Bevacizumab (Generic Name)

Other Names: Avastin

About this drug

Bevacizumab is used to treat cancer. It is given in the vein (IV).

Possible Side Effects (More Common)

  • Slow wound healing (see Special Instructions)
  • Nose bleeds (see Special Instructions)
  • High blood pressure. Your doctor will check your blood pressure as needed.
  • Decrease in the number of white blood cells. This may raise your risk for infection.
  • Effects on your kidneys. Your doctor will test your urine as needed.
  • Nausea and throwing up (vomiting).These symptoms may happen within a few hours after your treatment and may last up to 96 hours. Medicines are available to stop or lessen these side effects.
  • Loose bowel movements (diarrhea) that may last for a few days.
  • Constipation (not able to move bowels)
  • Abdominal pain
  • Passing gas or feeling bloated
  • Indigestion
  • Decrease in appetite (decreased hunger)
  • Changes in the way food and drinks taste
  • Weakness
  • Headache
  • Dizziness
  • Eyes tearing more often

Possible Side Effects (Less Common)

  • Blood clots. A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause trouble breathing, pain when breathing, and/or chest pain.
  • Sore mouth and throat
  • Dry skin or rash
  • Blurred vision or other changes in eyesight
  • Congestive heart failure. You may be short of breath. Your arms, hands, legs and feet may swell.
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, especially on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; or sudden, severe headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • Serious or fatal bleeding. Seek medical attention immediately for serious bleeding.

Infusion Reactions

While you are getting this drug in your vein (IV), you may have a reaction. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain.

These reactions may happen the first 24 hours after you get your this drug. Call 911 for emergency care.

Allergic Reactions

Serious allergic reactions including anaphylaxis are rare. While you are receiving this drug, tell your nurse right away if you have any of the following symptoms of an allergic reaction:

  • Trouble catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat quickly or in a not normal way (palpitations)
  • Feeling dizzy or lightheaded
  • Flushing, itching, rash and/or hives

Treating Side Effects

  • Drink 6-8 cups of fluids every day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body due to losing too much fluid)
  • Ask your doctor or nurse about medicine to help prevent or lessen nausea, vomiting, diarrhea, constipation, indigestion, abdominal pain, bloating, or headache.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of ½ teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can bother your mouth and throat.
  • Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry.
  • If you are dizzy, get up slowly after sitting or lying down.

Special Instructions

  • Bevacizumab may cause slow wound healing. It should not be given within 28 days of surgery or any test or any procedure requiring conscious sedation. If you must have emergency surgery or have an accident that results in a wound, tell the treating doctor that you are on bevacizumab. Call your cancer doctor as soon as possible for further orders.
  • If you have a nose bleed, sit with your head tipped slightly forward. Apply pressure by lightly pinching the bridge of your nose between your thumb and pointer finger. Call your doctor if you feel dizzy or lightheaded or if the bleeding doesn’t stop after 10 to 15 minutes.

Food and Drug Interactions

There are no known interactions of bevacizumab with food. Bevacizumab may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs, and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor’s help.

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Bleeding or bruising that is not usual
  • Wheezing or trouble breathing
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
  • Blurred vision or other changes in eyesight
  • Pain when passing urine; blood in urine
  • Pain in your lower back or side
  • Confusion or agitation
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired or weak, unusual itching, or yellowing of the eyes or skin

Call your doctor or nurse as soon as possible if any of these symptoms happen:

  • Change in hearing, ringing in the ears
  • Decreased urine
  • Unusual thirst or passing urine often
  • Painful mouth or throat that makes it hard to eat or drink
  • Nausea not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medicines
  • Heavy menstrual period lasting longer than normal
  • Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, clumsiness in buttoning clothes, opening jars, or other routine hand motions
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Headache that does not go away
  • Painful, red, or swollen areas on your hands or feet.
  • No bowel movement for 3 days or you feel uncomfortable
  • Extreme weakness that interferes with normal activities

Reproduction Concerns

  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used by both men and women during your cancer treatment and for at least 6 months after your treatment is done.
  • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Breast feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Revised - July 2014

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