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Bortezomib side effects: what 88,896 FDA adverse event reports show

Bortezomib · 1,232 reaction terms · 250,859 drug–reaction co-reports · data 2026-09-14
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Drug class

Proteasome Inhibitor

FDA label (Established Pharmacologic Class)

Who reports

88,896 reports · 84% serious · 14,068 with death outcome · 45% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Bortezomib for Injection is a proteasome inhibitor indicated for: treatment of adult patients with multiple myeloma ( 1.1 ) treatment of adult patients with mantle cell lymphoma ( 1.2 ) 1.1 Multiple Myeloma Bortezomib for Injection is indicated for the treatment of adult patients with multiple myeloma.

FDA label, Indications and Usage

What it is

Bortezomib for Injection, a proteasome inhibitor, contains bortezomib which is an antineoplastic agent. Bortezomib is a modified dipeptidyl boronic acid.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 6Labeled (related wording) 6Likely indication confounding 6Lab value / disease marker 2Not in label — unassessed 20
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,192 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Plasma cell myeloma refractory744322.3
288.4–360.1ROR 325.0 · calibrated p 5e-12 ✓
134.9 EB05 127.0 · IC025 +6.8
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=743 · 95% cliniciannot reported in cached trials
Plasma cell myeloma recurrent1,265149.4
139.3–160.3ROR 151.5 · calibrated p 4e-9 ✓
91.1 EB05 87.0 · IC025 +6.4
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=1,227not reported in cached trials
Leukaemia plasmacytic57125.8
91.1–173.7ROR 125.9 · calibrated p 4e-8 ✓
79.8 EB05 63.9 · IC025 +5.1
3/3 methods agree
Not in label — unassessedserious n=57 · 100% cliniciannot reported in cached trials
Plasma cell leukaemia205123.1
103.9–145.8ROR 123.4 · calibrated p 3e-8 ✓
80.1 EB05 71.4 · IC025 +5.8
3/3 methods agree
Not in label — unassessedserious n=205 · 93% cliniciannot reported in cached trials
Plasmacytoma49383.9
75.7–93.0ROR 84.4 · calibrated p 4e-7 ✓
61.7 EB05 57.3 · IC025 +5.7
3/3 methods agree
Not in label — unassessedserious n=483not reported in cached trials
Blood stem cell harvest failure3880.8
55.8–116.9ROR 80.8 · calibrated p 1e-6 ✓
58.5 EB05 44.5 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=37 · 100% cliniciannot reported in cached trials
Plasma cell myeloma9,11771.7
70.1–73.3ROR 79.8 · calibrated p 6e-7 ✓
55.0 EB05 54.0 · IC025 +5.7
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
age-adj. PRR 52.8 · serious PRR 39.4 · 92% cliniciannot reported in cached trials
Light chain disease3471.0
48.3–104.2ROR 71.0 · calibrated p 3e-6 ✓
53.0 EB05 39.7 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=34 · ♀ 0% (drug 45%) · 100% cliniciannot reported in cached trials
Hyperviscosity syndrome6466.8
50.6–88.2ROR 66.9 · calibrated p 3e-6 ✓
51.3 EB05 41.6 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=64 · 100% cliniciannot reported in cached trials
Autonomic neuropathy18151.2
43.6–60.1ROR 51.3 · calibrated p 1e-5 ✓
41.9 EB05 37.0 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious n=180 · 91% cliniciannot reported in cached trials
Monoclonal immunoglobulin increased4949.4
36.3–67.2ROR 49.4 · calibrated p 2e-5 ✓
40.3 EB05 31.7 · IC025 +4.4
3/3 methods agree
Lab value / disease markerserious n=38not reported in cached trials
Light chain analysis increased17749.1
41.7–57.7ROR 49.2 · calibrated p 2e-5 ✓
40.5 EB05 35.7 · IC025 +4.9
3/3 methods agree
Not in label — unassessedserious n=117not reported in cached trials
Plasmablastic lymphoma5643.8
33.0–58.3ROR 43.9 · calibrated p 4e-5 ✓
36.6 EB05 29.2 · IC025 +4.4
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=56 · 100% cliniciannot reported in cached trials
Ivth nerve paralysis3441.5
28.8–59.7ROR 41.5 · calibrated p 7e-5 ✓
34.7 EB05 26.0 · IC025 +4.0
3/3 methods agree
Not in label — unassessedserious n=34 · ♀ 0% (drug 45%) · 100% cliniciannot reported in cached trials
B-cell type acute leukaemia10439.8
32.4–49.0ROR 39.9 · calibrated p 6e-5 ✓
33.9 EB05 28.8 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=104 · 100% cliniciannot reported in cached trials
Multiple myeloma67939.4
36.4–42.8ROR 39.7 · calibrated p 6e-5 ✓
33.8 EB05 31.7 · IC025 +4.9
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=675 · 97% cliniciannot reported in cached trials
Mantle cell lymphoma21238.2
33.1–44.2ROR 38.3 · calibrated p 7e-5 ✓
32.9 EB05 29.3 · IC025 +4.7
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=209 · 94% cliniciannot reported in cached trials
Monoclonal immunoglobulin present10437.0
30.1–45.5ROR 37.1 · calibrated p 1e-4 ✓
31.9 EB05 27.1 · IC025 +4.5
3/3 methods agree
Lab value / disease markerserious n=78not reported in cached trials
Amyloidosis23036.1
31.5–41.5ROR 36.2 · calibrated p 1e-4 ✓
31.3 EB05 28.1 · IC025 +4.7
3/3 methods agree
Labeled adverse reaction
exact term
serious n=227not reported in cached trials
Morganella infection3531.8
22.3–45.3ROR 31.8 · calibrated p 3e-4 ✓
27.7 EB05 20.8 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=35 · 100% cliniciannot reported in cached trials
Paraproteinaemia3731.5
22.4–44.4ROR 31.5 · calibrated p 3e-4 ✓
27.5 EB05 20.8 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=36not reported in cached trials
Cardiac amyloidosis12831.4
26.1–37.7ROR 31.4 · calibrated p 2e-4 ✓
27.7 EB05 23.9 · IC025 +4.4
3/3 methods agree
Labeled adverse reaction
exact term
serious n=128 · 94% cliniciannot reported in cached trials
B precursor type acute leukaemia4430.0
21.9–41.0ROR 30.0 · calibrated p 4e-4 ✓
26.4 EB05 20.5 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=44 · 100% cliniciannot reported in cached trials
Stem cell transplant25927.5
24.2–31.3ROR 27.6 · calibrated p 4e-4 ✓
24.7 EB05 22.2 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=247not reported in cached trials
Osteolysis19825.1
21.7–29.1ROR 25.2 · calibrated p 7e-4 ✓
22.7 EB05 20.2 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=197not reported in cached trials
Chalazion6125.0
19.2–32.6ROR 25.0 · calibrated p 8e-4 ✓
22.5 EB05 18.2 · IC025 +3.8
3/3 methods agree
Labeled adverse reaction
exact term
serious n=47 · 90% cliniciannot reported in cached trials
Polyneuropathy1,07323.3
21.9–24.8ROR 23.6 · calibrated p 9e-4 ✓
21.3 EB05 20.2 · IC025 +4.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 14.7 · 93% cliniciannot reported in cached trials
Monoclonal gammopathy5321.7
16.3–28.7ROR 21.7 · calibrated p 0.002 ✓
19.8 EB05 15.7 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=53not reported in cached trials
Engraftment syndrome4519.5
14.4–26.4ROR 19.5 · calibrated p 0.003 ✓
17.9 EB05 13.9 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious n=45 · 100% cliniciannot reported in cached trials
Meningitis listeria3919.4
14.0–26.9ROR 19.4 · calibrated p 0.003 ✓
17.8 EB05 13.5 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious n=39 · 100% cliniciannot reported in cached trials
Peripheral sensory neuropathy43018.7
16.9–20.6ROR 18.7 · calibrated p 0.003 ✓
17.3 EB05 16.0 · IC025 +3.9
3/3 methods agree
Labeled adverse reaction
exact term
serious n=417 · 94% clinicianNCT01371981: 14/575 (2.4%) on Bortezomib (serious AE)
Pneumonia pneumococcal8915.0
12.1–18.6ROR 15.0 · calibrated p 0.008 ✓
14.1 EB05 11.8 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious n=89 · 100% cliniciannot reported in cached trials
Neuropathy9914.3
11.7–17.5ROR 14.3 · calibrated p 0.009 ✓
13.4 EB05 11.3 · IC025 +3.3
3/3 methods agree
Labeled adverse reaction
exact term
serious n=81NCT01371981: 14/575 (2.4%) on Bortezomib (serious AE)
Bone lesion20614.2
12.4–16.4ROR 14.3 · calibrated p 0.009 ✓
13.4 EB05 11.9 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=190not reported in cached trials

Clinical concept groups

MedDRA splits one clinical problem across several terms (e.g. "neutropenia", "neutrophil count decreased", "agranulocytosis"), which dilutes term-level signals. These rows count reports with any term in a concept group (an exact union, not a sum), compared with all other drugs. Groups are hand-built and listed in the methods.

ConceptReportsPRR 95% CIReading
Thrombocytopenia5,8606.46.3–6.6signal
Neutropenia / agranulocytosis4,5734.44.3–4.5signal
Opportunistic infection1,7633.12.9–3.2signal
Anaemia3,7883.02.9–3.1signal
Serious infection8,4572.62.5–2.7signal
Osteonecrosis6302.62.4–2.8signal
Venous thromboembolism2,1602.42.3–2.5signal
Heart failure1,7162.32.2–2.4signal
Hyponatraemia7662.32.1–2.4signal
Kidney injury4,0272.12.0–2.2signal
Severe cutaneous reaction6352.01.9–2.2raised
Interstitial lung disease7942.01.8–2.1raised
Arrhythmia / qt1,5951.91.9–2.0raised
Liver injury1,3801.11.0–1.1raised
Gi bleeding7601.00.9–1.1no difference
Pancreatitis3281.00.9–1.1no difference

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Bortezomib as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (4 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Plasma cell myeloma9,11771.7
70.1–73.3ROR 79.8 · calibrated p 6e-7 ✓
55.0 EB05 54.0 · IC025 +5.7
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
age-adj. PRR 52.8 · serious PRR 39.4 · 92% cliniciannot reported in cached trials
Off label use (used outside approved label)6,4241.8
1.7–1.8ROR 1.8 · calibrated p 0.836
1.7 EB05 1.7 · IC025 +0.8Reporting / coding artifactage-adj. PRR 1.8 · serious PRR 2.0not reported in cached trials
Diarrhoea (diarrhea)5,1821.9
1.9–2.0ROR 2.0 · calibrated p 0.924
1.9 EB05 1.9 · IC025 +0.9Labeled adverse reaction
exact term
age-adj. PRR 1.5 · serious PRR 1.7NCT01371981: 9/575 (1.6%) on Bortezomib (serious AE)
Fatigue (tiredness)4,5511.4
1.3–1.4ROR 1.4 · calibrated p 0.578
1.4 EB05 1.3 · IC025 +0.4Labeled adverse reaction
exact term
age-adj. PRR 1.1 · serious PRR 1.2NCT01371981: 4/559 (0.7%) on Bortezomib
Death4,1941.1
1.1–1.2ROR 1.2 · calibrated p 0.411
1.1 EB05 1.1 · IC025 +0.1Outcome field, not a reactionage-adj. PRR 0.7 · serious PRR 0.8NCT01371981: 38/559 (6.8%) on Bortezomib (serious AE)
Pneumonia (lung infection)4,0693.0
2.9–3.1ROR 3.1 · calibrated p 0.598
3.0 EB05 2.9 · IC025 +1.5
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.6 · serious PRR 2.1not reported in cached trials
Drug ineffective (drug did not work)3,7500.7
0.7–0.7ROR 0.7 · calibrated p 0.109
0.7 EB05 0.7 · IC025 -0.6
PRR-only: not supported by EBGM or IC
Reporting / coding artifactage-adj. PRR 0.9 · serious PRR 1.2not reported in cached trials
Thrombocytopenia (low platelets)3,7108.1
7.8–8.3ROR 8.4 · calibrated p 0.057
7.8 EB05 7.6 · IC025 +2.9
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 6.1 · serious PRR 5.3 · 92% cliniciannot reported in cached trials
Nausea3,1140.9
0.9–1.0ROR 0.9 · calibrated p 0.260
0.9 EB05 0.9 · IC025 -0.2
PRR-only: not supported by EBGM or IC
Labeled adverse reaction
exact term
age-adj. PRR 0.8 · serious PRR 0.9NCT01371981: 1/575 (0.2%) on Bortezomib (serious AE)
Pyrexia (fever)2,8662.0
1.9–2.0ROR 2.0 · calibrated p 0.940
2.0 EB05 1.9 · IC025 +0.9Labeled adverse reaction
exact term
age-adj. PRR 1.9 · serious PRR 1.5not reported in cached trials
Neutropenia (low neutrophils (infection-fighting cells))2,7174.8
4.6–5.0ROR 4.9 · calibrated p 0.243
4.7 EB05 4.6 · IC025 +2.2
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 3.7 · serious PRR 3.2 · 94% clinicianNCT01371981: 21/575 (3.7%) on Bortezomib (serious AE)
Anaemia (low red blood cells)2,7033.4
3.3–3.5ROR 3.4 · calibrated p 0.497
3.3 EB05 3.2 · IC025 +1.7
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.4 · serious PRR 2.4NCT01371981: 3/575 (0.5%) on Bortezomib (serious AE)
Rash2,4441.3
1.3–1.4ROR 1.3 · calibrated p 0.535
1.3 EB05 1.3 · IC025 +0.3Labeled adverse reaction
exact term
age-adj. PRR 1.3 · serious PRR 1.2NCT01371981: 10/575 (1.7%) on Bortezomib (serious AE)
Disease progression2,4445.0
4.8–5.2ROR 5.1 · calibrated p 0.226
4.9 EB05 4.7 · IC025 +2.2
3/3 methods agree
Reporting / coding artifactage-adj. PRR 4.4 · serious PRR 3.8 · 93% cliniciannot reported in cached trials

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Bortezomib (proteasome inhibitors) ↔ Peripheral neuropathy.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Bortezomib?

In FDA FAERS, the most frequently co-reported reaction terms for Bortezomib are plasma cell myeloma, neuropathy peripheral, diarrhoea, fatigue, pneumonia, thrombocytopenia. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Bortezomib have an FDA boxed warning?

No. The FDA label retrieved for Bortezomib has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Bortezomib causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.