Abevmy 400 mg (Bevacizumab SOLUTION) 400 MG

Bevacizumab is licensed for advanced cancers that depend on new blood vessel growth, usually alongside chemotherapy.

• Metastatic colorectal cancer: given with fluoropyrimidine-based chemotherapy, though it is not indicated as adjuvant treatment for colon cancer.
• Non-squamous non-small cell lung cancer: first-line treatment of unresectable, advanced, recurrent, or metastatic disease with carboplatin and paclitaxel.
• Metastatic renal cell carcinoma: given in combination with interferon alfa.
• Cervical cancer: treats persistent, recurrent, or metastatic disease alongside chemotherapy.
• Ovarian, fallopian tube, and primary peritoneal cancer: used in advanced and recurrent disease with chemotherapy, then as a single agent.
• Recurrent glioblastoma: treats recurrent disease in adults. Note that ophthalmic use of bevacizumab in conditions such as macular degeneration is off-label and outside this product’s licence.

• Bevacizumab binds and neutralises vascular endothelial growth factor, or VEGF, the signal tumours release to recruit new blood vessels. Growing tumours cannot expand far without their own blood supply to deliver oxygen and nutrients. By capturing VEGF before it reaches receptors on the cells lining blood vessels, bevacizumab prevents new vessels forming and helps normalise existing tumour vessels, which can also improve delivery of chemotherapy given alongside it.

Report abdominal pain, unusual bleeding, or wound problems promptly, as these relate to the most serious risks.

Common Side Effects

• High blood pressure: very common and often requires antihypertensive treatment.
• Protein in the urine: frequent, so urine is monitored during treatment.
• Nosebleeds and minor bleeding: common bleeding effects.
• Fatigue, headache, and taste changes: general effects during treatment.

Serious or Rare Side Effects

• Gastrointestinal perforation and fistula: a hole forming in the bowel wall; seek emergency care for severe abdominal pain, fever, or vomiting.
• Serious haemorrhage: including bleeding in the lungs or gut; seek emergency care for coughing blood, black stools, or heavy bleeding.
• Wound healing complications and thromboembolism: wounds may fail to heal or reopen, and arterial or venous clots including stroke and heart attack can occur.

Bevacizumab requires planning around surgery and active monitoring of blood pressure and kidney function.

• Plan around surgery: stop treatment at least four weeks before elective surgery and do not restart until the wound has fully healed.
• Monitor blood pressure: check at each visit and treat hypertension promptly, interrupting treatment if it cannot be controlled.
• Monitor urine protein: test regularly and withhold or stop for significant proteinuria or nephrotic syndrome.
• Watch for bowel perforation: investigate severe abdominal pain urgently and stop treatment permanently if perforation occurs.
• Assess bleeding and clot risk: use caution in patients with recent significant bleeding, or a history of arterial thromboembolism.
• Store at 2-8°C: keep refrigerated in the carton, protect from light, do not freeze or shake, and use the diluted infusion within the recommended time.

Bevacizumab is an intravenous antibody and is not affected by food or by liver enzyme pathways, so review focuses on other treatments.

Major Interactions (Avoid)

• Sunitinib: the combination has been associated with microangiopathic haemolytic anaemia and is avoided.
• Anthracyclines and chest radiotherapy in combination: added cardiotoxicity risk means the combination needs specialist assessment before use.

Moderate Interactions (Monitor Closely)

• Anticoagulants and antiplatelet agents: these add to the bleeding risk already raised by bevacizumab, so monitor closely.
• Platinum or taxane chemotherapy: combined regimens can increase severe neutropenia and infection, so monitor blood counts.
• Live vaccines: avoid during treatment, particularly when bevacizumab is combined with chemotherapy.