Avastin (bevacizumab) 16ml of 400mg/16ml
Avastin (bevacizumab) 16ml of 400mg/16ml is a monoclonal antibody. It is used to treat cervical cancer, colorectal cancer, glioblastoma multiforme, non-small cell lung cancer (NSCLC), ovarian cancer, and renal cell cancer. Indications and Usage, Recurrent Glioblastoma Dosage and Administration, Recurrent Glioblastoma. Warnings and Precautions, Congestive Heart Failure.
INDICATIONS AND USAGE
Avastin is a vascular endothelial growth factor directed antibody indicated for the treatment of:
• Metastatic colorectal cancer, in combination with intravenous 5-fluorouracil-based chemotherapy for first- or second-line treatment.
• Metastatic colorectal cancer, in combination with fluoropyrimidineirinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy for second-line treatment in patients who have progressed on a first-line Avastin-containing regimen.
DOSAGE AND ADMINISTRATION
Do not administer Avastin for 28 days following major surgery and until surgical wound is fully healed.
• 5 mg/kg every 2 weeks with bolus-IFL
• 10 mg/kg every 2 weeks with FOLFOX4
• 5 mg/ kg every 2 weeks or 7.5 mg/kg every 3 weeks with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy after progression on a first-line Avastin containing regimen.
WARNINGS AND PRECAUTIONS
• Perforation or Fistula: Discontinue for tracheoesophageal fistula, grade 4 fistula, or necrotizing fasciitis. (5.1)
• Arterial Thromboembolic Events (ATE): Discontinue for severe ATE.
• Venous Thromboembolic Events (VTE): Discontinue for Grade 4 VTE.
• Hypertension: Monitor blood pressure and treat hypertension. Withhold if not medically controlled; resume once controlled. Discontinue for hypertensive crisis or hypertensive encephalopathy.
• Posterior Reversible Encephalopathy Syndrome (PRES): Discontinue.
• Renal Injury and Proteinuria: Monitor urine protein. Discontinue for nephrotic syndrome. Withhold until less than 2 grams of protein in urine.
• Infusion Reactions: Decrease rate for infusion reactions. Discontinue for severe infusion reactions and administer medical therapy.
• Embryo-fetal Toxicity: Advise females of potential risk to fetus and need or use of effective contraception.
• Ovarian Failure: Advise females of the potential risk.
• Congestive Heart Failure (CHF): Discontinue if CHF.
Most common adverse reactions incidence (incidence > 10%) are epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, rectal hemorrhage, lacrimation disorder, back pain and exfoliative dermatitis.