Velcade (bortezomib) injection can cause mild to serious side effects. More common side effects include nausea, diarrhea, and skin rash. If side effects become difficult to tolerate, talk with your doctor about coping tips or other treatment options.

Key takeaways

  • Common and mild side effects of Velcade include skin rash, fever, fatigue, and digestive system problems.
  • Velcade also has several common serious side effects, including nerve damage, low levels of red blood cells, white blood cells, and platelets.
  • While hair loss is not a direct side effect of Velcade, it can occur when Velcade is used in combination with other cancer medications.

Velcade is a prescription medication used to treat multiple myeloma and mantle cell lymphoma in adults. Velcade contains the active ingredient bortezomib. It’s a kind of targeted therapy and belongs to a group of drugs known as proteasome inhibitors. Velcade is not immunotherapy or traditional chemotherapy.

Keep reading to learn about the common, mild, and serious side effects Velcade can cause. To learn more about Velcade, including its uses, dosage, and cost, read this Velcade overview article.

Velcade can cause certain side effects, some more common than others. These side effects may be temporary, lasting a few days to weeks. Talk with your doctor if side effects do not go away, get worse, or become too difficult for you to tolerate.

Velcade’s commonly reported side effects include:

To learn more about some of these side effects, see the “Side effects explained” section.

Mild side effects have been reported with Velcade. These include:

  • skin rash
  • fever
  • fatigue
  • decreased appetite
  • dizziness
  • headache
  • swelling of your arms or legs
  • digestive problems, such as nausea, diarrhea, and vomiting
  • insomnia

To learn more about some of these side effects, see the “Side effects explained” section.

In most cases, these side effects should be temporary, and 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. They’ll help determine if you should stop Velcade treatment due to any side effects you experience.

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

Velcade may cause serious side effects. The following list may not include all possible serious side effects of the drug. For more information, you can refer to Velcade’s prescribing information.

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

Serious side effects that have been reported with Velcade include:

To learn more about some of these side effects, see the “Side effects explained” section.

If you develop serious side effects while using 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.

ALLERGIC REACTION

Like most drugs, Velcade can cause an allergic reaction in some people. In general, symptoms of an allergic reaction can be mild or serious.

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 difficulty 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.

Learn more about some of the side effects Velcade may cause.

Neuropathy

Velcade may cause neuropathy in some people. This was one of the more common side effects reported by people receiving 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 previously listed 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 Velcade dose. Or they may recommend that you stop receiving Velcade, either permanently or at least until your neuropathy eases.

Psychiatric (mental health) side effects

It’s possible to develop mental health side effects while receiving Velcade. In studies, these side effects were rare. They include:

Mental health side effects can lead to insomnia, which was a common side effect of Velcade in studies.

What might help

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

If you develop mental health 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 receiving Velcade and switch to another treatment.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

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
  • diarrhea
  • vomiting
  • constipation
  • abdominal pain

In some cases, these side effects can be severe and cause dehydration. 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.

To help prevent dehydration due to digestive problems, be sure to drink plenty of fluids during Velcade treatment. 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 Velcade 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 common side effect reported by people receiving Velcade in studies. In some cases, people reported low blood pressure when changing positions, such as when getting up from lying down. Symptoms of low blood pressure include:

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

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

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, you and your doctor will 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.

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 for Velcade to cause long-term side effects. But these side effects are usually rare. Examples include:

  • heart failure or other heart diseases
  • lung problems, such as swelling in your lungs
  • liver problems, such as hepatitis
  • blood clotting conditions
  • kidney problems, such as kidney failure

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

In some cases, your side effects may go away after you stop receiving 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 who received 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 receiving 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 receiving 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, such as dexamethasone. Other drugs may raise your risk of 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 receiving 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 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-related side effects. In other, more serious cases, they may have you stop Velcade treatment and switch to a different medication to treat your cancer.

Before starting Velcade treatment, discuss your health history with your doctor. Velcade may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

  • neuropathy
  • allergic reaction
  • low blood pressure or fainting
  • heart failure or other heart conditions
  • history of herpes infection
  • lung conditions
  • liver conditions
  • diabetes
  • pregnancy
  • breastfeeding

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.