Bevacizumab


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Metastatic colorectal cancer 5 mg/kg or 10 mg/kg once every 2 wk, or 7.5 mg/kg or 15 mg/kg once every 3 wk. Non-small cell lung cancer 7.5 mg/kg or 15 mg/kg once every 3 wk, in combination w/ carboplatin and paclitaxel. Metastatic breast cancer 10 mg/kg once every 2 wk or 15 mg/kg once every 3 wk, in combination w/ paclitaxel. Advanced renal cell carcinoma; Metastatic renal cell carcinoma 10 mg/kg once every 2 wk, in combination w/ interferon alfa. Glioblastoma 10 mg/kg once every 2 wk. Cervical cancer 15 mg/kg every 3 wk, in combination w/ paclitaxel/cisplatin or paclitaxel/topotecan. All doses to be given via infusion over 90 minutes on the 1st dose and may be infused thereafter over 60 or 30 minutes depending on tolerability.
Dosage Details
Intravenous
Metastatic breast cancer
Adult: 10 mg/kg once every 2 wk or 15 mg/kg once every 3 wk via infusion over 90 minutes on the 1st dose and may be infused thereafter over 60 or 30 minutes depending on tolerability, in combination w/ paclitaxel.

Intravenous
Non-small cell lung cancer
Adult: 7.5 mg/kg or 15 mg/kg once every 3 wk via infusion over 90 minutes on the 1st dose and may be infused thereafter over 60 or 30 minutes depending on tolerability. Usually in combination w/ carboplatin and paclitaxel.

Intravenous
Advanced renal cell carcinoma, Metastatic renal cell carcinoma
Adult: 10 mg/kg once every 2 wk via infusion over 90 minutes on the 1st dose and may be infused thereafter over 60 or 30 minutes depending on tolerability, in combination w/ interferon alfa.

Intravenous
Metastatic colorectal cancer
Adult: 5 mg/kg or 10 mg/kg once every 2 wk, or 7.5 mg/kg or 15 mg/kg once every 3 wk via infusion over 90 minutes on the 1st dose and may be infused thereafter over 60 or 30 minutes depending on tolerability. Doses depend on drug combination used in the regimen.

Intravenous
Cervical cancer
Adult: 15 mg/kg every 3 wk via infusion over 90 minutes on the 1st dose and may be infused thereafter over 60 or 30 minutes depending on tolerability, in combination w/ paclitaxel/cisplatin or paclitaxel/topotecan.

Intravenous
Glioblastoma
Adult: 10 mg/kg once every 2 wk via infusion over 90 minutes on the 1st dose and may be infused thereafter over 60 or 30 minutes depending on tolerability.
Reconstitution
Dilute in 100 mL of NaCl 0.9%. Final concentration should be 1.4-16.5 mg/mL.
Special Precautions
Patient w/ CV disease, pre-existing HTN, CNS metastases, diabetes, history of arterial thromboembolism; at risk of thrombocytopenia, GI perforation and gall bladder perforation. Discontinue treatment if hypertensive crisis or hypertensive encephalopathy develops. Withhold treatment prior to elective surgery. Do not initiate treatment for at least 28 days after major surgery or until surgical wound is fully healed. Elderly >65 yr. Pregnancy and lactation.
Adverse Reactions
Gall bladder perforation, ileus, intestinal obstruction, hepatobiliary disorder, GI disorder, arterial thromboembolism, HTN, fatigue or asthenia, pyrexia, pain, mucosal inflammation, abdominal pain, diarrhoea, constipation, nausea, vomiting, anorexia, febrile neutropenia, leucopenia, neutropenia, thrombocytopenia, peripheral sensory neuropathy, dysarthria, headache, dysgeusia, eye disorder, increased lacrimation, venous thromboembolism, dyspnoea, rhinitis, rectal haemorrhage, stomatitis, exfoliative dermatitis, skin discolouration, dry skin, arthralgia, proteinuria, ovarian failure, sepsis, abscess, infection, UTI, anaemia, hypersensitivity infusion reaction, dehydration, CVA, somnolence, syncope, CHF, supraventricular tachycardia, DVT, pulmonary embolism, hypocia, epistaxis, dysphonia, Palmar-plantar erythrodysaesthesia syndrome, fistula, myalgia, muscular weakness, lethargy.
Potentially Fatal: GI perforation, necrotising fasciitis, wound healing and surgical complications, haemorrhage (including haemoptysis, GI bleeding, pulmonary and CNS haemorrhage, vag bleeding, epistaxis).
MonitoringParameters
Monitor BP every 2-3 wk. Monitor for development or worsening of proteinuria/nephritic syndrome w/ urine dipstick.
Drug Interactions
May increase risk of microangiopathic haemolytic anaemia w/ sunitinib. May increase risk of agranulocytosis and pancytopenia w/ dipyrone. May increase risk of agranulocytosis w/ clozapine. May increase risk of hand-foot skin reaction w/ sorafenib. May increase risk of osteonecrosis of the jaw w/ bisphosphonate derivatives.
Action
Description: Bevacizumab is a recombinant humanised monoclonal antibody that binds to vascular endothelial growth factor (VEGF). It prevents interaction of VEGF w/ its receptors (Flt-1, KDR) on the surface of endothelial cells & thereby inhibits the angiogenesis that occurs during tumour growth.
Pharmacokinetics:
Distribution: Volume of distribution: 46 mL/kg.
Excretion: Elimination half-life: Approx 20 days.
Storage
Store between 2-8°C. Do not freeze. Protect from light. Reconstituted soln: Store between 2-8°C, stable up to 8 hr.
ATC Classification
L01XC07 - bevacizumab ; Belongs to the class of monoclonal antibodies, other antineoplastic agents. Used in the treatment of cancer.
References
Anon. Bevacizumab. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/11/2014.

Avastin Injection, Solution (Genentech, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/11/2014.

Avastin Solution for Intravenous Infusion. U.S. FDA. https://www.fda.gov/. Accessed 03/11/2014.

Buckingham R (ed). Bevacizumab. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/11/2014.

Joint Formulary Committee. Bevacizumab. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/11/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Bevacizumab. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 03/11/2014.

Disclaimer: This information is independently developed by MIMS based on Bevacizumab from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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