Boruzu (Bortezomib) for Multiple Myeloma

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Boruzu (bortezomib) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults with multiple myeloma.

What Members Say

MHT logo These insights are based on 197 comments about Boruzu from MyMyelomaTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Lab numbers often improve during treatment, sometimes leading to remission or pre-remission.
Bone pain and anemia symptoms sometimes ease as treatment starts working.
Subcutaneous shots are part of many treatment plans and can be quick to receive.
Dose changes or schedule adjustments can help manage side effects during treatment.
Maintenance dosing schedules can feel more manageable after initial treatment cycles.

Considerations:

Peripheral neuropathy in the feet is a frequent concern and can worsen over time.
Diarrhea, constipation, nausea, and vomiting can interrupt daily routines.
Fatigue and weakness can be significant, especially around treatment days.
Low blood counts can require close monitoring, treatment pauses, or dose reductions.
Treatment often involves repeated injections, lab checks, and ongoing clinic visits.

How Boruzu Works and How It’s Taken

Boruzu is a type of proteasome inhibitor that works by blocking the 26S proteasome, a cell system that breaks down unwanted proteins. In myeloma, this blockage causes a buildup of proteins, which can disrupt cancerous myeloma cells and lead to cancer cell death.

Doctors prescribe Boruzu for adults with multiple myeloma.

Boruzu is given as an injection, typically on a repeating schedule over several weeks. It may be given intravenously (into a vein) or subcutaneously (under the skin) in a clinic or treatment setting.

Typical Dosing for Multiple Myeloma

The recommended starting dose for multiple myeloma is 1.3 milligrams per square meter of body surface area (a standard calculation based on height and weight used by healthcare providers to determine dosing). For previously untreated disease, it is given with melphalan and prednisone for nine six-week treatment cycles, usually twice weekly in cycles 1 through 4, then once weekly in cycles 5 through 9.

For relapsed multiple myeloma, extended treatment after more than eight cycles may use a maintenance schedule. This schedule is once weekly on days 1, 8, 15, and 22, followed by a 13-day rest period.

Doctors may pause treatment or lower the dose if side effects occur, including nerve problems. This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Boruzu

These insights are based on 197 comments about Boruzu from MyMyelomaTeam members.

Members who use Boruzu often talk about watching closely for side effects, keeping up with lab work, and staying in touch with their oncology team when something changes. Many also describe practical ways they got through treatment, from adjusting routines to asking about dose changes when side effects became hard to manage.

1

Talk to your doctor about dose changes for side effects.
“There is wiggle room with doses to manage side effects without loss of ground."
2

Watch for neuropathy and tell your doctor early.
“The only notable side effect from that was a ‘vibration’ in my feet, which was the beginning of neuropathy.”
3

Use simple strategies for stomach side effects.
“The only side effect I had was a little constipation, which was fixed with a stool softener taken before bed each night.”

Connect with others who understand life with multiple myeloma. Join MyMyelomaTeam for free.

Boruzu Side Effects

In clinical studies of Boruzu for adults with multiple myeloma, the most common side effects happened in between 7 percent and 52 percent of people. These side effects were reported in studies of people who were newly diagnosed and in people whose multiple myeloma had come back after treatment. Your experience can vary based on your treatment plan and other health conditions.

Common side effects include:

Nausea
Diarrhea
Low blood platelet count, which can raise bleeding risk
Low neutrophil count, which can raise infection risk
Peripheral neuropathy (numbness, tingling, or pain, usually in the hands or feet)
Fatigue
Nerve pain
Low red blood cell count, which can cause tiredness or shortness of breath
Low white blood cell count, which can raise infection risk
Constipation
Vomiting
Low lymphocyte count, which can raise infection risk
Rash
Fever
Decreased appetite

Serious Side Effects and Warnings

Boruzu can cause serious side effects that may require immediate medical attention. These include:

Severe peripheral neuropathy — Serious nerve damage can affect feeling or movement.
Low blood pressure — This can cause dizziness, lightheadedness, or fainting.
Heart problems — These might include new or worsening heart failure or reduced heart-pumping function.
Serious lung problems — These include acute respiratory distress syndrome, pneumonitis, interstitial pneumonia, lung infiltration, or pulmonary hypertension.
Posterior reversible encephalopathy syndrome — PRES is a rare brain condition that can cause headache, confusion, vision changes, high blood pressure, or seizures.
Severe gastrointestinal problems — These include severe nausea, vomiting, diarrhea, constipation, or ileus, which is when the intestines slow down or stop moving.
Low blood counts, including low platelets and low neutrophils — Low platelets can raise bleeding risk, and low neutrophils can raise infection risk.
Tumor lysis syndrome — This rapid breakdown of cancer cells can harm the kidneys and other organs.
Severe liver problems — These include acute liver failure, hepatitis, high liver enzymes, or high bilirubin.
Thrombotic microangiopathy — This includes TTP/HUS, a rare blood vessel and blood-clotting condition that can damage organs.
Serious infections — These include progressive multifocal leukoencephalopathy (PML) and herpes virus infections affecting the eyes or brain.
Severe skin reactions — These include Stevens-Johnson syndrome or toxic epidermal necrolysis.
Severe allergic reactions — This includes anaphylaxis.
Embryo-fetal toxicity — This medication may harm a fetus if used during pregnancy.

Get medical help right away if you think you are having a serious reaction to Boruzu.

How To Save on Boruzu

Amneal Pharmaceuticals, the manufacturer of Boruzu, offers the Amneal PATHways Patient Support Program. Eligible people with commercial insurance may pay as little as $0 per treatment with Boruzu through the program.

The program also offers help from specialists who can explain benefits and insurance coverage, connect you with cost-savings assistance, and share program updates as they occur. To learn more, visit Boruzu reimbursement and support or call 866-426-6325.

What To Know Before Taking Boruzu

Tell your doctor if you have any allergies to bortezomib, boron, or mannitol.

Tell your doctor about all medications you take, including prescription drugs, over-the-counter medicines, and supplements.

Also let your doctor know if you have had nerve problems, such as numbness, pain, burning, tingling, or weakness in your hands or feet.

Do not take Boruzu if you have had a serious allergic reaction to bortezomib, boron, or mannitol. Do not receive Boruzu into the spinal canal, also called intrathecal use.

Boruzu is also FDA approved to treat adults with mantle cell lymphoma.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Boruzu, talk with your doctor about the risks and benefits. Boruzu can harm a fetus.

If you can become pregnant, you will need a pregnancy test before starting Boruzu, and you should use effective birth control during treatment and for seven months after your last dose. If you have a sexual partner who can become pregnant, you should use effective birth control during treatment and for four months after the last dose. Do not breastfeed during treatment and for two months after treatment ends.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Boruzu?

In a study of people with previously untreated multiple myeloma, bortezomib combined with melphalan and prednisone was compared with melphalan and prednisone alone. The median time until disease progression was 20.7 months with the bortezomib combination and 15 months with melphalan and prednisone. The response rate was 69 percent with the bortezomib combination versus 34 percent with melphalan and prednisone.

In an updated analysis, median overall survival was 56.4 months with the bortezomib combination and 43.1 months with melphalan and prednisone. Bortezomib may be most commonly used in combination with other agents such as lenalidomide, daratumumab, cyclophosphamide, and dexamethasone. Different regimens with bortezomib in newly diagnosed patients have shown response rates between 70 percent and 87.9 percent.

Can Boruzu cause nerve problems in people with multiple myeloma?

Yes. Bortezomib can cause peripheral neuropathy, which is nerve damage that is usually sensory but can also be severe and affect movement. The occurrence of nerve damage may differ based on how Boruzu is administered, subcutaneously or with an IV.

In a relapsed multiple myeloma study, grade 2 or higher peripheral neuropathy happened in 24 percent of people who got bortezomib under the skin and 39 percent of those who got it by IV, while grade 3 or higher neuropathy happened in 6 percent and 15 percent, respectively.

Report new or worsening numbness, tingling, pain, or weakness to your doctors. You may need to change your dose or stop treatment depending on the severity of your symptoms.

What tests or monitoring are needed with Boruzu for multiple myeloma?

Blood counts should be checked often during treatment. Platelet counts should be measured before each dose, and complete blood counts should be reviewed frequently. Liver function should be tested, since people with moderate or severe liver impairment may need a lower starting dose. People with risk factors for heart problems should be monitored closely, and those with diabetes who take oral diabetes medicines may need close blood sugar monitoring.