Bevacizumab (Generic Name)

Other Names: Avastin 

About this drug

Bevacizumab is used to treat cancer. It is given intravenously (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 increase your risk for infection.
  • Effects on your kidneys. Your doctor will test your urine as needed.
  • Nausea and vomiting
  • Diarrhea or constipation (diarrhea is more common but some people have constipation)
  • Abdominal pain
  • Passing gas or feeling bloated
  • Indigestion
  • Decrease in appetite
  • Changes in the way food and beverages taste
  • Weakness
  • Headache
  • Dizziness
  • Eyes tearing more often

Possible Side Effects (Less Common)

  • Sore mouth and throat
  • Dry skin or rash
  • Allergic reactions to this drug are rare. Signs of allergic reaction are shortness of breath, rash or itching, dizziness or lightheadedness, or palpitations (feeling your heart beat rapidly)
  • Chest pain (rare)
  • Heart attack (rare)
  • Stroke (rare)

 Reproductive Concerns

  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment. 
  •  Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.
  • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women are advised to discuss with their doctor the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and seriously harm a breast feeding infant.

Special Instructions

  • Bevacizumab may cause slow wound healing. It should not be given within 28 days of surgery 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 instructions.
  • 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 forefinger. Call your doctor if you feel dizzy or faint or if the bleeding doesn’t stop after 10 to 15 minutes.

Treating Side Effects

  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated. 
  • Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • Ask your doctor or nurse about medicine to help prevent or lessen nausea, vomiting, diarrhea, constipation, indigestion, abdominal pain, bloating, or headache.
  • Mouth care is very important. You should brush your teeth gently with a very soft tooth brush. Rinse your mouth with a mix of 1/2 teaspoon of salt in 8 ounces of water or 1/2 teaspoon of baking soda (sodium bicarbonate) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • Avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate 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. Ask your doctor or nurse to recommend a product for dry skin.

Food and Drug Interactions

There are no known interactions of this drug 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 currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly 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 advice.

While you are receiving this drug by IV, tell your nurse immediately if you have any of the following symptoms of an allergic reaction:

    • Shortness of breath
    • Rash or itching
    • Dizziness or lightheadedness
    • Feeling your heart beat rapidly (palpitations)

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Unusual bleeding or uncontrolled bleeding
  • Severe abdominal pain
  • Trouble breathing
  • Chest pain or symptoms of a heart attack. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes. Or the discomfort may go away and come back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. Sometimes discomfort 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. 
  • Uncontrolled nausea that keeps you from eating or drinking
  • Vomiting more than 3 times in 1 day

 

Call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Rash that does not go away with prescribed medicine
  • Nausea or vomiting that does not go away with prescribed medicine
  • No bowel movement for 3 days or you feel uncomfortable
  • Diarrhea of 5 or 6 stools in 1 day or diarrhea with weakness
  • Extreme weakness that interferes with normal activities

Revised January 2011

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