Bevacizumab

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

Avoid having surgery while you are being treated with bevacizumab. You may 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 for at least 4 weeks while your surgical incision heals.

Before being treated with bevacizumab, tell your doctor if you have liver disease, kidney disease, heart disease, high blood pressure, a history of stroke or blood clots, or an open wound.

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 serious side effects such as blood in your stools or vomit, sudden numbness or weakness (especially on one side of the body), sudden headache or confusion, problems with vision or speech, chest pain spreading to the arm or shoulder, shortness of breath, swelling, rapid weight gain, or flu symptoms.

Bevacizumab can cause a rare but serious neurologic disorder affecting the brain. Symptoms include headache, confusion, vision problems, feeling light-headed, 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 tested on a regular basis. Your urine may also need to be tested. Do not miss any scheduled visits to your doctor.

This medication can affect a woman's fertility (ability to have children). Talk to your doctor about your specific risks.

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 cancers of the colon and rectum. It is usually given as part of a combination of cancer medicines.

Bevacizumab may also be used for purposes other than those listed in this medication guide.

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

Treatment with bevacizumab may cause you to have problems with wound healing, which could result in bleeding or infection. Before receiving this medication, tell your doctor if you have had any type of surgery within the past 4 weeks. You may need to wait until your incision is completely healed before you are treated with bevacizumab.

Before being treated with bevacizumab, tell your doctor if you have:

• liver disease;
• kidney disease;
• heart disease or high blood pressure;
• a history of stroke or blood clots;
• if you have an open wound; or
• if you are receiving chemotherapy or medications to prevent anemia (lack of red blood cells).

If you have any of these conditions, you may not be able to use bevacizumab, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether bevacizumab passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more likely to have side effects from this medication.

Bevacizumab can affect a woman's fertility (ability to have children). Talk to your doctor about your specific risks.

How should I use bevacizumab?

This medication is given as an injection through a needle placed into a vein. You will receive this injection in a clinic or hospital setting. The medicine must be given slowly through an IV infusion, and 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 tested on a regular basis. Your urine may also need to be tested. Do not miss any scheduled visits to your doctor.

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

What happens if I miss a dose?

Contact your doctor if you miss an appointment to receive your bevacizumab infusion.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine. An overdose of bevacizumab may cause a severe headache.

What should I avoid while using bevacizumab?

Avoid having surgery while you are being treated with bevacizumab. You could have problems with wound healing, which may result in bleeding or infection.

If you need to have any type of surgery, you will need to stop receiving bevacizumab for at least 4 weeks while your surgical incision heals.

What are the possible side effects of bevacizumab?

Bevacizumab can cause a rare but serious neurologic disorder affecting the brain. Symptoms include headache, confusion, vision problems, feeling light-headed, 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, itchy, or have a fast heartbeat, chills, wheezing, or chest pain during the injection.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

• stomach pain with vomiting or constipation;
• black, bloody, or tarry stools;
• vomit that looks like blood or coffee grounds;
• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
• increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
• feeling short of breath, even with mild exertion;
• swelling or rapid weight gain;
• feeling light-headed, fainting;
• urinating less than usual or not at all;
• fever, chills, body aches, flu symptoms;
• easy bruising or bleeding, unusual weakness; or
• white patches or sores inside your mouth or on your lips;

Other less serious side effects are more likely to occur, such as:

• diarrhea, stomach pain, loss of appetite;
• dry mouth, increased thirst;
• dizziness; or
• hair loss.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect bevacizumab?

There may be other drugs that can affect bevacizumab. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your healthcare provider may have additional information about bevacizumab that you may read.

What does my medication look like?

Bevacizumab injection is available with a prescription under the brand name Avastin. Other brand or generic formulations may also be available. Ask your healthcare provider or pharmacist any questions you have about this medication, especially if it is new to you.

• Avastin 100 mg/4 mL
• Avastin 400 mg/16 mL

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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