Bevacizumab, Injection

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KEY POINTS

• This medicine is given by IV to treat cancer.
• You may get infections more easily when you are taking this medicine.
• Keep all appointments for tests to see how this medicine affects you.
• This is a very strong medicine and may cause serious and life-threatening side effects, including bleeding. It may keep wounds from healing properly, or other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antineoplastic (anticancer); monoclonal antibody

Generic and brand names: bevacizumab, injection; Avastin

What is this medicine used for?

This medicine is given by IV infusion (slow drip through a needle into a large vein) to treat:

• Cervical cancer
• Colorectal cancer
• Glioblastoma (a type of brain tumor)
• Kidney cancer
• Non-small cell lung cancer
• Ovarian cancer

It is given with other medicines.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A stroke or transient ischemic attack (TIA)
• Blood clots or bleeding problems
• Diabetes
• Heart disease, heart attack, or other heart problems
• High blood pressure
• Kidney or liver problems
• Problems with wound healing
• Protein in the urine (proteinuria)
• Ulcers

Also tell your healthcare provider if you have had surgery in the past month.

Females of childbearing age: Talk with your healthcare provider if you pregnant or plan to become pregnant. This medicine may cause your ovaries to stop working and make you unable to have children. It is not known whether this medicine will harm an unborn baby. Use an effective method of birth control while you are receiving this medicine and for at least 6 months after your therapy is completed. Do not breast-feed while taking this medicine without your healthcare provider’s approval.

How do I use it?

The infusions are usually given every 2 to 3 weeks by your healthcare provider. Be sure to keep all appointments for these infusions and for blood tests to find out how this medicine affects you. While you are receiving this medicine, your healthcare provider will carefully watch you for any serious side effects.

Your healthcare provider may prescribe medicines to reduce nausea and diarrhea, which are common side effects of this medicine. Follow your healthcare provider's directions exactly.

What should I watch out for?

This is a very strong medicine and may cause serious and life-threatening side effects. If you have severe stomach pain, constipation, nausea, vomiting or fever, contact your healthcare provider right away.

This medicine may keep wounds from healing properly. It may also cause serious and sometimes life-threatening bleeding. Contact your healthcare provider right away if you cough up blood, notice any unusual bleeding, or have a wound that splits open or doesn’t heal.

This medicine may cause the ovaries to stop working (ovarian failure). This may make you unable to have children. Contact your healthcare provider right away if you have decreased sexual drive, hot flashes, irritability, night sweats, painful sex, or if you have irregular periods or have missed periods for 3 months.

You may get infections more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections. Also, do not have any vaccines without getting your healthcare provider's approval first. If you develop a fever (over 100°F, or 37.8°C), contact your healthcare provider right away. The fever may be caused by a low white blood cell count, which would increase your risk of getting severe infections.

This medicine may increase your risk for blood clots, angina, stroke, or a heart attack. Talk with your healthcare provider about this.

This medicine increases the risk for reversible posterior leukoencephalopathy syndrome (RPLS). Call your healthcare provider right away if you have:

• Headache
• Seizures
• Weakness
• Confusion
• Trouble seeing or changes in vision
• Problems thinking

You will need to have regular lab tests and blood pressure checks while receiving this medicine. Keep all appointments.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine. You may need to stop taking this medicine before surgery and start after surgery when your healthcare providers tells you to.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking, chest pain, pain with breathing, shortness of breath, coughing up blood.

Serious (Report these to your healthcare provider right away.): Unusual bruising or bleeding; vomiting blood or something that looks like coffee grounds; black, tarry bowel movements; red or brown urine; unexplained pain or swelling in chest, face, hands, feet, or other joints; leg numbness or weakness; severe or prolonged diarrhea; fever, chills, cough, or sore throat; mouth sores; severe nausea and vomiting; constipation with stomach pain and vomiting; severe dizziness or fainting; swelling, pain, or warmth in the calf; increase or decrease in urinating; confusion; problems with thinking; seizures; irregular periods or missing a period for 3 months; hot flashes; night sweats; decrease in sexual drive; irritability; painful sex; thinning and drying of vagina; severe skin redness, rash, blistering, or peeling; wound that does not heal.

Other: Loss of appetite, mild diarrhea, mild nausea or vomiting, unusual taste in mouth, mild headache, muscle pain, weight loss, runny or stuffy nose, heartburn, mild dizziness, hair loss, dry mouth, voice changes, dry skin, watery eyes, back pain.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Other cancer medicines such as sorafenib (Nexavar) and sunitinib (Sutent)
• Vaccines

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.