This medication can rarely cause a tear in the stomach/intestines (gastrointestinal perforation and wound dehiscence), bloody vomit, or bleeding in the lungs, which sometimes can be fatal. Seek immediate medical attention if you develop: severe stomach/abdominal pain, constipation with vomiting, fever, black/bloody stools, blood in vomit, or coughing up blood.

Tell your surgeon that you are taking this medication before having any type of surgery (see also Precautions section).

This medication is a man-made antibody (IgG1) used to treat kidney, colon, and rectal cancer. Bevacizumab is also used to treat lung cancer (non-small cell type), certain types of breast cancer, and certain types of brain tumors. This drug works by blocking a certain protein (vascular endothelial growth factor-VEGF) thereby decreasing the blood supply to the tumor and slowing tumor growth.

This medication is given by infusion into a vein by a health care professional. The first dose is usually given over 90 minutes. If you tolerate the first dose well, then later infusions may be given over a shorter time (60 or 30 minutes).

The dosage is based on your medical condition, response to previous therapy, and your weight. Tell your doctor if your weight changes.

Use this medication regularly in order to get the most benefit from it. Try not to miss any doses.

Dry mouth, cough, voice changes, loss of appetite, diarrhea, vomiting, constipation, mouth sores, nausea, headache may occur. If any of these effects persist or worsen, notify your doctor or pharmacist immediately.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these serious side effects occur: trouble breathing, swelling of ankles/feet, sudden weight gain, unusual tiredness, fast heartbeat, fainting, signs of infection (e.g., fever, persistent sore throat), difficulty urinating.

Tell your doctor immediately if any of these unlikely but serious side effects occur: calf pain/swelling, muscle cramps.

Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: severe stomach/abdominal pain, frothy/dark urine, yellowing eyes/skin, muscle loss, decreased amount of urine.

Bevacizumab infrequently may cause blood clots to form, leading to serious medical conditions (heart attack/angina, stroke/TIA). Seek immediate medical attention if you develop chest pain/tightness, sudden vision changes, weakness on one side of the body, confusion, or slurred speech. If any of these conditions occur, you should not be given this medication again.

This medication can cause bleeding. Some episodes may be minor including nosebleeds, minor gum bleeding, and vaginal bleeding. If these persist or worsen, notify your doctor or pharmacist promptly. Other episodes may be more serious including stomach bleeding or bleeding in the lungs (see also Warning section).

Have your blood pressure checked regularly while taking this medication. Learn how to monitor your own blood pressure at home, and share the results with your doctor.

Rarely, bevacizumab may cause a condition called RPLS (reversible posterior leukoencephalopathy syndrome). Seek immediate medical attention if you develop persistent headache, seizures, sudden vision changes, mental/mood changes (e.g., confusion).

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, severe trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before using bevacizumab, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: stomach/intestinal ulcers, recent bloody vomiting or coughing up blood, recent major surgery, a fistula (an abnormal tunnel connecting two body cavities such as the bladder and the vagina).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: high blood pressure, heart disease or blood clots (arterial vessels), kidney disease.

Before having any surgery (including dental), tell your doctor that you are using this medication. Bevacizumab has been shown to slow wound healing. Do not begin using this medication until at least 28 days after any major surgery, unless directed otherwise by your doctor.

Do not have immunizations/vaccinations without your doctor's consent and avoid contact with people who have recently received oral polio vaccine.

Use caution with sharp objects like safety razors or nail cutters and avoid activities such as contact sports to lower the chance of getting cut, bruised, or injured.

Caution is advised when using this drug in the elderly because they may be at greater risk for side effects (e.g., blood clots, kidney effects such as protein in the urine). See also Side Effects section.

This medication should be used only when clearly needed during pregnancy. Bevacizumab may cause harm to an unborn baby. If you become pregnant or think you may be pregnant, inform your doctor immediately. Women of child-bearing age should use an effective form of birth control while using this medication and for an extended period after stopping this drug. Discuss the risks, benefits and any other concerns with your doctor.

Based on information from related drugs, this medication may pass into breast milk. Therefore, breast-feeding while using this medication is not recommended. Also, do not breast-feed for extended period after stopping this drug. Consult your doctor or pharmacist before breast-feeding and if more details are needed.

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: sunitinib.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: severe headache.

Do not share this medication with others.

Laboratory and/or medical tests (e.g., blood pressure monitoring, urine tests for protein, kidney function tests, bilirubin levels, complete blood counts-CBC) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

If you miss a dose, contact your doctor or pharmacist to immediately to establish a new dosing schedule.

Refrigerate between 36-46 degrees F (2-8 degrees C). Do not freeze. Keep all medicines away from children and pets.

Once mixed, the drug may be stored for up to 8 hours in the refrigerator. Discard if not used within the 8 hours.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).

Information last revised August 2009 Copyright(c) 2009 First DataBank, Inc.