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Insurance Coverage and Payment Resources

Understanding health insurance and payment options for your treatment can be confusing. If you have no insurance or have a problem paying for VELCADE® (bortezomib), we may be able to help you find the resources to get the treatment you need.

Paying for VELCADE

When you or your healthcare provider call the VELCADE Reimbursement Assistance Program (VRAP), one of our dedicated Case Managers will be available to answer questions and provide helpful information. VRAP is available 8:00 am to 8:00 pm EST, Monday through Friday. Call 1-866-VELCADE (835-2233), option 2.

  • Dedicated Case Managers are available
  • Calls are accepted from patients, caregivers, physicians, and other healthcare practice professionals
  • Information can be mailed or faxed to patient or caregiver’s home or physician office

VRAP provides the following services:

  • Insurance verification
  • Payer policy research
  • Claim appeals support
  • Identification of alternative and supplemental insurance coverage options
  • Co-payment Foundation support information
  • Screening and enrollment of eligible patients into the Patient Assistance Program
    • If you have no insurance coverage for VELCADE, you may be eligible to participate in the Patient Assistance Program. If you qualify for the program, free VELCADE product will be delivered to your treating physician
  • Transportation resources

Common questions that patients ask our dedicated Case Managers:

  • Will my insurance cover treatment with VELCADE?
  • If I don’t have insurance, can anything be done to help me get my treatment with VELCADE?
  • What will my out-of-pocket payments be for my treatment?
  • If I am having difficulty paying my out-of-pocket costs, are there options that can help me?
  • My insurance plan denied a claim for VELCADE – can you help me?
  • Are there organizations that can provide more information on helping with financial challenges?

Medicare

The following section provides an overview of Medicare coverage, which includes: Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage or Medicare Managed Care), and Part D (Prescription Drug Coverage).

Each of these parts will describe the different components of Medicare and the costs associated with each of them.

Part A - Hospital Insurance
Medicare Part A is also known as hospital insurance. It helps cover inpatient care in hospitals, including critical access hospitals and skilled nursing facilities. It also helps cover hospice care and some home health care, but certain conditions must be met in order to get these benefits.

You usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working. However, if you aren’t eligible for premium-free Part A, you may be able to buy Part A if you meet the citizenship or residency requirements and the age requirements. There is a payment obligation once you are admitted to a hospital or a skilled nursing facility.

You can obtain additional information on Medicare Part A by going to www.Medicare.gov.
Part B - Medical Insurance
Medicare Part B (Medical Insurance) helps cover services provided by a doctor and outpatient care. It also covers some other medical services that are not covered under Part A such as physical and occupational therapy, home health care, and some preventative services. Infused drugs like VELCADE are also covered under the Part B benefit. These services and supplies must be considered medically necessary in order to be covered under Part B.

There are costs associated with having Part B Medicare. The monthly premium is automatically deducted from your Social Security check every month. If you don’t receive Social Security benefits, you will be billed for Part B. There is also an annual deductible of $162 that you must pay before Medicare begins to pay its share. Typically you will have a 20% co-insurance amount for services received under Part B. If you have a supplemental insurance plan for Medicare Part B, this plan may cover the deductible and/or the co-insurance amounts.

If you don’t already have a supplemental plan for Medicare Part B, you may consider purchasing a type of supplemental plan called a Medigap policy to help cover the co-insurance amounts. A Medigap policy is health insurance sold by private insurance companies to fill the "gaps" in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will pay both their shares of covered health care costs. Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay a premium to the Medigap insurance company, and the premium amounts will vary by company and by state.

You can obtain additional information on Medicare Part B by going to www.Medicare.gov.
Part C - Medicare Advantage or Medicare Managed Care
Medicare Advantage Plans are health plan options (like an HMO or PPO) approved by Medicare and offered by private companies. These plans are part of Medicare and are sometimes called "Part C" or "MA Plans." Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. Medicare Advantage Plans provide your Medicare health coverage and usually Medicare drug coverage. They are not supplemental insurance plans.

Medicare Advantage Plans provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. At a minimum, these plans must cover all of the services that Original Medicare covers. However, each Medicare Advantage Plan can charge different out-of-pocket costs. These are usually co-payments but there can also be co-insurance and deductibles. It’s important to call any plan before joining to find out the plan’s rules, what your costs will be, and to make sure the plan meets your needs.

In addition, Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (usually for an extra cost). Depending on the plan, you may need a referral to see specialists or you can only see doctors who belong to the plan or go to certain hospitals to get covered services.

In some plans, if you see a doctor or other provider who doesn’t contract or participate with the plan, your services may not be covered at all, or your costs will likely be higher. You should check with your doctors or hospital to find out if they accept the plan.

You can obtain additional information on Medicare Advantage Plans by going to www.Medicare.gov.
Part D - Prescription Drug Coverage
Medicare offers prescription drug coverage (Part D) for everyone with Medicare. To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and the drugs that are covered. It is important to choose a Medicare Prescription Drug Plan that meets your needs and that is compatible with your health coverage.

There are two ways to get Medicare prescription drug coverage:
  1. Medicare Prescription Drug Plans: These plans (sometimes called “PDPs”) add drug coverage to Original Medicare as well as some of the Medicare Cost Plans, Medicare Private Fee for Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
  2. Medicare Advantage Plans (like an HMO or PPO) or other Medicare health plans that offer Medicare prescription drug coverage. You get all of your Part A and Part B coverage, including prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called "MA-PDs." Please see the Part C section above for additional information on Medicare Advantage plans.
Exact coverage and costs for each plan will vary, but a standard level of service is expected to be provided by each plan. Standard out-of-pocket costs include the following:
  • Monthly premium — a monthly fee that varies by plan. You pay this in addition to the Part B premium
  • Yearly deductible — the amount you pay for your prescriptions before your plan begins to pay. Some drug plans charge no deductible
  • Co-payments or co-insurance — the amounts you pay for your prescriptions after the deductible. You pay your share, and your plan pays its share for covered drugs
  • Coverage gap — Most Medicare drug plans have a coverage gap. This means that after you and your plan have spent a certain amount of money for covered drugs, there is no coverage from your plan up to a limit ($6,447.50). The limit doesn’t include the drug plan’s premium, only covered Part D drug spending. Prior to 2011, you would have paid 100% of the cost within the coverage gap. Starting in 2011, eligible Medicare Part D beneficiaries whose spending on Part D prescription drugs enters them into the coverage gap will receive a 50% manufacturer discount on the total cost of brand-name drugs and a 7% government subsidy on the total cost of generic drugs within the coverage gap. Once you get out of the coverage gap, you are responsible for 5% of all prescription drug costs
Some plans offer coverage during the gap for generic drugs. However, plans with gap coverage may charge a higher monthly premium. Remember to check with the plan first to see if your drugs would be covered during the gap.

You can obtain additional information on Medicare Part D by going to www.Medicare.gov.

Privately Insured Coverage

Private payer or commercial payer coverage will vary by individual patient plan. However, most payers typically cover VELCADE for indications approved by the FDA and when it is considered medically necessary.

Depending on your insurance plan, you can receive treatment with VELCADE in the physician office or in a hospital outpatient setting. Most commercial payers cover VELCADE under their medical benefit, while a few have VELCADE as a part of their pharmacy benefit. Sometimes prior authorization or other medical documentation is required.

Since coverage varies by each patient’s plan, it’s a good idea to confirm coverage with your specific insurance plan before you start therapy.

The VELCADE Reimbursement Assistance Program (VRAP), 1-866-VELCADE (835-2233), option 2, accepts calls from patients, caregivers, physicians, and other healthcare practice professionals. We will talk with you to find out more about your needs and how we can help.

While most insurance plans cover and reimburse for VELCADE, there may be instances when the insurance has denied coverage. Alternatively, in some cases the insurance has paid its portion, but the remaining out-of-pocket treatment costs are high. Regardless of the situation, for some patients and their families, out-of-pocket treatment costs may create undue financial or emotional strain. If you are having financial difficulty during your treatment with VELCADE, VRAP provides free education and counseling to connect you with programs that can help cover the cost of co-payments and deductibles.

For instance, VRAP dedicated Case Managers can help by:

  • Investigating your insurance benefits and coverage options
  • Working with you and your healthcare provider to appeal a denied claim or denied prior authorization request
  • Referring you to foundations that can help offset your co-pay and other out-of-pocket medical expenses
  • Identifying alternative and supplemental insurance coverage options.

VRAP is easily accessed by calling 1-866-VELCADE and selecting option 2. Dedicated Case Managers are available from 8:00 am to 8:00 pm, EST.

If you need help with investigating insurance benefits, please have your insurance card available when you call.

Medicaid Coverage

State Medicaid programs typically cover VELCADE for indications approved by the FDA and when it is considered medically necessary. Each state, however, state will apply its own coverage and payment policies. This could include requirements for prior authorization. Depending on the state Medicaid policy, patients can receive treatment for VELCADE either in the physician office or hospital outpatient setting. Almost all Medicaid agencies cover VELCADE under their medical benefit, while a few have VELCADE as a part of their pharmacy benefit. In addition, some Medicaid plans may require prior authorization.

Since coverage varies from state to state, it’s a good idea to confirm coverage with your specific Medicaid plan before you begin therapy.

If you need help in learning more about your Medicaid coverage for VELCADE, the VELCADE Reimbursement Assistance Program (VRAP) dedicated Case Managers can help you by:

  • Investigating your insurance benefits and coverage options
  • Working with you and your healthcare provider to appeal a denied claim or denied prior authorization request

VRAP is easily accessed by calling 1-866-VELCADE and selecting option 2. Dedicated Case Managers are available from 8:00 am to 8:00 pm, EST.

The hotline accepts calls from patients, caregivers, physicians, and other healthcare practice professionals. We will talk with you to find out more about the patient’s needs and how we can help.

Uninsured or Underinsured

If You Have No Insurance:
VELCADE Reimbursement Assistance Program (VRAP) dedicated Case Managers can help you by researching alternative options for insurance and funding.

If you have no insurance coverage for VELCADE, you may be eligible to participate in the Patient Assistance Program. If you qualify for the program, free VELCADE product will be delivered to your treating physician.

Eligibility for the VELCADE Patient Assistance Program is based on several criteria, including such factors as:

  • Household income
  • Treatment setting
  • U.S. residency
  • Confirmation that VELCADE is prescribed for a use that is medically appropriate

VRAP is easily accessed by calling 1-866-VELCADE and selecting option 2. Dedicated Case Managers are available from 8:00 am to 8:00 pm, EST.

The hotline accepts calls from patients, caregivers, physicians, and other healthcare practice professionals. We will talk with you to find out more about the patient’s needs and how we can help.

If You Have Insufficient Insurance:
Sometimes, insufficient insurance coverage prevents a patient from receiving the physician’s treatment of choice. That could be due to limited coverage benefits or high out-of-pocket costs.

If that is the situation you face, VRAP dedicated Case Managers may help by:

  • Referring you to foundations that may be able to help offset your co-pay and other out-of-pocket medical expenses
  • Identifying alternative and supplemental insurance coverage options

VRAP is easily accessed by calling 1-866-VELCADE and selecting option 2. Dedicated Case Managers are available from 8:00 am to 8:00 pm, EST.

The hotline accepts calls from patients, caregivers, physicians, and other healthcare practice professionals. We will talk with you to find out more about the patient’s needs and how we can help.

Co-payment Resources

Co-payment foundations are available to help underinsured patients who cannot afford the costs associated with their drug coverage. They are non-profit organizations, and the monetary assistance will vary among the different foundations.

Co-payment Assistance Eligibility

Criteria for patient eligibility vary among co-payment foundations, but can include:

  • Specific disease states
  • Financial eligibility based on a percentage of federal poverty level
  • Type of insurance
  • U.S. citizenship/residency

Co-payment foundations that may be able to offer assistance for patients with multiple myeloma and relapsed mantle cell lymphoma include the following:

Patient Advocate Foundation
www.patientadvocate.org
Phone: (800) 532-5274

HealthWell Foundation
www.healthwellfoundation.org
Phone: (800) 675-8416

Patient Access Network Foundation
www.panfoundation.org
Phone: (866) 316-7263

Chronic Disease Fund
www.cdfund.org
Phone: (877) 968-7233

Leukemia and Lymphoma Society
www.lls.org
Phone: (800) 955-4572

The Assistance Fund
www.theassistancefund.org
Phone: (877) 245-4412

The dedicated Case Managers at the VELCADE Reimbursement Assistance Program (VRAP) can assist you through the application process for co-payment assistance by calling 1-866-VELCADE and selecting option 2 from 8:00 am to 8:00 pm, EST.

NEXT: Understanding the Coverage Process

Reimbursement

The process of paying for healthcare services, supplies, and medications. Insurance plans, the government, and patients reimburse healthcare providers and pharmacies for the services and products they provide

Co-Payment

Fixed amount of money a patient is responsible for at each doctor’s visit, at the hospital or emergency room, or when a prescription is filled at a pharmacy (i.e. $10, $20, etc.). Amounts defined by the patient’s insurance benefit structure.

Medicare

Government program that provides insurance coverage to elderly individuals and individuals in several other eligibility categories. Medicare is a federal program.

Medicare Advantage

Health plan options (like an HMO or PPO) approved by Medicare and offered by private companies. Medicare Advantage plans are an alternative to Medicare Part A and Part B. Their benefits must be, at a minimum, what conventional Medicare covers. They may provide additional benefits beyond those offered by conventional Medicare. Also referred to as “Medicare Part C.”

Medically Necessary

Term used by payers to determine if procedures, drugs, or other healthcare services are necessary given your medical condition and diagnosis

Deductible

The amount that a patient must pay of his/her medical expenses before insurance benefits are applied, typically calculated on an annual basis. Amounts defined by a patient’s insurance benefit structure.

Co-Insurance

Percent of the allowable charges a patient is responsible for (i.e. 15%, 20%, etc.), as defined in the patient’s insurance benefit structure

Medigap

Health insurance sold by a private company to help Medicare Part A and Medicare Part B patients pay for their out-of-pocket expenses. Also referred to as “supplemental insurance.”

Prescription Drug Plan (PDP)

Health plan options (like an HMO or PPO) approved by Medicare and offered by private companies to provide Medicare beneficiaries with prescription drug coverage. Can be offered as a stand-alone product, or can be incorporated into a Medicare Advantage plan. All Medicare beneficiaries who elect to have prescription drug coverage must select a PDP. Medicare does not offer the Part D benefit directly.

Coverage Gap

Applies to the Medicare Part D (prescription drug) benefit wherein the beneficiary is responsible for 100% of the costs of the covered Part D drug prescriptions he/she fills. The coverage gap takes effect when total spending in a calendar year on covered Part D drugs reaches $2,700 and ends when the total reaches $6,153.75, equating to a total out-of-pocket expense of $3,453.75 while the beneficiary is in the coverage gap. The coverage gap only applies to covered Medicare Part D drugs (i.e. prescriptions filled at the pharmacy) and not to Medicare Part B drugs (i.e. drugs administered intravenously in a physician’s office).

Privately Insured Coverage

Privately funded health insurance options (like a HMO or PPO), commonly obtained via employment or through individual purchase. Medicare Advantage plans and PDPs are not considered privately insured coverage, as these types of plans are funded by the government.

Prior Authorization

Approval required from an insurance company or Medicare before certain procedures, drugs, or other healthcare services are provided in order for the company or Medicare to pay the subsequent claim(s)


Important Safety Information

What is VELCADE® (bortezomib) used for?

VELCADE is approved for the treatment of patients with multiple myeloma (a cancer of the plasma cells). VELCADE is also approved for the treatment of patients with mantle cell lymphoma (a cancer of the lymph nodes) who have already received other treatments.

How is VELCADE administered?

VELCADE is prescribed by a physician experienced in the use of medications to treat cancer. It is administered by a healthcare professional as an injection into your vein (intravenously, or IV) or under your skin (subcutaneously). VELCADE must not be administered into your spinal fluid (intrathecally).

Who should not receive VELCADE?

Before you receive treatment with VELCADE, tell your doctor about all of your medical conditions. You should not receive VELCADE if you are allergic to bortezomib, boron, or mannitol.

What are the possible side effects of VELCADE?

VELCADE can cause serious side effects, including:

  • Peripheral neuropathy. VELCADE can cause damage to the nerves, a condition called peripheral neuropathy. You may feel muscle weakness, tingling, burning, pain, and loss of feeling in your hands and feet, any of which can be severe. Tell your doctor if you notice any of these symptoms. Your doctor may change the dose and/or schedule of VELCADE, or stop it altogether. If you have peripheral neuropathy before starting VELCADE, your doctor could consider giving you VELCADE subcutaneously.
  • Low blood pressure. VELCADE can cause a drop in blood pressure. Tell your doctor if you have low blood pressure, feel dizzy, or feel as though you might faint. If you are taking drugs that lower blood pressure, your medications might need to be adjusted. If you are not drinking enough liquids, your doctor may need to administer IV fluids.
  • Heart problems. Treatment with VELCADE can cause or worsen heart rhythm problems and heart failure. Your doctor may closely monitor you if you have, or are at risk for, heart disease. Tell your doctor if you experience chest pressure or pain, palpitations, swelling of your ankles or feet, or shortness of breath.
  • Lung disorders. There have been reports of lung disorders in patients receiving VELCADE. Some of these events have been fatal. Tell your doctor if you experience any cough, shortness of breath, wheezing, or difficulty breathing.
  • Liver disease. If you have liver problems, it can be harder for your body to get rid of VELCADE. VELCADE has caused sudden liver failure in patients who were taking many medications or had other serious medical conditions. Symptoms of liver problems include a yellow discoloration of the eyes and skin (jaundice) and changes in liver enzymes measured in blood tests. Your doctor will closely monitor you if you have liver disease. In patients with moderate or severe liver disease, VELCADE should be started at a lower dose. Additional dose adjustments may be made based on your tolerance of the drug.
  • Gastrointestinal problems. VELCADE treatment can cause nausea, vomiting, diarrhea, and constipation. If your symptoms are severe, your doctor may recommend IV fluids and/or medications.
  • Neutropenia (low levels of neutrophils, a type of white blood cell) and thrombocytopenia (low levels of platelets). VELCADE can cause low levels of white blood cells (infection-fighting cells) and/or platelets (clot-forming cells). You will have regular blood tests to check your cell counts during your treatment with VELCADE. If the number of these cells is very low, your doctor may change the dose and/or schedule of VELCADE. If your white blood cells become low, you can be at higher risk for infections. Tell your doctor if you develop a fever or believe you have an infection. If platelets become very low, there is an increased risk of bleeding. Your doctor may recommend a platelet transfusion. There have been cases of bleeding in the stomach, bowels, and brain during treatment with VELCADE.
  • Tumor lysis syndrome (TLS). TLS can occur with cancer treatments, and your doctor will be monitoring your blood and urine for any signs of this syndrome. If you develop TLS, your doctor will take appropriate steps to treat it.
  • Reversible posterior leukoencephalopathy syndrome (RPLS). There have been reports of a rare, reversible condition involving the brain, called RPLS, in patients treated with VELCADE. Patients with RPLS can have seizures, high blood pressure, headaches, tiredness, confusion, blindness, or other vision problems. Treatment with VELCADE should be stopped in cases of RPLS.

More than 30% of patients receiving VELCADE have experienced the following side effects: thrombocytopenia, neutropenia, nausea, peripheral neuropathy, neuralgia (nerve pain), pyrexia (fever), diarrhea, anemia, leukopenia (low levels of white blood cells), decreased appetite, fatigue, constipation, vomiting, dehydration, dyspnea (difficulty breathing), cough, asthenia (low energy), insomnia (trouble sleeping), peripheral edema (swelling of the limbs), and headache.

What other information should you discuss with your doctor?

Women should avoid becoming pregnant or breastfeeding while being treated with VELCADE. Discuss with your doctor when it is safe to restart breastfeeding after finishing your treatment.

You should also tell your doctor if you:

  • Have kidney disease. If you are on dialysis, your doctor will administer VELCADE after the dialysis procedure.
  • Are taking medication for diabetes. VELCADE can affect your blood glucose levels. Your doctor may require close monitoring of your blood glucose levels and change the dose of your diabetes medicine while you are being treated with VELCADE.
  • Have liver disease.
  • Are using medicines like ketoconazole (an antifungal), ritonavir (an antiviral), and rifampin (an antibiotic), which will require close monitoring during treatment with VELCADE.
  • Are using any other medications (including over-the-counter drugs), herbal or dietary supplements, or holistic treatments. St. John’s Wort should be avoided.
  • Develop a rash of any type while receiving VELCADE.

The side effects of VELCADE may impair your ability to drive or operate machinery.

These are not all of the possible side effects with VELCADE. It is important to always contact your doctor if you experience any side effects while on VELCADE. If you have any questions about VELCADE, contact your doctor.

Please click here for the full Prescribing Information for VELCADE, including Warnings and Precautions.

Page last updated 1/23/2012

Learn what to expect from treatment with VELCADE.
Important Safety Information
What is VELCADE® (bortezomib) used for?

VELCADE is approved for the treatment of patients with multiple myeloma (a cancer of the plasma cells). VELCADE is also approved for the treatment of patients with mantle cell lymphoma (a cancer of the lymph nodes) who have already received other treatments.

How is VELCADE administered?

VELCADE is prescribed by a physician experienced in the use of medications to treat cancer. It is administered by a healthcare professional as an injection into your vein (intravenously, or IV) or under your skin (subcutaneously). VELCADE must not be administered into your spinal fluid (intrathecally).

Who should not receive VELCADE?

Before you receive treatment with VELCADE, tell your doctor about all of your medical conditions. You should not receive VELCADE if you are allergic to bortezomib, boron, or mannitol.

What are the possible side effects of VELCADE?

VELCADE can cause serious side effects, including:

  • Peripheral neuropathy. VELCADE can cause damage to the nerves, a condition called peripheral neuropathy. You may feel muscle weakness, tingling, burning, pain, and loss of feeling in your hands and feet, any of which can be severe. Tell your doctor if you notice any of these symptoms. Your doctor may change the dose and/or schedule of VELCADE, or stop it altogether. If you have peripheral neuropathy before starting VELCADE, your doctor could consider giving you VELCADE subcutaneously.
  • Low blood pressure. VELCADE can cause a drop in blood pressure. Tell your doctor if you have low blood pressure, feel dizzy, or feel as though you might faint. If you are taking drugs that lower blood pressure, your medications might need to be adjusted. If you are not drinking enough liquids, your doctor may need to administer IV fluids.
  • Heart problems. Treatment with VELCADE can cause or worsen heart rhythm problems and heart failure. Your doctor may closely monitor you if you have, or are at risk for, heart disease. Tell your doctor if you experience chest pressure or pain, palpitations, swelling of your ankles or feet, or shortness of breath.
  • Lung disorders. There have been reports of lung disorders in patients receiving VELCADE. Some of these events have been fatal. Tell your doctor if you experience any cough, shortness of breath, wheezing, or difficulty breathing.
  • Liver disease. If you have liver problems, it can be harder for your body to get rid of VELCADE. VELCADE has caused sudden liver failure in patients who were taking many medications or had other serious medical conditions. Symptoms of liver problems include a yellow discoloration of the eyes and skin (jaundice) and changes in liver enzymes measured in blood tests. Your doctor will closely monitor you if you have liver disease. In patients with moderate or severe liver disease, VELCADE should be started at a lower dose. Additional dose adjustments may be made based on your tolerance of the drug.
  • Gastrointestinal problems. VELCADE treatment can cause nausea, vomiting, diarrhea, and constipation. If your symptoms are severe, your doctor may recommend IV fluids and/or medications.
  • Neutropenia (low levels of neutrophils, a type of white blood cell) and thrombocytopenia (low levels of platelets). VELCADE can cause low levels of white blood cells (infection-fighting cells) and/or platelets (clot-forming cells). You will have regular blood tests to check your cell counts during your treatment with VELCADE. If the number of these cells is very low, your doctor may change the dose and/or schedule of VELCADE. If your white blood cells become low, you can be at higher risk for infections. Tell your doctor if you develop a fever or believe you have an infection. If platelets become very low, there is an increased risk of bleeding. Your doctor may recommend a platelet transfusion. There have been cases of bleeding in the stomach, bowels, and brain during treatment with VELCADE.
  • Tumor lysis syndrome (TLS). TLS can occur with cancer treatments, and your doctor will be monitoring your blood and urine for any signs of this syndrome. If you develop TLS, your doctor will take appropriate steps to treat it.
  • Reversible posterior leukoencephalopathy syndrome (RPLS). There have been reports of a rare, reversible condition involving the brain, called RPLS, in patients treated with VELCADE. Patients with RPLS can have seizures, high blood pressure, headaches, tiredness, confusion, blindness, or other vision problems. Treatment with VELCADE should be stopped in cases of RPLS.

More than 30% of patients receiving VELCADE have experienced the following side effects: thrombocytopenia, neutropenia, nausea, peripheral neuropathy, neuralgia (nerve pain), pyrexia (fever), diarrhea, anemia, leukopenia (low levels of white blood cells), decreased appetite, fatigue, constipation, vomiting, dehydration, dyspnea (difficulty breathing), cough, asthenia (low energy), insomnia (trouble sleeping), peripheral edema (swelling of the limbs), and headache.

What other information should you discuss with your doctor?

Women should avoid becoming pregnant or breastfeeding while being treated with VELCADE. Discuss with your doctor when it is safe to restart breastfeeding after finishing your treatment.

You should also tell your doctor if you:

  • Have kidney disease. If you are on dialysis, your doctor will administer VELCADE after the dialysis procedure.
  • Are taking medication for diabetes. VELCADE can affect your blood glucose levels. Your doctor may require close monitoring of your blood glucose levels and change the dose of your diabetes medicine while you are being treated with VELCADE.
  • Have liver disease.
  • Are using medicines like ketoconazole (an antifungal), ritonavir (an antiviral), and rifampin (an antibiotic), which will require close monitoring during treatment with VELCADE.
  • Are using any other medications (including over-the-counter drugs), herbal or dietary supplements, or holistic treatments. St. John’s Wort should be avoided.
  • Develop a rash of any type while receiving VELCADE.

The side effects of VELCADE may impair your ability to drive or operate machinery.

These are not all of the possible side effects with VELCADE. It is important to always contact your doctor if you experience any side effects while on VELCADE. If you have any questions about VELCADE, contact your doctor.

Please click here for the full Prescribing Information for VELCADE, including Warnings and Precautions.