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What should I discuss with my healthcare provider before receiving bevacizumab (Avastin)?

You should not use bevacizumab if you are allergic to it, or if you have:

• untreated or uncontrolled high blood pressure;
• severe or uncontrolled bleeding;
• an open skin wound;
• an open surgical incision;
• if you have had surgery within the past 4 weeks (28 days);
• if you have recently been coughing up blood; or
• if you plan to have surgery within the next 4 weeks (28 days).

To make sure you can safely receive bevacizumab, tell your doctor if you have any of these other conditions:

• a bleeding or blood-clotting disorder;
• a history of stomach or intestinal bleeding;
• a history of perforation (a hole or tear) in your esophagus, stomach, or intestines;
• heart disease, congestive heart failure;
• high blood pressure; or
• a history of heart attack, stroke, or blood clots.

FDA pregnancy category C. It is not known whether bevacizumab will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Bevacizumab may cause a woman's ovaries to stop working correctly. Symptoms of ovarian failure include 3 or more missed menstrual periods in a row. This may affect your fertility (ability to have children). Talk to your doctor about your specific risks.

It is not known whether bevacizumab passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are being treated with bevacizumab.

Older adults may be more likely to have side effects from this medication.

How is bevacizumab used (Avastin)?

Treatment with bevacizumab may cause you to have problems with wound healing, which could result in bleeding or infection. If you need to have any type of surgery, you will need to stop receiving bevacizumab at least 4 weeks ahead of time. Do not start using bevacizumab for at least 4 weeks after surgery, or until your surgical incision heals.

Bevacizumab is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Bevacizumab must be given slowly, and the IV infusion can take up to 90 minutes to complete.

Bevacizumab is usually given once every 2 weeks.

To be sure this medication is not causing harmful effects, your blood pressure will need to be checked often. Your urine may also need to be tested. Visit your doctor regularly.

Bevacizumab must be stored in a refrigerator and kept from freezing. Bevacizumab bottles should never be shaken.

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