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Date issued: June 2021

Review date: June 2023 

Ref: F-60

PDF:  How to self administer Bortezomib velcade final June 2021.pdf [pdf] 273KB

Contact numbers:

When feeling unwell or if you have a question please contact the numbers below.

If unwell please call: 01752 432680

(Available Monday to Friday 8.30am-6.30pm)

Birch Day Case: 01752 432674 (Birch Reception) or 01752 432678 (Nurses Station)

(For general enquiries Monday to Friday 08.30-6.30pm)

Bracken Ward: 01752 432494

(If unwell and for advice overnight and weekends)

Information for patients, their families and carers

This is an information booklet to help you and your family understand how to safely self-administer Bortezomib/Velcade.  It also covers how to dispose of the waste, potential side effects and how to contact the haematology unit if you have any issues or queries.  It will supplement the information given to you by your doctors, nurse specialist and ward nurses.

You will also be given an information sheet from Macmillan giving details of your specific regime and drugs.

Advantages of self-administration at home

Administering your own injections at home will mean less visits to the hospital for your treatment.  You will still need to attend the hospital for appointments, blood tests and reviews as required by your treatment regimen.

Your chemotherapy nurse will teach you how to prepare the equipment and how to give yourself the injection.  A designated competent member of your family or carer can also be trained to administer the injections.  You will be able to practise this with the chemotherapy nurse before deciding whether you want to go ahead with injecting yourself.

Before You Start

• Make sure you are giving yourself the Bortezomib on the day it is due: check your medication record sheet for your dosing schedule.  It is important to stick to your treatment schedule.

• If you have a high or low temperature or are feeling unwell do not give yourself the Bortezomib injection.  You must contact Birch or Bracken Ward and speak to a nurse or doctor first.

• If you have any new or worsening side effects, especially peripheral neuropathy symptoms (see P12 for details) bleeding or bruising, infection and/or a raised or lowered temperature, do not give yourself the Bortezomib injection.  You must contact Birch or Bracken and speak to a healthcare professional first.

How to administer Bortezomib/Velcade

Step 1:

Wash your hands thoroughly:

1. Wet your hands with running water, either warm or cold.

2. Apply liquid, bar or powder soap.

3. Lather well. Rub your hands vigorously for at least 15 seconds.

4. Rinse well.

5. Dry your hands with a clean or disposable towel or air dryer.

Step 2:

Collect all your equipment needed

• Syringe (take out of fridge 30 mins in advance)

• Clean surface or tray for equipment

• Needle

• Gauze swab

• Gloves

• Chemotherapy apron if family member or carer is administering the injection

• Purple lidded sharps bin close by

Check the details on the label have YOUR NAME on it.

Also check the injection has not passed the expiry date.

• Use the diagram above to help you choose the area you are going to inject.

• Alternate between your right and left abdomen and your right and left thigh.

• Remove the cap from the syringe and dispose of it in the purple lidded sharps bin.

• Attach the orange needle by twisting firmly onto the syringe.

• Get ready to inject yourself by pinching some skin and fatty tissue between your thumb and forefingers of your  opposite hand.

• Holding the syringe like a pen (in your dominant hand) flip the cover off the needle.

• Push the needle straight into the pinched skin at a 90 degree angle.

• Inject the Bortezomib solution slowly into the fatty tissue until the syringe plunger can go no further down the barrel.

• Keeping hold of the fatty tissue, remove the needle and release your grip.

• Flip the protective cover over the needle, then dispose of the syringe straight into the sharps bin.  Do not detach the needle from the syringe.

• If any fluid or blood leaks from the injection site press the area lightly with gauze for 10 seconds. Dispose of the gauze in the sharps bin.

• Wash your hands again.

Step 4:

Dispose of the syringe and needle in the purple lidded sharps bin provided to you. Store the chemotherapy bins securely and out of reach of children or animals. Do not overfill the bin. When it is about three quarters full, close it securely and return to Birch Unit. Details of how to do this will be given to you by your nurse.

Replacement bins can be obtained from the haematology unit.

Frequently asked questions

What is Bortezomib subcutaneous injection?

Bortezomib is a chemotherapy drug used to treat multiple myeloma.  It is given as a subcutaneous injection under the skin.  It can be used on its own or given with other chemotherapy drugs.

Bortezomib is usually given once or twice a week depending on your individual regimen.

How will I be reviewed and monitored?

If you would like to administer Bortezomib at home, you will be assessed and instructed on the process going forward.

You will continue to have a review by the myeloma Consultant in clinic at the end of each cycle of treatment. 

Each week you will be required to have a blood test and a telephone consultation with a trained healthcare professional before administering your injection. 

If you become unwell or experience problems outside of these times it is essential that you report these to us immediately.

Possible Side Effects

It is very important if you feel unwell to contact the haematology day case or ward. The telephone numbers are listed at the front of this booklet. Do not administer the Bortezomib if you experience any of the following symptoms.

Infections or a raised temperature

Your immune system can be reduced with Bortezomib and makes you vulnerable to infections.

Signs of an infection include:

• A temperature of 37.5°C or above or below 36°C

• Feeling unwell

• Feeling shivery, cough, diarrhoea or passing urine frequently

Bruising and bleeding

Bortezomib can reduce the number of platelets in your blood.  Platelets help your blood clot.  If these are low you may have symptoms of nosebleeds, bleeding gums, bruising of the skin or red blood spots on your skin.  If you have any of these symptoms do not administer the bortezomib and contact the haematology department.

Peripheral Neuropathy

Bortezomib can cause a condition called peripheral neuropathy where the nerves are affected in your hands and feet.  You may have numbness, tingling or a burning sensation.  You may find it difficult to do certain tasks like buttoning your clothes or holding some objects.

We will monitor this each time you come to clinic but it is important that you notify us of any changes or deteriation with this symptom.  Peripheral neuropathy symptoms can continue even after treatment has stopped.

Supply and Storage of Bortezomib

Bortezomib subcutaneously injections will be provided on an individual named patient basis with one prefilled syringe per dose. The syringe will be clearly marked with the patient’s name and expiry date.

The pharmacy department will dispense the Bortezomib subcutaneous injections for self-administration and deliver them to the Haematology Day Case Unit for collection by the patient or carer. All other equipment and consumables will be provided by Haematology Day Case Unit.

Patients should provide a rigid plastic container (approximate size 15cm x 15cm x 15cm) to transport and store Bortezomib subcutaneous injections.

The Bortezomib injections must be stored in the fridge. They must be kept separate from food and other items and out of reach of children.

Who can administer and handle the Bortezomib injections?

Bortezomib is cytotoxic and hazardous to humans and animals.  Bortezomib syringes and all waste should be kept out of reach of children and animals and pregnant or breastfeeding mothers.

Bortezomib injections should only be handled at home by you or a designated family member or carer.  Always wear gloves when administering the injections.  The designated person should also wear a chemotherapy apron.

Storage at home

The Bortezomib syringes must be stored in the fridge and kept in the sealed outer packaging. Place separately in a plastic container with a lid to avoid contamination with other fridge items. Do not unpack them until immediately before use.

Do not use the syringes if:

• There has been a power cut

• Problems with the fridge temperature

• You notice frozen solution in the syringe

• The solution inside the syringes is cloudy, has changed colour or contains visible particles in it.  The solution should be clear.

Sharps injury

If you or anyone accidently punctures their skin with the needle, encourage the puncture site to bleed by running it under warm water.  Wash the wound and cover it and contact the haematology department.

Spillage

You will be given a small Cytotoxic Spillage Kit which can be used in the event of an accidental spillage of Bortezomib.

If you get any Bortezomib on your skin, wash the skin under plenty of cool water for 10 minutes.  Do not scrub the skin.

If the Bortezomib gets into the eyes, wash them with plenty of cool water for 10 minutes.  Please contact the haematology department for advice as you will need to be seen by a specialist.

In the case of spillage onto a hard surface keep pets or other people out of the contaminated area.  Try to clean up the spillage yourself to avoid others being exposed to the chemotherapy.

Open the spill kit and follow the instructions on the packet.  You will need to wear the protective equipment provided and soak up any spilled liquid with the absorbent towels in the kit.  Wash the area after with plain water.  All waste will need to be returned to the hospital on your next visit.