Bortezomib is used in adults to treat multiple myeloma and mantle cell lymphoma.

Bortezomib may also be used for purposes not listed in this medication guide.

Tell your doctor if you use other medicines or have other medical conditions or allergies.

Bortezomib comes as a solution (liquid) to inject into a vein or subcutaneously (under the skin). Bortezomib is given by a doctor or nurse in a medical office or clinic. Your dosing schedule will depend on the condition that you have, the other medications you are using, and how well your body responds to treatment.

Be sure to tell your doctor how you are feeling during your treatment. Your doctor may stop your treatment for a while or decrease your dose of bortezomib if you experience side effects of the medication.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Bortezomib is injected into a vein or under your skin. A healthcare provider will give you this injection.

You may be given medication to prevent nausea or vomiting while you are receiving bortezomib.

You may need frequent medical tests and your cancer treatments may be delayed based on the results.

You should not be treated with bortezomib if you are allergic to it, or to mannitol, or boron.

Tell your doctor if you have ever had:

• numbness, tingling, or burning pain in your hands or feet;

• high or low blood pressure;

• heart disease, congestive heart failure;

• headache, confusion, thinking problems, weakness, vision loss, seizure;

• a low level of platelets or low white or red blood cell counts;

• skin rash or herpes zoster (also called shingles);

• lung disease, or breathing problems;

• diabetes;

• if you are dehydrated;

• liver disease; or

• kidney disease (or if you are on dialysis).

Bortezomib can harm an unborn baby if the mother or the father is using bortezomib.

• If you are a woman, you may need a pregnancy test to make sure you are not pregnant. Use birth control while using this medicine and for at least 7 months after your last dose.

• If you are a man, use birth control if your sex partner is able to get pregnant. Keep using birth control for at least 4 months after your last dose.

• Tell your doctor right away if a pregnancy occurs.

Pregnancy may be less likely to occur while the mother or the father is using this medicine. Both men and women should still use birth control to prevent pregnancy because the medicine can harm an unborn baby.

Do not breastfeed while using this medicine, and for at least 2 months after your last dose.

Call your doctor for instructions if you miss an appointment for your bortezomib injection.

In a medical setting an overdose would be treated quickly.

Bortezomib will be stored in the medical office or clinic.

Talk to your doctor about eating grapefruit and drinking grapefruit juice while using this medication.

Drink plenty of fluids every day during your treatment with bortezomib, especially if you vomit or have diarrhea.

You may get dehydrated during prolonged illness. Call your doctor if you are sick with vomiting or diarrhea.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

bortezomib may cause blurred vision and may impair your reactions. Avoid driving or hazardous activity until you know how this medicine will affect you.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Bortezomib may cause a brain infection that can lead to disability or death. Tell your doctor if you have problems with speech, thought, vision, or muscle movement. These symptoms can get worse quickly.

Bortezomib can cause life-threatening blood clots in the small blood vessels inside your organs, such as your brain or kidneys. Seek medical help right away if you have symptoms of this condition, such as a fever, tiredness, decreased urination, bruising, or nosebleeds.

Bortezomib may cause serious side effects. Call your doctor at once if you have:

• headache, confusion, thinking problems, weakness, vision loss, seizure, a light-headed feeling, like you might pass out;

• pain, bruising, swelling, or irritation where the medicine was injected;

• severe or ongoing nausea, vomiting, diarrhea, or constipation, stomach pain;

• fever with shortness of breath or trouble breathing;

• dehydration--dizziness, confusion, feeling very thirsty, less urination;

• low blood cell counts--fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath;

• liver problems--loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• heart problems--swelling, rapid weight gain, feeling short of breath; or

• signs of tumor cell breakdown--tiredness, weakness, muscle cramps, nausea, vomiting, diarrhea, fast or slow heart rate, tingling in your hands and feet or around your mouth.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common side effects of bortezomib may include:

• numbness, burning pain, or tingly feeling;

• loss of appetite, nausea, vomiting;

• diarrhea, constipation;

• fever, chills, cold or flu symptoms;

• low blood cell counts;

• skin rash; or

• feeling tired.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective.

Many drugs can affect bortezomib. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all other medicines you use.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to bortezomib.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.