Medicine Information

Avastin

Name: Avastin
Brand: Avastin
Rating: 4.5 (117 reviews)

Solution for intravenous infusion100 mg/4 mLAntineoplastic agent, Monoclonal antibodyATC: L01XC07

Generic Name

Bevacimab 100 mg Injection

Manufacturer

Genentech (A member of the Roche Group)

Country

USA / Switzerland

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
bevacimab 100 mg injection	৳ 16,100.00	N/A

Description

Overview of the medicine

Bevacimab is a recombinant humanized monoclonal antibody that selectively binds to and neutralizes vascular endothelial growth factor (VEGF-A), thereby inhibiting angiogenesis and tumor growth. It is used in combination with chemotherapy for various cancers.

Uses & Indications

Metastatic Colorectal Cancer (mCRC)

Non-Small Cell Lung Cancer (NSCLC)

Glioblastoma

Metastatic Renal Cell Carcinoma (mRCC)

Cervical Cancer (persistent, recurrent, or metastatic)

Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

Dosage

Adults

Dosage varies by indication and body weight, typically 5-15 mg/kg administered intravenously every 2-3 weeks. Must be diluted prior to use.

Elderly

No specific dose adjustment recommended for elderly patients; caution advised due to increased risk of side effects.

Renal_impairment

No dose adjustment required for patients with renal impairment.

Hepatic_impairment

No dose adjustment required for patients with hepatic impairment.

How to Take

For intravenous infusion only. DO NOT administer as an intravenous push or bolus. The initial infusion should be administered over 90 minutes. Subsequent infusions can be administered over 60 minutes if the first infusion was well-tolerated, or over 30 minutes if the 60-minute infusion was well-tolerated.

Mechanism of Action

Bevacimab selectively binds to the VEGF-A isoform, preventing its interaction with VEGF receptors (VEGFR-1 and VEGFR-2) on the surface of endothelial cells. This inhibits new blood vessel formation (angiogenesis), starving the tumor of nutrients and oxygen, thus impeding its growth and metastasis.

Pharmacokinetics

Onset

Rapidly distributed following intravenous infusion.

Excretion

Elimination primarily through the reticuloendothelial system via catabolism. Minimal renal elimination.

Half life

Approximately 20 days (range 11-50 days).

Absorption

Administered intravenously, resulting in 100% bioavailability.

Metabolism

Catabolized via proteolytic pathways throughout the body, similar to endogenous IgG. No specific hepatic or renal metabolism.

Side Effects

Contraindications

Known hypersensitivity to bevacimab or any component of the formulation
Severe active bleeding
Patients who have recently undergone surgery (within 28 days) or who have unhealed wounds

Drug Interactions

Sunitinib

Serious and sometimes fatal microangiopathic hemolytic anemia (MAHA) was observed in patients with metastatic renal cell carcinoma receiving bevacimab in combination with sunitinib.

Chemotherapy

May increase risk of myelosuppression and other toxicities when combined with certain chemotherapeutic agents. Close monitoring is required.

Other Anti-Angiogenic Agents

Increased risk of toxicities like gastrointestinal perforation and hemorrhage. Concomitant use is generally not recommended.

Storage

Store refrigerated at 2°C - 8°C (36°F - 46°F). Do not freeze. Protect from light. Do not shake.

Overdose

There is no specific antidote for bevacimab overdose. Management should involve supportive care and symptomatic treatment. Discontinuation of bevacimab and close monitoring are recommended.

Pregnancy & Lactation

Pregnancy Category D. Bevacimab may cause fetal harm when administered to a pregnant woman. Advise pregnant women of the potential risk to the fetus. Avoid breastfeeding during treatment and for at least 6 months after the last dose due to potential for serious adverse reactions in the infant.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

100 mg/4 mL single-use vial400 mg/16 mL single-use vial

Shelf Life

Typically 24-36 months when stored as recommended. Once diluted, use immediately or store for up to 24 hours at 2°C - 8°C.

Availability

Hospitals, specialized oncology clinics

Approval Status

FDA approved (original Avastin)

Patent Status

Patent expired for original molecule, biosimilars available

WHO Essential Medicine

Yes

Clinical Trials

Bevacimab has undergone extensive clinical trials across various cancer types, demonstrating efficacy in improving progression-free survival and overall survival when used in combination with standard chemotherapy regimens. Ongoing research continues to explore its potential in new indications and treatment combinations.

Lab Monitoring

Monitor blood pressure every 2-3 weeks and manage hypertension
Monitor for proteinuria (e.g., urine dipstick) prior to each dose
Perform complete blood count (CBC) with differential regularly
Monitor renal function (creatinine, BUN)
Monitor liver function tests (LFTs) periodically

Doctor Notes

Careful patient selection and risk assessment are crucial, especially regarding bleeding risk, history of thrombosis, and uncontrolled hypertension.
Strict monitoring for adverse events, particularly hypertension and proteinuria, throughout the treatment course.
Consider temporary or permanent discontinuation for severe adverse events such as GI perforation or severe hemorrhage.

Patient Guidelines

Report any unusual bleeding, severe headache, vision changes, or high blood pressure.
Inform your doctor about any recent surgeries or unhealed wounds.
Understand the risk of gastrointestinal perforation and report severe abdominal pain.
Do not get pregnant during treatment and for at least 6 months after the last dose.

Missed Dose Advice

If a dose is missed, contact your healthcare provider immediately to reschedule the infusion. Do not double the next dose.

Driving Precautions

Bevacimab may cause fatigue, dizziness, or vision disturbances. Patients should be cautioned about driving or operating machinery if they experience these symptoms.