BEVACIZUMAB

Gastrointestinal perforation: This medication can rarely cause a tear in the stomach/intestines (gastrointestinal perforation). It may also increase the risk of serious (possibly fatal) bleeding, such as bleeding from the stomach/intestines or in the brain.

Bleeding problems: You should not receive this medication if you have any serious bleeding problems. Get medical help right away if you have any signs of these serious side effects, including bloody or black/tarry stools, persistent or severe stomach/abdominal pain, constipation with vomiting, vomit that is bloody or looks like coffee grounds, coughing up blood, shortness of breath, dizziness/fainting, unusual or persistent tiredness/weakness, severe headache, fever.

Affects healing: This medication may also cause wounds to heal slowly or poorly or cause the wounds to break open. It can also rarely cause very serious (possibly fatal) skin and tissue infections that spread quickly. Get medical help right away if you have wounds that are not healing well, a fever, severe pain/redness/heat/swelling at the surgery site or other areas on the skin, fluid-filled blisters in the skin, discolored/scaling/peeling skin, confusion, dizziness, or fainting. You should not receive this medication for at least 4 weeks before and after a major surgery and until the wound from the surgery is fully healed.

Common side effects:

• dry mouth
• cough
• voice changes
• loss of appetite
• diarrhea
• vomiting
• constipation
• mouth sores
• nausea
• headache

Tell your doctor right away if you have any serious side effects, including: swelling of ankles/feet, sudden weight gain, fast heartbeat, signs of infection (e.g., fever, persistent sore throat), muscle cramps, muscle loss, yellowing eyes/skin, frothy/dark urine, difficulty urinating, decreased amount of urine.

Symptoms of a severe infusion reaction that may occur during bevacizumab treatment include:

• difficulty breathing
• flushing
• severe dizziness
• nausea/vomiting
• shaking
• chest pain

Bevacizumab may rarely cause blood clots (such as pulmonary embolism, stroke, heart attack, deep vein thrombosis). You may be at increased risk for blood clots if you have a history of blood clots, heart/blood vessel disease, or if you are immobile (such as on very long plane flights or being bedridden). If you use estrogen-containing products, these may also increase your risk.

This medication can cause bleeding. Some episodes may be minor including nosebleeds, minor gum bleeding, and vaginal bleeding. If these persist or worsen, notify your doctor or pharmacist promptly. Other episodes may be more serious including stomach bleeding or bleeding in the lungs

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high. Your doctor may control your blood pressure with medication.

Rarely, bevacizumab may cause a condition called PRES (posterior reversible encephalopathy syndrome). Get medical help right away if you develop persistent headache, seizures, sudden vision changes, mental/mood changes (e.g., confusion).

This medication may affect the ovaries, possibly reducing fertility and causing hormone changes. Talk to your doctor for more details.

Precautions

• Allergy: Before using bevacizumab, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
• Medical History: Before using this medication, tell your doctor or pharmacist if you had: stomach/intestinal ulcers, bleeding problems (such as recent bloody vomiting or coughing up blood), recent major surgery, recent injuries/wounds, high blood pressure, kidney disease, diabetes.
• Bevacizumab can make you more likely to get infections or may worsen any current infections. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.
• Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

Pregnancy Risk: Category C. During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor.

Breastfeeding: Based on information from related drugs, this medication may pass into breast milk.

Interactions

• A product that may interact with this drug is: sunitinib.

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately.

Notes: Laboratory and/or medical tests (e.g., blood pressure monitoring, urine tests for protein, kidney function tests, bilirubin levels, complete blood counts-CBC) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose: For the best possible benefit, it is important to receive each scheduled dose of this medication as directed. If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule.

Storage: Not applicable. This medication is given in a clinic and will not be stored at home.

Brands:

Available Brands

• Avastin [ Roche ]