৳ 20,000/unit
Pack: ৳ 20,000
৳ 20,000/unit
Pack: ৳ 20,000
At a glance
Bevacizumab is an anti-angiogenic anticancer medication used in the treatment of colorectal cancer, non-small cell lung cancer, renal cell carcinoma, glioblastoma, ovarian cancer, and cervical cancer. It prevents the formation of new blood vessels that feed tumors, thereby stopping tumor growth.
Indications
- Metastatic colorectal cancer (first and second-line)
- Non-squamous non-small cell lung cancer
- Glioblastoma (progressive disease)
- Metastatic renal cell carcinoma
- Cervical cancer (persistent, recurrent, or metastatic)
- Platinum-resistant and platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer
Pharmacology
Bevacizumab is a recombinant humanized monoclonal IgG1 antibody that inhibits the biological activity of human vascular endothelial growth factor (VEGF) in in-vitro and in-vivo assay systems. It contains human framework regions and murine complementarity-determining regions that bind to VEGF. Bevacizumab has an approximate molecular weight of 149 kD. It is produced in a mammalian cell (Chinese Hamster Ovary) expression system in a nutrient medium containing gentamicin. Gentamicin is not detectable in the final product.
Dosage
Metastatic Colorectal Cancer (mCRC):
First-line: 5 mg/kg every 2 weeks OR 7.5 mg/kg every 3 weeks. Second-line: 10 mg/kg every 2 weeks OR 15 mg/kg every 3 weeks (with FOLFOX4) OR 5 mg/kg every 2 weeks or 7.5 mg/kg every 3 weeks (with fluoropyrimidine-based regimen) until disease progression.
Non-Squamous Non-Small Cell Lung Cancer (NSNSCLC): 15 mg/kg every 3 weeks (with carboplatin and paclitaxel).
Glioblastoma: 10 mg/kg every 2 weeks (single agent).
Metastatic Renal Cell Carcinoma (mRCC): 10 mg/kg every 2 weeks (with interferon alfa).
Cervical Cancer: 15 mg/kg every 3 weeks (with paclitaxel and cisplatin or paclitaxel and topotecan).
Platinum-Resistant Recurrent Ovarian Cancer: 10 mg/kg every 2 weeks OR 15 mg/kg every 3 weeks.
Platinum-Sensitive Recurrent Ovarian Cancer: 15 mg/kg every 3 weeks (with carboplatin and paclitaxel OR carboplatin and gemcitabine for 6-10 cycles, then single agent until progression).
Exudative Age-Related Macular Degeneration: 1.25 mg (0.05 mL solution) intravitreal injection monthly.
Do not initiate Bevacizumab for 28 days following major surgery (until wound is fully healed).
Side effects
Common (incidence >10% and at least twice control arm rate):
Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, rectal hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis.
Other:
Gastrointestinal hemorrhage, minor gum bleeding, vaginal hemorrhage, neutropenia, leukopenia, anemia, dehydration, anorexia, asthenia, sepsis, deep thrombophlebitis, congestive heart failure, diarrhea, constipation, hypokalemia, hyponatremia.
Use in pregnancy
May be unsafe during pregnancy. Animal studies have shown harmful effects on the developing baby. Your doctor will weigh benefits and risks before prescribing. Use effective contraception during treatment.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Precautions & warnings
- Perforation or Fistula: Discontinue Bevacizumab if occurs.
- Arterial Thromboembolic Events (ATE): Myocardial infarction, cerebral infarction; discontinue for severe ATE.
- Venous Thromboembolic Events (VTE): Discontinue for life-threatening VTE.
- Hypertension: Monitor and treat. Temporarily suspend if not controlled; discontinue for hypertensive crisis or encephalopathy.
- Posterior Reversible Encephalopathy Syndrome (PRES): Discontinue.
- Proteinuria: Monitor urine protein. Discontinue for nephrotic syndrome; temporarily suspend for moderate proteinuria.
- Infusion Reactions: Stop for severe infusion reactions.
- Embryo-fetal Toxicity: Advise females of potential risk and need for effective contraception.
- Ovarian Failure: Advise females of potential risk.
- Wound Healing: Inform doctor before surgery (healing ability reduced).
- Bleeding Risk: Notify doctor if unusual bleeding occurs.
- Driving: Sleepiness and dizziness may occur; avoid driving.
Overdose effects
The highest dose tested in humans (20 mg/kg IV) was associated with headache in 9 out of 16 patients and severe headache in 3 out of 16 patients. Overdose may increase bleeding risk, hypertension, and proteinuria.
Storage conditions
Store the vial in a refrigerator at 2-8°C. Keep in the outer carton to protect from light. Do not freeze. Keep out of reach of children.