Ziv-aflibercept (Generic Name)

Other Names: Zaltrap®

About This Drug

Ziv-aflibercept is a drug used to treat colorectal cancer. This drug 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.
  • Redness and/or swelling of the hands or feet, especially in combination with other cancer therapies.
  • Bone marrow depression, especially in combination with other anti-cancer therapies. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • This drug may affect how your kidneys work. Your kidney function will be checked as needed. 
  • Fatigue
  • Headache
  • Diarrhea (loose bowel movements)
  • Abdominal pain
  • Infection
  • Soreness of the mouth and throat
  • Weight loss
  • Decrease in appetite
  • Shortness of breath
  • Trouble speaking

Possible Side Effects (Less Common)

  • Changes to the color of your skin
  • Dehydration
  • Runny nose
  • 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.
  • Stroke: 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, 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. 
  • Blood in your stools (call your doctor right away if this happens)

Allergic Reactions

  • Serious allergic reactions including anaphylaxis are rare.  While you are getting this drug in your vein (IV), tell your nurse right away if you have any of these 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

Special Instructions

  • Ziv-aflibercept may cause slow wound healing. It should not be given within 28 days of surgery or any test and/or procedure needing conscious sedation. If you must have emergency surgery or have an accident that results in a wound, tell the doctor that you are on ziv-aflibercept.  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 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 from losing too much fluid).
  • 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 1/2 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 each 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.
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat.

Food and Drug Interactions

There are no known interactions of ziv-aflibercept with food. This drug 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 higher
  • Chills
  • Easy bleeding or bruising
  • Blood in your bowel movements
  • 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 lightheadedness
  • 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 and 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
  • Blurred vision or other changes in eyesight
  • Decreased urine
  • Unusual thirst or passing urine often
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Nausea that is not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medicines
  • Heavy menstrual period that lasts longer than normal
  • Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, feeling clumsy when 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: It is not known if this drug may harm an unborn child.  For this reason, be sure to talk with your doctor if you are pregnant or planning to become pregnant while getting this drug.
  • 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 November 2014

©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com