Avastin 100 - Injection Bevacizumab - 100mg/4ml 1 4ml Bottle(s) / 4ml Bottle Roche Bangladesh Pharmaceutical Introduction: Avastin 100 is an anticancer medication. It is used in the treatment of cancer of colon and rectum, non-small cell lung cancer, kidney cancer, brain tumor, ovarian and cervical cancer. It helps to prevent the growth of new blood vessels that feed tumors and stops tumors from growing. Avastin 100 is an effective medicine, first-line option when used together with other cancer medicines. It is given as an infusion. That means you get it through a small needle in your vein or through a port, which is a device placed under your skin. The doctor will decide your dose and... Uses of Avastin 100: Cancer of colon and rectumNon-small cell lung cancerKidney cancerBrain tumorOvarian cancerCervical cancer Side effects of Avastin 100: Rectal bleedingTaste changeHeadacheNosebleedsBack painDry skinHigh blood pressureProtein in urineInflammation of the nose How to use Avastin 100: Your doctor or nurse will give you this medicine. Kindly do not self administer. How Avastin 100 works: Avastin 100 is a anti-angiogenic medication. It works by blocking a protein called vascular endothelial growth factor (VEGF). This stops the formation of blood vessels that bring oxygen and nutrients to cancerous cells. What if you forget to take Avastin 100?: If you miss a dose of Avastin 100, please consult your doctor. Indication: Colo-rectal cancer, Lung cancers, Renal cancers, Ovarian cancers, Breast cancers, glioblastoma multiforme of the brain, Exudative ARMD Administration: IV Preparation Aseptically withdraw necessary amount & dilute in a total volume of 100 mL NS Diluted solutions for infusion may be stored at 2-8°C for 8 hr IV Administration Do not administer as IV push or bolus; administer only as an IV infusion Do not initiate until at least 28 days following major surgery; wait until the surgical incision has fully healed Deliver first infusion over 90 min IV; if well-tolerated, second infusion may be administered over 60 min & each subsequent infusion, over 30 min if 60 min infusion tolerated Adult Dose: General: Bevacizumab should be prepared by a healthcare professional using aseptic technique. The initial Bevacizumab dose should be delivered over 90 min as an IV infusion. If the 1st infusion is well tolerated, the 2nd infusion may be administered over 60 min. If the 60-min infusion is well tolerated, all subsequent infusions may be administered over 30 min. Dose reduction of Bevacizumab for adverse events is not recommended. If indicated, Bevacizumab should either be permanently discontinued or temporarily suspended. Metastatic Colorectal Cancer (mCRC): The recommended dose of Bevacizumab, administered as an IV infusion, is as follows: First-line Treatment: 5 mg/kg... Contraindication: Hypersensitivity to any component Recent hemoptysis Mode of Action: Bevacizumab binds to VEGF, the key driver of vasculogenesis and angiogenesis, and thereby inhibits the binding of VEGF to its receptors, Flt-1 (VEGFR-1) and KDR (VEGFR-2), on the surface of endothelial cells. Neutralising the biological activity of VEGF reduces the vascularisation of tumours, normalises remaining tumour vasculature and inhibits the formation of new tumour vasculature thereby inhibiting tumour growth. Precaution: Gastrointestinal perforations Gastrointestinal (GI) perforation, fistula formation, and/or intra-abdominal abscess unrelated to therapy duration reported in patients with colorectal cancer as well as other types of cancers Typical presentation reported as abdominal pain associated with symptoms such as constipation and vomiting Include GI perforation in the differential diagnosis of patients presenting with abdominal pain Discontinue therapy permanently in patients with GI perforation Wound healing complications Administration may result in the development of fatal wound dehiscence Discontinue therapy in patients with wound dehiscence requiring medical intervention Hemorrhage Fatal pulmonary hemorrhage can occur in patients with non-small cell lung cancer treated with... Side Effect: >10% Weakness (73-74%),Hypertension (23-67%; grades 3/4: 8-18%),Pain (61-62%),Abdominal pain (50-61%; grades 3/4: 8%),Vomiting (47-52%, grades 3/4:6-11%),URI (40-47%),Constipation (29-40%),Leukopenia (grades 3/4: 37%),Proteinuria (36%, grades 3/4: 3%),Epistaxis (32-35%),Ovarian failure (with mFolfox) (34%),Diarrhea (grades 3/4: 2-34%),Stomatitis (30-32%),Alopecia (6-32%),Neutropenia (grades 3/4: 6-27%),Headache (26%; grades 3/4: 2-4%),Dyspnea (25-26%),Dizziness (19-26%),GI hemorrhage (19-24%),Dyspepsia (17-24%),Taste alteration (14-21%),Dry skin (7-20%),Exfoliative dermatitis (3-19%),Fatigue (grades 3/4: 5-19%),Flatulence (11-19%),Lacrimation disorder (6-18%),Neuropathy (grades 3/4: 1-17%),Weight loss (15-16%),Hypokalemia (12-16%),Skin discoloration (2-16%),Thromboembolic events (grades 3/4: 15%),Myalgia (8-15%),Hypotension (7-15%),Nausea (grades 3/4: 4-12%),Back pain (undefined) 1-10% Dehydration (grades 3/4: 3-10%),DVT (6-9%; grades 3/4: 9%),Polyuria (3-6%),Bilirubinemia (1-6%),Colitis (1-6%),Confusion (1-6%),Neutropenia (5%),Thrombocytopenia (5%),Xerostomia (4-7%),Ileus (grades 3/4: 4-5%),Abnormal gait (1-5%),Bone pain... Pregnancy Category Note: Pregnancy Based on findings from animal studies and its mechanism of action, drug may cause fetal harm in pregnant women Limited postmarketing reports describe cases of fetal malformations with bevacizumab use in pregnancy; however, these reports are insufficient to determine drug associated risks Animal data In animal reproduction studies, IV administration of bevacizumab to pregnant rabbits every 3 days during organogenesis at doses ~1-10 times the clinical dose of 10 mg/kg produced fetal resorptions, decreased maternal and fetal weight gain and multiple congenital malformations including corneal opacities and abnormal ossification of the skull and skeleton including limb and phalangeal defects... Interaction: Irinotecan/5–fluorouracil/leucovorin The incidence of epistaxis and grade 1 or 2 hemorrhage (including GI hemorrhage, minor gum bleeding, vaginal hemorrhage) was greater in patients receiving bevacizumab plus irinotecan/5-fluorouracil/leucovorin compared with patients receiving irinotecan/5-fluorouracil/leucovorin plus placebo. Closely monitor the patient during coadministration. Live vaccines The administration of live vaccines to patients receiving bevacizumab may result in a reduced immune response. Avoid coadministration. Paclitaxel Decreased paclitaxel exposure was seen when paclitaxel/carboplatin was given in combination with bevacizumab. Closely monitor the patient during coadministration. Sunitinib Coadministration of bevacizumab and sunitinib has been reported to cause unexpected severe toxicity (eg, microangiopathic hemolytic anemia). Coadministration of...