Bortezomib

• You may place a cool compress over the affected area for 15 to 20 minutes several times a day for relief.

• Muscle aches and/or joint pain. Mild pain can be relieved by taking Paracetamol.

• Inform your doctor if the symptoms do not go away.

Decrease in white blood cell count

• This may increase your chances of getting an infection.

• To reduce the risk of infections:
  • Maintain good hand hygiene. Wash your hands before handling food and after using the toilet.
  • Avoid crowds and do not go near people who are sick. Wear a mask if necessary.
  • Eat freshly cooked and well-cooked food. Avoid raw meats, vegetables and eggs, or half-cooked or uncooked food.
• Proceed to the A&E department immediately if you have any signs of infection, such as having
  • A fever of 38°C and above
  • Chills
  • Bad sore throat
  • Pain when you pass urine
  • Mouth sores or wounds that do not heal
• You should avoid taking Paracetamol to relieve fever as this may mask your fever and delay the treatment of your infection.

Decrease in platelet count 

• Low platelet levels can increase your chance of bleeding.

• To reduce the risk of bleeding:
  • Be careful when using sharp objects such as scissors or knives.
  • Brush your teeth gently with a soft bristle toothbrush to prevent gum bleeding.
  • Try not to bruise, cut, or knock yourself. Apply direct pressure to any cuts or wounds to help stop bleeding.
• Proceed to the A&E department immediately if you have symptoms of serious bleeding including:
  • Blood in the urine
  • Black, sticky or bloody stools
  • Unexplained large bruises
  • Coughing up blood or coffee ground-like vomit
  • Bleeding that does not stop

Decrease in the number of red blood cells (anaemia)

• This means there are less red blood cells in your body to carry oxygen to your organs and tissues.
• Symptoms may include worsening tiredness, pale skin or lips, feeling breathless more easily, or having a fast heartbeat while resting.

• Proceed to the A&E department immediately if you have:
  • Unusual giddiness or light-headedness that does not go away
  • Severe breathlessness or rapid breathing
  • An unusually fast heartbeat 

Nerve problems

• You may experience numbness or tingling sensation in the hands or feet.
• This side effect usually affects the fingertips and toes or soles of your feet after a few cycles of chemotherapy.

• Inform your doctor if this symptom troubles you or affects your daily activities such as buttoning up shirts or picking up objects.
• Take extra care when walking or getting up if the numbness affects your feet, and when handling hot or sharp objects.

• Avoid hot showers. Use cool or lukewarm water to bathe.
• Apply a moisturiser to areas with dry skin.
• Avoid staying out under the sun. Use sunscreen with Sun Protection Factor (SPF) of at least 30 and covered clothing when you are out in the sun.
• Please see a doctor immediately if the rashes are painful, or affect a large area of the skin

• Take small and frequent meals.
• Avoid foods or smells that may make you feel nauseous, such as oily, fried, or strong-smelling food.
• Avoid tight-fitting clothes around the waist.
• Your doctor may prescribe medications to help relieve or prevent nausea or vomiting. Take these as instructed.

• Consume more fibre by eating more fruits and vegetables, unless otherwise advised by your doctor to limit the amount of fibre you can take.
• Drink enough fluids every day (at least 2 litres or 8 glasses) unless otherwise advised by your doctor.
• Your doctor may prescribe medications to help relieve or prevent constipation. Take these as instructed.

• Drink plenty of clear fluids (at least 2 litres or 8 glasses every day).
• Eat food that is gentler on the stomach such as porridge or soup.
• Avoid milk, dairy products, high-fibre food and oily or spicy food.
• Your doctor may prescribe medications to help relieve diarrhoea. Take these as instructed.
• Proceed to the A&E Department immediately if you have very bad diarrhoea (for example increase in bowel movement of more than 4 times per day) that does not improve even after taking medications for diarrhoea.

• You will be prescribed anti-viral meds to reduce risk of happening

• Inform your doctor if you develop painful skin rashes with blisters.

Hypersensitivity (allergic) reaction 

• Allergies are usually uncommon.
• This is usually mild or moderate, but rarely can be more severe.

• Inform the nurse immediately if you experience any of the following during the infusion:

  • Flu-like symptoms such as fever, chills or dizziness, feeling warm or flushed
  • Red, warm, and itchy bumps on the skin
  • Swelling of the lips, tongue or throat
  • Breathlessness, wheezing, cough or sudden difficulty breathing
  • Back pain or chest pain

   

• You may require tests to check how well your heart is working before, during and sometimes after treatment.
• Proceed to the A&E department immediately if you have
  • Increased shortness of breath or difficulty breathing
  • Tightness in your chest or chest pain
  • Unusually fast or irregular heartbeat 
  • Sudden swelling of legs

Liver problems

• Rarely, this medication can injure or damage the liver. A liver injury may recover on its own. However, in some cases, it can cause serious liver damage.

• Stop this medication and proceed to the A&E department immediately if you experience any:
  • Dark coloured urine
  • Llight-coloured stools
  • Yellowing of your skin or eyes
  • Nausea, vomiting that does not go away
  • Severe abdominal pain

Brain problems

This medication can cause Progressive Multifocal Leukoencephalopathy, which is a rare but serious viral infection of the brain. This can cause problems with brain function and symptoms can include: 

• Changes in your mood or usual behaviour
• Feeling confused or having difficulty thinking
• Memory loss
• Changes in your vision, speech, or walking
• Decreased strength or weakness on one side of the body
• This may occur within three months of stopping treatment. 

• Proceed to the A&E department immediately.