What is this medication?
Antineoplastic; Monoclonal Antibody; Vascular Endothelial Growth Factor Inhibitor
Officially indicated for various forms of cancer but is sometimes used off-label in sports medicine to treat tendinosis.
How does this medication work?
Bevacizumab is a recombinant, humanized monoclonal antibody which bind and neutralizes vascular endothelial growth factor (VEGF) which prevents the proliferation and formation of new blood vessels. The inhibition of microvascular growth is believed to retards cancerous growth, however it also been effective in treating tendinopathy. Intratendinous injection of Bevacizumab has been shown to accelerate tendon healing in the early stages of tendinosis.
How should I take this medication?
IV: Off-Label dosing to be determined by medical doctor.
Note: Bevacizumab should never be administered within 28 days after surgery and healing of any surgical wound.
How is Avastin, Mvasi, Zirabev/Bevacizumab Given: by intravenous infusion with an initial dose given over 90 minutes. The length of the infusion can be reduced on subsequent treatments if the initial infusion is well tolerated. After tolerance at the 90-, 60-, and 30-minute infusion rates have been established, some infusion clinics may use an off-label 10-minute infusion rate (0.5mg/kg/minute). Medical care staff must always closely monitor the patient for any signs/symptoms of an infusion reaction.
What should I watch for while using this medication?
Do not use in patients with hypersensitivity or intolerant to pentoxifylline or other xanthines (i.e.
Do not use in patients who have or develop GI perforation, tracheoesophageal fistula, fistula formation
Discontinue use in patients who develop heart failure
Discontinue use in patients who develop grade 3 or 4 hemorrhage
Discontinue use in patients who experience a hypertensive crisis
Discontinue use in patients who experience a severe infusion reaction and administer appropriate medical therapy
Discontinue use in patients who develop necrotizing fasciitis
Females of reproductive age should be informed of the potential risk of ovarian failure prior to Bevacizumab initiation
Discontinue use in patients who develop nephrotic syndrome
Do not use in patients with severe arterial thromboembolic events or venous thromboembolism
What if I miss a dose?
Avastin (bevacizumab is administered in a hospital or cancer treatment center by a nurse or other licensed healthcare professional. Contact your physician immediately if you miss an appointment for your Avastin injection.
How should I store this medication?
Store diluted solution refrigerated at 2°C to 8°C (36°F to 46°F) for up to 8 hours. No incompatibilities between Avastin and polyvinylchloride or polyolefin bags have been observed.
For single use only. The vials should be used once only and any remaining contents should be discarded.
What are the possible side effects of using this medication?
Percentages reported as monotherapy and as part of combination chemotherapy regimens. Some studies only reported hematologic toxicities grades ≥4 and nonhematologic toxicities grades ≥3.
Cardiovascular: Hypertension (24% to 42%), peripheral edema (15%), venous thromboembolism (grades 3/4: 5% to 11%)
Central Nervous System: Fatigue (33% to 82%), headache (22% to 49%), dizziness (23%), insomnia (21%), anxiety (17%), myasthenia (13% to 15%), voice disorder (5% to 13%), dysarthria (8% to 12%), taste disorder
Dermatologic: Exfoliative dermatitis, xeroderma
Endocrine & Metabolic: Ovarian failure (34%), hyperglycemia (26%), hypomagnesemia (24%), weight loss (20% to 21%), hyponatremia (19%), hypoalbuminemia (16%)
Gastrointestinal: Nausea (53% to 72%), diarrhea (21% to 40%), decreased appetite (34% to 36%), stomatitis (15% to 25%), abdominal pain (grade 3/4: 8% to 12%)
Genitourinary: Urinary tract infection (22%), proteinuria (5% to 20%), pelvic pain (14%)
Hematologic & Oncologic: Thrombocytopenia (58%; grade 3/4: 20% to 40%), leukopenia (grades 3/4: 37% to 53%), pulmonary hemorrhage (4% to 31%), neutropenia (12%; grades ≥3: 8% to 21%), bruise (17%), lymphocytopenia (12%; grades 3/4: 6%), rectal hemorrhage
Neuromuscular & Skeletal: Arthralgia (28% to 41%), limb pain (19% to 25%), back pain (12% to 21%), myalgia (19%)
Ophthalmic: Disease of the lacrimal apparatus
Renal: Increased serum creatinine (16%)
Respiratory: Epistaxis (17% to 55%), dyspnea (26% to 30%), cough (26%), oropharyngeal pain (16%), sinusitis (15%)
Miscellaneous: Postoperative wound complication (5% to 15%)
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