If you have a certain type of blood cancer that affects white blood cells, your doctor might suggest Velcade as a treatment option for you.
Velcade is a prescription medication that’s used in adults to treat:
The active ingredient in Velcade is bortezomib. This means that bortezomib is the ingredient that makes Velcade work. It belongs to a group of drugs called proteasome inhibitors.
Velcade comes as a powder, which a healthcare professional mixes with a liquid to make a solution. They’ll then give you the solution as an injection under your skin or into a vein.
This article describes the dosages of Velcade, as well as its strength and the drug is given. To learn more about Velcade, see this in-depth article.
Note: This article covers Velcade’s typical dosages and dosing schedules, which are provided by the drug’s manufacturer. But your doctor will prescribe the Velcade dosage that’s right for you.
The chart below summarizes Velcade’s basic dosage and schedules. You’ll find details in the “What is Velcade’s dosage?” section that follows.
|Velcade form||Velcade strength||Starting dosage||Dosing schedule for multiple myeloma||Dosing schedule for MCL|
|Powder in a vial that is mixed with a liquid to make a solution||3.5 milligrams (mg) per vial||1.3 mg per meters squared (mg/m2)||Cycles 1–4:
Twice weekly injection per 6-week treatment cycle. Injection on days 1, 4, 8, 11, 22, 25, 29, 32.
Twice weekly injection per 3-week treatment cycle. Injection on days 1, 4, 8, 11.
Below is information about Velcade dosages. The dosing schedule you have will depend on the condition that you’re using Velcade to treat.
What are the forms of Velcade?
Velcade is available as a powder in a vial. It’s mixed with liquid to form a solution that’s injected.
What strength does Velcade come in?
Velcade comes in a strength of 3.5 milligrams (mg) per vial. The final strength of the mixed solution differs, depending on whether you receive it as an injection under your skin or into a vein.
The strengths of Velcade are 2.5 mg per 1 milliliter (mL) for injections under your skin and 1 mg/1 mL for injections into a vein.
What are the typical dosages of Velcade?
The information below describes the Velcade dosages that are commonly used or recommended. (Note that the manufacturer doesn’t give a maximum dose for this drug.) Your doctor will determine the best dosage, dosing schedule, and type of injection to fit your needs.
Your doctor calculates your dosage of Velcade based on your body surface area. Velcade injections are given in cycles, depending on the type of blood cancer you have.
Dosage for multiple myeloma
The starting dosage of Velcade is 1.3 mg per meters squared (mg/m2). For multiple myeloma, you’ll receive the drug by injection under your skin or into a vein.
Velcade is typically given in nine treatment cycles, with each cycle being 6 weeks long. There must be at least 3 days between your Velcade injections. During the first 4 days of every cycle, you’ll most likely take two other drugs: Alkeran (melphalan) and Rayos (prednisone).
There are two phases of Velcade treatment for multiple myeloma. The first phase has twice-weekly dosing. The second phase has weekly dosing.
The first treatment phase has four 6-week cycles. In each cycle, you’ll receive two injections of Velcade per week for 2 weeks. Then you’ll have a 10-day rest period with no injections.
The second treatment phase has five 6-week cycles. In each cycle, you’ll receive one injection of Velcade per week for 2 weeks. Then you’ll have a 13-day rest period with no injections.
If you have relapsed multiple myeloma (symptoms of multiple myeloma returning after they’ve gone away for a while), your doctor may prescribe a different dosing schedule of Velcade.
Dosage for mantle cell lymphoma
The starting dose of Velcade is 1.3 mg/m2. For mantle cell lymphoma (MCL), you’ll receive the drug by injection into a vein.
Velcade is given in six treatment cycles that are 3 weeks long. There must be at least 3 days between injections. You’ll most likely receive four other drugs during treatment with Velcade: Rituxan (rituximab), cyclophosphamide, Doxil (doxorubicin), and Rayos (prednisone).
In each cycle, you’ll receive an injection of Velcade twice a week for 2 weeks. Then you’ll have a 10-day rest period with no injections. Your doctor may continue your MCL treatment after six cycles, depending on how you respond to Velcade.
If you have relapsed MCL (symptoms of MCL returning after they’ve gone away for a while), your doctor may prescribe a different dosing schedule of Velcade.
Is Velcade used long term?
Yes, Velcade is typically a long-term treatment. The length of treatment depends on the type of cancer you’re treating and how your body responds to Velcade. If you and your doctor determine that Velcade is safe and effective for you, it’s likely that you’ll use it long term.
Once you’ve completed your treatment schedule, your doctor may stop your Velcade treatment.
Your doctor might adjust your dosage of Velcade in the following situations:
- You have liver problems. If you have moderate or severe liver problems, your doctor might adjust your Velcade dosage.
- You’re taking certain other medications with Velcade. Certain medications can affect how Velcade works in your body. If you need to take such medications during Velcade treatment, your doctor may adjust your dosage of Velcade.
Below are some frequently asked questions about Velcade.
Is a 1.5-mg/m2 dose of Velcade ever given?
It’s possible to receive a dose of 1.5 milligrams per meters squared (mg/m2) for treating multiple myeloma.
The recommended starting dose for the blood cancers that the Food and Drug Administration (FDA) has approved this drug to treat is 1.3 mg/m2. (For more information, see the “What are the typical dosages of Velcade?” section above.)
But sometimes drugs are used for a purpose other than what they’re approved for by the FDA. This is called off-label use.
Using a Velcade dose of 1.5 mg/m2 together with cyclophosphamide and dexamethasone for the treatment of multiple myeloma is an off-label use. If your doctor determines that this dose is right for you, they may suggest an off-label dosage schedule for Velcade.
What is a maintenance dose? And does Velcade require one?
A maintenance dose is the amount of medication needed to maintain a certain level of the drug in your blood.
Velcade has a maintenance dosing schedule. That is, you’ll receive the drug at specific times in cycles to maintain certain levels of the drug in your blood. The Velcade maintenance dose is the same as the starting dose: 1.3 mg/m2.
If you have bothersome side effects or abnormal blood test results, your doctor may adjust your Velcade dose during maintenance dosing.
Is there a dose calculator for Velcade?
Your doctor will calculate the Velcade dosage that is right for you based on your body surface area (BSA). Body surface area is calculated in m2 using your height and weight.
The starting dose of Velcade is 1.3 mg/m2. This means that you’ll need 1.3 mg of the drug for every m2 of BSA. Your doctor will multiply your BSA by 1.3 to determine your dose.
The dosage of Velcade you’re prescribed may depend on several factors. These include:
- the type and severity of the condition you’re using Velcade to treat
- your body surface area
- other medications you’re taking
- other conditions you may have (see “Dosage adjustments” under “What is Velcade’s dosage?”)
You’ll receive Velcade as an injection under your skin or into a vein.
A healthcare professional will prepare your medication before giving you the injection. Velcade comes as a powder that they’ll mix with a liquid to form a solution.
For injections under your skin, the healthcare professional will typically give you the injection in your belly or thigh. For injections into a vein, they’ll likely choose a vein in your arm or hand.
If you miss an appointment for your Velcade injection, contact your doctor’s office right away to reschedule. Your doctor can advise you about how to get back on track with your Velcade dosing schedule.
If you need help remembering your appointments for your Velcade injections, try writing them down on a calendar. Or you can download a reminder app on your phone.
The sections above describe the typical dosages provided by the drug’s manufacturer. If your doctor recommends Velcade for you, they’ll prescribe the dosage that’s right for you. Talk with your doctor if you have questions or concerns about your current dosage.
Here are some examples of questions that you may want to ask your doctor:
- Will my dosage of change if I’m using Velcade for a relapse of multiple myeloma?
- Does my dosage of Velcade need to change if I have liver or kidney problems?
- Will my dosage schedule change if Velcade isn’t working well enough for me?
Will my dosing schedule for Velcade be different, depending on whether I receive injections under my skin or into a vein?
Your dosing schedule for Velcade won’t be different based on the way you receive the medication.
But the strength of Velcade will differ depending on the type of injection you have. Compared with the injection into a vein, the injection under the skin has a higher strength, so it uses less liquid. (For details, see “What strength does Velcade come in?” above.)
A healthcare professional will make sure you receive the correct strength of Velcade for your injections.
If you have questions about Velcade injections, you should talk with your doctor.
Dena Westphalen, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Disclaimer: Healinggeeks 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.
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