancy test is usually done before starting. Use effective birth control during treatment and for a time after your last dose (often 7 months if you can become pregnant; 4 months if your partner can become pregnant). Do not breastfeed during treatment and for 2 months after the last dose.
- Fertility may be affected in some people. If you plan to have children in the future, talk with your care team.
- You will need regular blood tests and checkups to watch your blood counts, organs, and overall health.
- This drug is given by a professional into a vein or under the skin. It must not be injected into the spine.
- If you have vomiting or diarrhea, contact your care team to help prevent dehydration and electrolyte problems.
Kind of Cancers It Is Used For (not a complete list)
- Multiple myeloma
- Mantle cell lymphoma (a type of non-Hodgkin lymphoma)
- It may also be used for other reasons as part of a treatment plan your doctor recommends.
Mechanism of Action
Bortezomib blocks the 26S proteasome, a system that cancer cells use to break down and recycle proteins. When this system is blocked, proteins build up inside the cell. This stresses the cancer cell, slows its growth, and can cause the cell to die. Blood cancer cells, like myeloma cells, are especially sensitive to this effect.
Common Side Effects
- Tiredness, weakness, or dizziness
- Headache or trouble sleeping
- Numbness, tingling, burning, or pain in hands or feet (peripheral neuropathy)
- Stomach pain, nausea, vomiting, diarrhea, or constipation
- Decreased appetite or weight loss
- Low blood counts: anemia (tiredness), low platelets (easy bruising or bleeding), low white blood cells (higher infection risk)
- Injection site redness, pain, or swelling
- Changes in blood sugar, especially if you have diabetes
If side effects are severe, do not go away, or worry you, contact your care team.
Last reviewed: 2025-12-15
