Medicine Information

Cyramza

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

Solution for injection, Intravenous (IV) infusion10 mg/mL solution for injection (100 mg/10 mL or 500 mg/50 mL vial)Antineoplastic agents, Monoclonal antibodies, VEGF inhibitorsATC: L01XC21

Generic Name

Ramucirumab

Manufacturer

Eli Lilly and Company

Country

USA

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
cyramza 10 mg injection	৳ 45,275.00	N/A

Description

Overview of the medicine

Ramucirumab is a human IgG1 monoclonal antibody that specifically binds to vascular endothelial growth factor receptor 2 (VEGFR2) and blocks the binding of VEGF-A, VEGF-C, and VEGF-D ligands, thereby inhibiting VEGFR2 activation. It is used in the treatment of various advanced cancers.

Uses & Indications

Advanced gastric or gastroesophageal junction adenocarcinoma (in combination with paclitaxel or as monotherapy)

Metastatic colorectal cancer (in combination with FOLFIRI)

Metastatic non-small cell lung cancer (in combination with docetaxel)

Hepatocellular carcinoma (as monotherapy)

Dosage

Adults

Dosage varies by indication and regimen. For example, for NSCLC: 10 mg/kg IV every 2 weeks (with docetaxel); for Gastric/GEJ: 8 mg/kg IV every 2 weeks (monotherapy). Administered via IV infusion.

Elderly

No specific dose adjustment recommended based on age.

Renal_impairment

No specific dose adjustment recommended for renal impairment.

How to Take

Administer as an intravenous infusion over 60 minutes after dilution. Do not administer as an intravenous push or bolus.

Mechanism of Action

Ramucirumab binds to VEGFR2, preventing the binding of VEGF ligands (VEGF-A, -C, -D). This inhibits ligand-induced activation of VEGFR2 and its downstream signaling pathways, leading to inhibition of angiogenesis (new blood vessel formation) and tumor growth.

Pharmacokinetics

Onset

Not immediate, therapeutic effect develops over time with repeat doses.

Excretion

Primarily via catabolism of IgG.

Half life

Approximately 14 days (range 8-28 days).

Absorption

Administered intravenously, so absorption phase is bypassed.

Metabolism

Expected to be metabolized via proteolytic degradation, like other IgG antibodies. Not metabolized by cytochrome P450 enzymes.

Side Effects

Contraindications

Severe hemorrhage
Gastrointestinal perforation
Patients with tumor infiltration of gastric wall or evidence of gross perforation (gastric cancer)
Known hypersensitivity to ramucirumab or any component

Drug Interactions

NSAIDs

May increase risk of GI perforation or hemorrhage.

Anticoagulants

Increased risk of hemorrhage when co-administered.

Storage

Store in a refrigerator (2°C to 8°C / 36°F to 46°F). Do not freeze. Protect from light.

Overdose

No specific antidote. Management involves symptomatic and supportive care.

Pregnancy & Lactation

May cause fetal harm. Advise women of reproductive potential to use effective contraception during treatment and for at least 3 months after the last dose. Advise women not to breastfeed during treatment and for at least 3 months after the last dose.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

100 mg/10 mL vial500 mg/50 mL vial

Shelf Life

Typically 2-3 years; refer to product labeling for exact shelf life.

Availability

Hospitals, specialized cancer treatment centers

Approval Status

FDA approved (2014)

Patent Status

Patented by Eli Lilly

Clinical Trials

Clinical efficacy and safety were established through multiple large-scale randomized controlled trials (e.g., REGARD, RAINBOW, REVEL, REACH) across various indications.

Lab Monitoring

Blood pressure monitoring regularly
Urine protein (dipstick or 24-hour collection) before each dose
Complete blood counts (CBC)
Liver and renal function tests

Doctor Notes

Careful monitoring for hemorrhage, GI perforation, and arterial thromboembolic events is crucial.
Blood pressure and proteinuria must be monitored before each dose.
Consider holding or discontinuing for severe adverse reactions.

Patient Guidelines

Report any unusual bleeding, severe abdominal pain, or blood in stools/vomit immediately.
Monitor blood pressure regularly at home if advised.
Report new or worsening headache, seizures, confusion, or visual disturbances.
Avoid pregnancy during treatment and for 3 months after.
Do not breastfeed.

Missed Dose Advice

If a dose is missed, administer it as soon as possible. Adjust the schedule to maintain the prescribed dosing interval.

Driving Precautions

May cause fatigue or vision disturbances; advise caution when driving or operating machinery.

Lifestyle Advice

Maintain good oral hygiene to manage stomatitis.
Stay hydrated to mitigate diarrhea.
Avoid activities that might lead to injury or bleeding.

Alternative Medicines in Bangladesh

Similar medicines available in the market

No direct generic biosimilar alternatives available in Bangladesh. Other anti-angiogenic agents may be considered depending on the specific cancer and clinical context.