Bevacizumab

Generic Name: bevacizumab (bev a CIZ oo mab)Brand Names: Avastin

What is bevacizumab?

Bevacizumab is a cancer medicine that interferes with the growth of cancer cells and slows their growth and spread in the body.

Bevacizumab is used to treat a certain type of brain tumor as well as cancers of the kidney, colon, rectum, lung, or breast. It is usually given as part of a combination of cancer medicines.

Bevacizumab may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about bevacizumab?

Avoid having surgery while you are being treated with bevacizumab. You may have problems with wound healing, which could result in bleeding or infection.

If you need to have any type of surgery, you will need to stop receiving bevacizumab for at least 4 weeks while your surgical incision heals.

Before being treated with bevacizumab, tell your doctor if you have liver disease, kidney disease, heart disease, high blood pressure, a history of stroke or blood clots, or an open wound.

Some people receiving a bevacizumab injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you feel dizzy, nauseated, light-headed, sweaty, itchy, or have a fast heartbeat, chills, wheezing, or chest pain during the injection.

Call your doctor at once if you have serious side effects such as blood in your stools or vomit, sudden numbness or weakness (especially on one side of the body), sudden headache or confusion, problems with vision or speech, chest pain spreading to the arm or shoulder, shortness of breath, swelling, rapid weight gain, or flu symptoms.

Bevacizumab can cause a rare but serious neurologic disorder affecting the brain. Symptoms include headache, confusion, vision problems, feeling light-headed, fainting, and seizure (blackout or convulsions). These rare symptoms may occur within hours of your first dose of bevacizumab, or they may not appear for up to a year after your treatment started. Call your doctor at once if you have any of these side effects.

To be sure this medication is not causing harmful effects, your blood pressure will need to be tested on a regular basis. Your urine may also need to be tested. Do not miss any scheduled visits to your doctor.

This medication can affect a woman's fertility (ability to have children). Talk to your doctor about your specific risks.

What should I discuss with my healthcare provider before using bevacizumab?

Treatment with bevacizumab may cause you to have problems with wound healing, which could result in bleeding or infection. Before receiving this medication, tell your doctor if you have had any type of surgery within the past 4 weeks. You may need to wait until your incision is completely healed before you are treated with bevacizumab.

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before receiving bevacizumab, tell your doctor if you have:

  • liver disease;
  • kidney disease;
  • heart disease or high blood pressure;

  • a history of stroke or blood clots;

  • if you have an open wound; or

  • if you are receiving chemotherapy or medications to prevent anemia (lack of red blood cells).

FDA pregnancy category C. It is not known whether bevacizumab is harmful to an unborn baby. Before receiving this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether bevacizumab passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medication.

Bevacizumab can affect a woman's fertility (ability to have children). Talk to your doctor about your specific risks.

How is bevacizumab used?

This medication is given as an injection through a needle placed into a vein. You will receive this injection in a clinic or hospital setting. The medicine must be given slowly through an IV infusion, and can take up to 90 minutes to complete.

Bevacizumab is usually given once every 2 weeks.

To be sure this medication is not causing harmful effects, your blood pressure will need to be tested on a regular basis. Your urine may also need to be tested. Do not miss any scheduled visits to your doctor.

Bevacizumab must be stored in a refrigerator and kept from freezing. Bevacizumab bottles should never be shaken.

What happens if I miss a dose?

Contact your doctor if you miss an appointment to receive your bevacizumab infusion.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine. An overdose of bevacizumab may cause a severe headache.

What should I avoid while using bevacizumab?

Avoid having surgery while you are being treated with bevacizumab. You could have problems with wound healing, which may result in bleeding or infection.

If you need to have any type of surgery, you will need to stop receiving bevacizumab for at least 4 weeks while your surgical incision heals.

Bevacizumab side effects

Bevacizumab can cause a rare but serious neurologic disorder affecting the brain. Symptoms include headache, confusion, vision problems, feeling light-headed, fainting, and seizure (blackout or convulsions). These rare symptoms may occur within hours of your first dose of bevacizumab, or they may not appear for up to a year after your treatment started. Call your doctor at once if you have any of these side effects.

Some people receiving a bevacizumab injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you feel dizzy, nauseated, light-headed, sweaty, itchy, or have a fast heartbeat, chills, wheezing, or chest pain during the injection.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
  • stomach pain with vomiting or constipation;

  • black, bloody, or tarry stools;

  • vomit that looks like blood or coffee grounds;

  • sudden numbness or weakness, especially on one side of the body;

  • sudden headache, confusion, problems with vision, speech, or balance;

  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

  • increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);

  • feeling short of breath, even with mild exertion;

  • swelling or rapid weight gain;

  • feeling like you might pass out;

  • urinating less than usual or not at all;

  • fever, chills, body aches, flu symptoms;

  • unusual bleeding such as nosebleeds, bleeding gums, or any bleeding that will not stop; or

  • white patches or sores inside your mouth or on your lips.

Less serious side effects may include::

  • diarrhea, stomach pain, loss of appetite;

  • dry mouth, increased thirst;

  • dizziness; or

  • hair loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Bevacizumab Dosing Information

Usual Adult Dose for Colorectal Cancer:

Initial dose: 5 mg/kg in combination with intravenous fluorouracil-based chemotherapyThe recommended dose of bevacizumab is based on a rate of 5 mg/kg or 10 mg/kg when used in combination with irinotecan, fluorouracil, and leucovorin in the IFL regimen.The recommended dose of bevacizumab is based on a rate of 10 mg/kg when used in combination with oxaliplatin, folinic acid, and fluorouracil in the FOLFOX4 regimen.A dose may be given once every 14 days as an IV infusion until disease progression is detected.The first dose of bevacizumab should be delivered over 90 minutes as an intravenous infusion following chemotherapy. If the first infusion is well tolerated, the second infusion may be administered over 60 minutes. If the 60 minute infusion is well tolerated, all subsequent infusions may be administered over 30 minutes.

Usual Adult Dose for Non-Small Cell Lung Cancer:

For use in combination with carboplatin and paclitaxel for the treatment of non-squamous, non-small cell lung cancer:Initial dose: 15 mg/kg as an intravenous infusion every 3 weeksThe first dose of bevacizumab should be delivered over 90 minutes as an intravenous infusion following chemotherapy. If the first infusion is well tolerated, the second infusion may be administered over 60 minutes. If the 60 minute infusion is well tolerated, all subsequent infusions may be administered over 30 minutes.

Usual Adult Dose for Breast Cancer:

Recommended dose: 10 mg/kg as an IV infusion every 14 days in combination with paclitaxel

Usual Adult Dose for Glioblastoma Multiforme:

Recommended dose: 10 mg/kg every 2 weeks

Usual Adult Dose for Ovarian Cancer:

15 mg/kg IV every 3 weeks

Usual Adult Dose for Renal Cell Carcinoma:

10 mg/kg IV every 2 weeks in combination with interferon alfa

Usual Pediatric Dose for Solid Tumors:

Monotherapy: 15 mg/kg IV every 2 weeks in 28 day cyclesCombination therapy: 5 to 10 mg/kg IV every 2 weeks as a part of combination chemotherapy regimens

What other drugs will affect bevacizumab?

There may be other drugs that can interact with bevacizumab. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your healthcare provider can provide more information about bevacizumab.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 7.02. Revision Date: 08/03/2009 3:43:12 PM.
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