Velcade 3.5mg is an anti-cancer medicine, which is available in the form of lyophilized powder
Velcade 3.5mg is a first beneficial proteasome inhibitor; proteasome is a cellular structure that breaks the proteins



3.5mg containing vial in a carton


Velcade 3.5mg is majorly used to treat
• Multiple myeloma
• Mantle cell lymphoma

Mechanism of action

Bortezomib is a kind of cancer treatment drug called a proteasome inhibitor.
In cells, Proteasomes are present. They need to break down proteins that the cell doesn't need. Bortezomib stops the proteasomes so the proteins build up inside the cell. The cell then dies.
The functioning site of proteasome has Chymotrypsin like, Trypsin like, Post glutamyl peptide hydrolysis activity.
The 26S proteasome enzyme diminish assorted proteins which demanding to cancer cells survival like cyclins, tumor suppressors, BCL-2 & cyclin dependent kinase inhibitors
Prohibition of these degenerations, sensitizes cells to apoptosis and cell arrest


The peak plasma level of Velcade 3.5mg occurs as 509ng/ml

The human plasma protein binding of Velcade 3.5mg occurs as nearly 83%

Major metabolic pathway: deboronation to form 2-deboronated metabolites which are inactive as 26S proteasome inhibitors
Velcade 3.5mg is metabolized hepatically with the help of cytochrome P 450 enzymes 3A4, 2C19, & 1A2 by oxidation

The single dose IV: The half-life period occurs at 9 to 15 hours;
Multiple 1mg/m2 dosing: 40 to 193 hours
Multiple 1.3mg/m2 dosing: 76 to 108 hours


Ingredients Bortezomib
Strength 3.5mg
Pack 3.5mg containing vial in a carton

Generally, Velcade is in lyophilized powder form; which is reconstituted by using 0.9% sodium chloride (NS)
Velcade3.5mg should be reconstituted in 3.5ml NS
The route of administration is IV bolus
Intrathecal not use for administration
In adults:
Mantle cell lymphoma:
The usual dose of Velcade for untreated mantle cell lymphoma is;
1.3mg/m2 of Velcade administered as IV bolus given as two times weekly by combining with rituximab, cyclophospahmide, doxorubicin and tablet prednisolone for two weeks (day I, IV, VIII & XI) followed by 10 day rest period (day II through 21)
In Relapse stage:
The recommended dose is 1.3mg/m2 administered as IV bolus or subcutaneous two times for two weeks (day I, IV, VIII & XI) followed by 10-day rest period (day II through 21)
The treatment continued for above 8 cycles may be taken for once weekly for 4 weeks (day 1, 8, 15 & 22), followed by 13-day rest (days 23 through 35)
Multiple myeloma:
In the therapy of previously untreated multiple myeloma:
1.3mg/m2 of dose should be administered as 3 to 5 seconds through IV bolus or subcutaneous by combining with tablet melphalan and prednisolone for nine 6 weeks therapy cycles
Cycles 1 over 4, is taken for two times weekly, (day 1, 4, 8, 11, 22, 25, 29 and 32)
Cycles 5 over 9, is taken once a week (day 1, 8, 22, and 29)
Key points:
Partially, 72 hours should be passing between following doses of Velcade
In Relapse stage:
The recommended dose of Velcade is 1.3mg/m2 should be administered through IV bolus or subcutaneous as two times for two weeks (day1, 4, 8, and 11) followed by a ten-day rest course (day 12 through 21)
Treatment schedule increased above 8 cycles may be taken once weekly for 4 weeks (day 1, 8, 15, and 22), followed by 13 day rest (day 23 over 35)
Important points:
Velcade should be used alone or combination with dexamethasone
Three-week course is considered as therapy cycle
A minimum 72 hours should slip away between constant doses of Velcade.

Most common side effects occurred after administration of Velcade 3.5mg includes;
Black tarry stools
Bleeding gums
Blood in urine
Blurred vision
Body aches
Burning, crawling, itching, numbness, prickling
Chest pain
Cough producing mucus, dizziness, faintness, nerve pain, painful urination, pale skin, runny nose, sore throat, stuffy nose, swollen glands, sunken eyes, ulcer, dry mouth, ear congestion, loss of voice. Less common side effects:
Dilated veins, discomfort, increased sensitivity of pain & touch, irregular breathing, heart beats, swelling of peripheral organs, thickening of bronchial secretions
Belching, bone pain, difficulty with moving & bowel movements, cold and shivering, loss of appetite, loss of taste, muscle cramps, muscle pain, stomach discomfort. Vomiting, loss of weight.


While taking Velcade 3.5mg some adverse effects occurs care should be taken in the conditions like
Velcade 3.5mg leads to peripheral neuropathy like burning sensation, hyperesthesia, hypoesthesia, paresthesia, neuropathic pain Manage postural Hypotension by altering the antihypertensive agents, hydration, and administration of mineralocorticoids or sympathomimetics
Cardiac toxicity
Pulmonary toxicity like Acute Respiratory Distress Syndrome, pneumonitis, interstitial pneumonia, lung infiltration
Posterior reversible encephalopathy syndrome-stop the Velcade 3.5mg therapy
Gastrointestinal toxicity-fluid or electrolyte replacements have to take
Thrombocytopenia and neutropenia
Tumor lysis syndrome
Hepatic toxicity
Embryo fetal toxicity.


  • Strong CYP3A4 inhibitors: there is a chance of getting Velcade toxicity; so to reduce the dose of Velcade while concomitant with CYP3A4 inhibitors

  • Strong CYP3A4 inducers: decrease the exposure of Velcade

  • Avoid concomitant with St. John’s wort to decrease the exposure of Velcade

  • No clinical effect on Velcade exposure while concomitant with melphalan-prednisone or dexamethasone alone


Hypersensitivity reaction occurs in patients who are contraindicated to Velcade 3.5mg, boron, boric acid or glycine Velcade 3.5mg is given through IV bolus or subcutaneous; whereas intrathecal administration is contraindicated to the patients who are receiving Velcade 3.5mg

Velcade 3.5mg is not recommended in pregnancy condition, it causes harm to fetus
Breast feeding is not recommended

Velcade 3.5mg vial should be stored at 20°C to 25°C (68°F to 77°F); excursion between 15°C to 30°C (59°F to 86°F)
Keep away from light and heat

Velcade 3.5mg is not a normal medicine used as anti-cancer drug; it is not to be self-medicated
If patient fail to take the dose of Velcade 3.5mg, must consult with medical oncologist and followed the dosing schedules
Do not self administered
Follow the advice given by physician and do not missed the cycles for course of therapy

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