Avastin
Generic Name
bevacimab
Manufacturer
Genentech/Roche (original)
Country
USA, Switzerland
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Description
Overview of the medicine
Bevacimab is a recombinant humanized monoclonal antibody that targets vascular endothelial growth factor (VEGF). It is used to treat various cancers by inhibiting angiogenesis, which is the formation of new blood vessels that tumors need to grow and spread.
Uses & Indications
Dosage
Adults
Dosage varies by indication. For metastatic colorectal cancer, typical doses are 5 mg/kg or 10 mg/kg IV every 2 weeks, or 7.5 mg/kg or 15 mg/kg IV every 3 weeks. Administered as an intravenous infusion over 30-90 minutes.
Elderly
No specific dose adjustment generally required, but close monitoring for adverse events due to potential age-related comorbidities.
Renal_impairment
No specific dose adjustment required for patients with renal impairment.
How to Take
Administered as an intravenous infusion over 30 to 90 minutes by a healthcare professional. Do not administer as an intravenous push or bolus. Ensure appropriate dilution before infusion.
Mechanism of Action
Bevacimab selectively binds to and neutralizes human vascular endothelial growth factor (VEGF), preventing its interaction with VEGF receptors (Flt-1 and KDR) on the surface of endothelial cells. This inhibition of VEGF leads to reduced angiogenesis, resulting in decreased tumor vascularization, inhibited tumor growth, and suppression of metastasis.
Pharmacokinetics
Onset
Therapeutic effects develop over weeks, not an immediate acute effect.
Excretion
Primarily via proteolytic degradation; no specific organ for excretion.
Half life
Approximately 20 days (range 11-50 days).
Absorption
Administered intravenously, resulting in 100% bioavailability.
Metabolism
Cleared through catabolism, similar to endogenous IgG.
Side Effects
Contraindications
- Known hypersensitivity to bevacimab or any components of the formulation
- Pregnancy (due to potential fetal harm)
Drug Interactions
Sunitinib
Increased risk of microangiopathic hemolytic anemia.
Recent surgery
Increased risk of wound healing complications if administered within 28 days of surgery.
Platinum/Taxane-containing chemotherapy
Potential increased risk of neutropenia and other myelosuppression (specific to certain regimens).
Storage
Store unopened vials refrigerated at 2°C to 8°C (36°F to 46°F) in the original carton to protect from light. Do not freeze. Do not shake.
Overdose
Limited clinical data on overdose. Symptoms may include severe hypertension, severe headaches. Management involves supportive and symptomatic treatment, as there is no specific antidote.
Pregnancy & Lactation
Bevacimab is contraindicated in pregnancy due to potential for fetal harm; women of childbearing potential should use effective contraception during treatment and for 6 months after the last dose. Advise women not to breastfeed during treatment and for 6 months following the last dose, as it is unknown if bevacimab is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months when stored under recommended conditions. Once diluted, the solution is stable for up to 24 hours at 2°C to 8°C.
Availability
Hospitals, specialized oncology centers
Approval Status
FDA Approved
Patent Status
Original patent expired; biosimilars available
WHO Essential Medicine
YesClinical Trials
Bevacimab has been extensively evaluated in numerous Phase III clinical trials across various cancer types, demonstrating significant improvements in progression-free survival and overall survival when used in combination with standard chemotherapy regimens.
Lab Monitoring
- Blood pressure monitoring (before each dose and regularly during treatment)
- Urinalysis for proteinuria (before each dose)
- Complete Blood Count (CBC) with differential
- Serum creatinine and electrolytes
- Coagulation parameters (if indicated)
Doctor Notes
- Prioritize patient education on critical adverse events like bleeding, GI perforation, and wound healing complications.
- Closely monitor blood pressure and perform regular urinalysis for proteinuria. Manage hypertension aggressively.
- Consider delaying bevacimab for at least 28 days post-surgery due to wound healing concerns.
- Exercise caution in patients with a history of thromboembolic events or cardiovascular disease.
Patient Guidelines
- Report any signs of bleeding (e.g., nosebleeds, unusual bruising, blood in stool/urine), severe headache, vision changes, or severe abdominal pain immediately to your doctor.
- Avoid elective surgery for at least 28 days following the last dose of bevacimab due to the risk of wound healing complications.
- Monitor blood pressure regularly at home if advised by your doctor.
Missed Dose Advice
If a dose is missed, contact your doctor or healthcare provider immediately to reschedule your treatment. Do not attempt to administer the dose yourself.
Driving Precautions
Bevacimab may cause side effects such as fatigue, headache, or vision changes, which could impair your ability to drive or operate machinery. Patients should exercise caution until they know how the drug affects them.
Lifestyle Advice
- Maintain a healthy and balanced diet to support overall health during cancer treatment.
- Stay well-hydrated.
- Follow all medical advice and attend all scheduled appointments for monitoring and treatment.
- Avoid strenuous activities or contact sports if there is an increased risk of bleeding.
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Global Brand Names
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