Bevacizumab
Cytostatic · Monoclonal antibody
Indications
Metastatic Colon/Rectum Carcinoma. Persistent/recurrent/metastatic cervical cancer, glioblastoma, non-small cell lung cancer, ovarian (epithelial), fallopian tube, or primary peritoneal cancer (platinum-resistant recurrent/platinum-sensitive recurrent), metastatic renal cell cancer.
Dosage
Metastatic Colon/Rectum Carcinoma: Adults: 5 mg/kg IV infusion over 90 min once every 14 days until disease progression is detected. If 1st infusion is well tolerated, administer 2nd infusion over 60 min. If 2nd infusion is well tolerated, administer subsequent doses over 30 min. Persistent/recurrent/metastatic cervical cancer: Adults: 15 mg/kg every 3 wks (in combination with paclitaxel and either cisplatin or topotecan) until disease progression or unacceptable toxicity. Glioblastoma: Adults: 10 mg/kg every 2 wks as a single agent until disease progression or unacceptable toxicity. Non-small cell lung cancer: Adults: 15 mg/kg every 3 wks (in combination with carboplatin and paclitaxel) for 6 cycles. Ovarian (epithelial), fallopian tube, or primary peritoneal cancer: Platinum-resistant recurrent: Adults: 10 mg/kg every 2 wks (in combination with weekly paclitaxel, every 4 wk…
Administration
Do not administer as an IV push or bolus. Administered only as an IV inf. Deliver the initial dose over 90 min as an IV inf following chemotherapy. If the first inf is well tolerated the second inf may be administered over 60 min. If the 60 min inf is well tolerated, all subsequent inf may be administered over 30 min. Compatibility: Stable in NS. Stability: Bevacizumab solutions for inf may be stored at 2°C-8°C (36°F-46°F) for upto 8 hours.
Adverse Effects
GI perforation or fistulae, tumour-associated and mucocutaneous hemorrhage, arterial and venous thromboembolism, HTN, proteinuria, CHF, immune system disorders, hypersensitivity and infusion reactions, hypertension, asthenia, fatigue, wt loss, blood dyscrasias, peripheral sensory neuropathy, anorexia, dysgeusia, dysphonia, headache, eye disorders, increased lacrimation, dyspnoea, epistaxis, cough, rhinitis, stomatitis, skin reactions, arthralgia, pyrexia, pain, mucosal inflammation, infections, dehydration, stroke, syncope, somnolence, supraventricular tachycardia, electrolyte disturbances, hypoxia, GI upset, ileus, GI obstruction, proctalgia, myalgia, muscle weakness, lethargy, dysarthria, ovarian failure. Reports of necrotising fasciitis (discontinue).
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Hypersensitivity to Chinese hamster ovary cell products or other recombinant human or humanised antibodies. Renal or hepatic impairment. Recent pulmonary haemorrhage/haemoptysis. Precautions: Increased risk for development of GI perforation. Increased risk of HTN; temporarily discontinue until HTN is controlled. Hypertensive crisis, development of arterial and thromboembolic events and pulmonary embolism; discontinue use. Preexisting CAD or CHF. May adversely affect wound healing process. Initiate therapy only atleast 28 days following major surgery or until surgical wound is fully healed. Leukoencephalopathy syndrome; discontinue if occurs. Risk of osteonecrosis of the jaw; avoid invasive dental procedures in patients who have previously received IV bisphosphonates.
Interactions
Irinotecan, sunitinib, IV bisphosphonates, EGFR, monoclonal antibodies.
Advice to Patient
Contact prescriber if there is severe headache, vomiting, chest pain, numbness of arms or legs, confusion, impaired speech, difficulty in breathing, blood with cough, changes in vision, dark coloured stools, difficulty in urination, swelling on lips/throat/face/eyelids. Avoid alcohol during therapy. Avoid activities that may cause bruising or injury. If a dose is missed, immediately inform prescriber to make a new dosing schedule. Keep all doctors and laboratory appointments.
Pharmacokinetics
Half-life elimination: IV: Pediatric patients (age: 1 to 21 years): Median: 11.8 days (range: 4.4 to 14.6 days). Adults: Approx 20 days. (range: 11 to 50 days). Intravitreal: Approx 5 to 10 days.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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