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, and certain types of cancers of the kidney, lung, colon and rectum. It is usually given as part of a combination of cancer medicines.

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

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

Treatment with bevacizumab may cause you to 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 at least 4 weeks ahead of time. Do not start using bevacizumab for at least 4 weeks after surgery, or until your surgical incision heals.

Before being treated with bevacizumab, tell your doctor if you have a bleeding or blood-clotting disorder, heart disease, congestive heart failure, high blood pressure, or a history of heart attack, stroke, blood clots, or stomach or intestinal bleeding (including perforation).

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: any unusual bleeding or bruising, blood in your urine or stools, coughing up blood, any bleeding that will not stop, severe stomach pain with fever and vomiting, sudden numbness or weakness, leg pain or swelling, chest pain, severe headache, problems with speech or balance, swelling or rapid weight gain, urinating less than usual, loss of bladder or bowel control, or missed menstrual periods.

Bevacizumab can cause a rare but serious neurologic disorder affecting the brain. Symptoms include headache, confusion, vision problems, feeling very weak or tired, 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 checked often. Your urine may also need to be tested. Visit your doctor regularly.

Bevacizumab may cause a woman's ovaries to stop working correctly. Symptoms of ovarian failure include 3 or more missed menstrual periods in a row. This may affect your fertility (ability to have children). Talk to your doctor about your specific risks.

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

You should not use bevacizumab if you are allergic to it, or if you have:

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  untreated or uncontrolled high blood pressure;

  
  


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  severe or uncontrolled bleeding;

  
  


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  an open skin wound;

  
  


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  an open surgical incision;

  
  


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  if you have had surgery within the past 4 weeks (28 days);

  
  


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  if you have recently been coughing up blood; or

  
  


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  if you plan to have surgery within the next 4 weeks (28 days).

  
  

To make sure you can safely receive bevacizumab, tell your doctor if you have any of these other conditions:

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  a bleeding or blood-clotting disorder;

  
  


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  a history of stomach or intestinal bleeding;

  
  


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  a history of perforation (a hole or tear) in your esophagus, stomach, or intestines;

  
  


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  heart disease, congestive heart failure;

  
  


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  high blood pressure; or

  
  


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  a history of heart attack, stroke, or blood clots.

  
  

FDA pregnancy category C. It is not known whether bevacizumab will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Bevacizumab may cause a woman's ovaries to stop working correctly. Symptoms of ovarian failure include 3 or more missed menstrual periods in a row. This may affect your fertility (ability to have children). Talk to your doctor about your specific risks. It is not known whether bevacizumab passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are being treated with bevacizumab. Older adults may be more likely to have side effects from this medication.

How is bevacizumab used?

Treatment with bevacizumab may cause you to 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 at least 4 weeks ahead of time. Do not start using bevacizumab for at least 4 weeks after surgery, or until your surgical incision heals.

Bevacizumab is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Bevacizumab must be given slowly, and the IV infusion 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 checked often. Your urine may also need to be tested. Visit your doctor regularly.

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

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your bevacizumab injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of bevacizumab may cause a severe headache.

What should I avoid while using bevacizumab?

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Bevacizumab side effects

Bevacizumab can cause a rare but serious neurologic disorder affecting the brain. Symptoms include headache, confusion, vision problems, feeling very weak or tired, 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, or have a headache, wheezing, or chest pain during the injection.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

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  any wound that will not heal;

  
  


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  severe stomach pain with fever, vomiting, and constipation;

  
  


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  blood in your urine or stools, vomit that looks like blood or coffee grounds;

  
  


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  easy bruising, unusual bleeding (nose, mouth, vagina, rectum), purple or red pinpoint spots under your skin, or any bleeding that will not stop;

  
  


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  fever, chills, body aches, flu symptoms, sores in your mouth and throat;

  
  


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  sudden numbness or weakness, severe headache, confusion, or problems with vision, speech, or balance;

  
  


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  pain, swelling, warmth, or redness in one or both legs;

  
  


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

  
  


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  dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, shortness of breath, uneven heartbeats, seizure);

  
  


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  puffy eyes, swelling in your stomach, arms, or legs;

  
  


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  rapid weight gain, urinating less than usual or not at all;

  
  


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  urine that looks foamy;

  
  


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  pain or burning when you urinate, loss of bladder or bowel control;

  
  


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  ongoing vaginal discharge, itching, or other irritation; or

  
  


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  missed menstrual periods.

  
  

Less serious side effects may include:

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  mild headache;

  
  


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  back pain;

  
  


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  diarrhea, loss of appetite;

  
  


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  cold symptoms such as stuffy nose, sneezing, sore throat;

  
  


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  dry or watery eyes;

  
  


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  dry or flaky skin, hair loss;

  
  


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  changes in your sense of taste; or

  
  


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  jaw pain, swelling, numbness, loose teeth, gum infection.

  
  

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 chemotherapy

The 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 weeks

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 Breast Cancer:

(Not approved by FDA)

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 cycles

Combination 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 medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More bevacizumab resources

• Bevacizumab Side Effects (in more detail)
• Bevacizumab Dosage
• Bevacizumab Use in Pregnancy & Breastfeeding
• Bevacizumab Drug Interactions
• Bevacizumab Support Group
• 6 Reviews for Bevacizumab - Add your own review/rating

• bevacizumab Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information


• Bevacizumab Professional Patient Advice (Wolters Kluwer)


• Bevacizumab Solution MedFacts Consumer Leaflet (Wolters Kluwer)


• Bevacizumab Monograph (AHFS DI)


• Avastin Prescribing Information (FDA)


• Avastin Consumer Overview

Compare bevacizumab with other medications

• Breast Cancer
• Breast Cancer, Metastatic
• Colorectal Cancer
• Glioblastoma Multiforme
• Macular Degeneration
• Malignant Glioma
• Neurofibromatosis
• Non-Small Cell Lung Cancer
• Ovarian Cancer
• Pancreatic Cancer
• Renal Cell Carcinoma
• Solid Tumors

Where can I get more information?

• Your doctor or pharmacist can provide more information about bevacizumab.

See also: bevacizumab side effects (in more detail)