Vegzelma Dosage

Generic name: BEVACIZUMAB 100mg in 4mL
Dosage form: injection, solution
Drug class: VEGF/VEGFR inhibitors

Medically reviewed by Drugs.com. Last updated on Feb 22, 2023.

Important Administration Information

Withhold for at least 28 days prior to elective surgery. Do not administer VEGZELMA until at least 28 days following major surgery and until adequate wound healing.

Metastatic Colorectal Cancer

The recommended dosage when VEGZELMA is administered in combination with intravenous fluorouracil-based chemotherapy is:

5 mg/kg intravenously every 2 weeks in combination with bolus-IFL.
10 mg/kg intravenously every 2 weeks in combination with FOLFOX4.
5 mg/kg intravenously every 2 weeks or 7.5 mg/kg intravenously every 3 weeks in combination with fluoropyrimidine-irinotecan-or fluoropyrimidine-oxaliplatin-based chemotherapy in patients who have progressed on a first-line bevacizumab product-containing regimen.

First-Line Non-Squamous Non-Small Cell Lung Cancer

The recommended dosage is 15 mg/kg intravenously every 3 weeks in combination with carboplatin and paclitaxel.

Recurrent Glioblastoma

The recommended dosage is 10 mg/kg intravenously every 2 weeks.

Metastatic Renal Cell Carcinoma

The recommended dosage is 10 mg/kg intravenously every 2 weeks in combination with interferon alfa.

Persistent, Recurrent, or Metastatic Cervical Cancer

The recommended dosage is 15 mg/kg intravenously every 3 weeks in combination with paclitaxel and cisplatin or in combination with paclitaxel and topotecan.

Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

Stage III or IV Disease Following Initial Surgical Resection

The recommended dosage is 15 mg/kg intravenously every 3 weeks in combination with carboplatin and paclitaxel for up to 6 cycles, followed by VEGZELMA 15 mg/kg every 3 weeks as a single agent for a total of up to 22 cycles or until disease progression, whichever occurs earlier.

Recurrent Disease

Platinum Resistant

The recommended dosage is 10 mg/kg intravenously every 2 weeks in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan (every week).

The recommended dosage is 15 mg/kg intravenously every 3 weeks in combination with topotecan (every 3 weeks).

Platinum Sensitive

The recommended dosage is 15 mg/kg intravenously every 3 weeks, in combination with carboplatin and paclitaxel for 6 to 8 cycles, followed by VEGZELMA 15 mg/kg every 3 weeks as a single agent until disease progression.

The recommended dosage is 15 mg/kg intravenously every 3 weeks, in combination with carboplatin and gemcitabine for 6 to 10 cycles, followed by VEGZELMA 15 mg/kg every 3 weeks as a single agent until disease progression.

Dosage Modifications for Adverse Reactions

Table 1 describes dosage modifications for specific adverse reactions. No dose reductions for VEGZELMA are recommended.

Table 1: Dosage Modifications for Adverse Reactions
Adverse Reaction	Severity	Dosage Modification
Gastrointestinal Perforations and Fistulae [see Warnings and Precautions (5.1)].	Gastrointestinal perforation, any grade Tracheoesophageal fistula, any grade Fistula, Grade 4 Fistula formation involving any internal organ	Discontinue VEGZELMA
Wound Healing Complications [see Warnings and Precautions (5.2)].	Any	Withhold VEGZELMA until adequate wound healing. The safety of resumption of bevacizumab products after resolution of wound healing complications has not been established.
	Necrotizing fasciitis	Discontinue VEGZELMA
Hemorrhage [see Warnings and Precautions (5.3)].	Grade 3 or 4	Discontinue VEGZELMA
Hemorrhage [see Warnings and Precautions (5.3)].	Recent history of hemoptysis of 1/2 teaspoon (2.5 mL) or more	Withhold VEGZELMA
Thromboembolic Events [see Warnings and Precautions (5.4, 5.5)].	Arterial thromboembolism, severe	Discontinue VEGZELMA
	Venous thromboembolism, Grade 4	Discontinue VEGZELMA
Hypertension [see Warnings and Precautions (5.6)].	Hypertensive crisis Hypertensive encephalopathy	Discontinue VEGZELMA
Hypertension [see Warnings and Precautions (5.6)].	Hypertension, severe	Withhold VEGZELMA if not controlled with medical management; resume once controlled
Posterior Reversible Encephalopathy Syndrome (PRES) [see Warnings and Precautions (5.7)].	Any	Discontinue VEGZELMA
Renal Injury and Proteinuria [see Warnings and Precautions (5.8)].	Nephrotic syndrome	Discontinue VEGZELMA
	Proteinuria greater than or equal to 2 grams per 24 hours in absence of nephrotic syndrome	Withhold VEGZELMA until proteinuria less than 2 grams per 24 hours
Infusion-Related Reactions [see Warnings and Precautions (5.9)].	Severe	Discontinue VEGZELMA
	Clinically significant	Interrupt infusion; resume at a decreased rate of infusion after symptoms resolve
	Mild, clinically insignificant	Decrease infusion rate
Congestive Heart Failure [see Warnings and Precautions (5.12)].	Any	Discontinue VEGZELMA

Preparation and Administration

Preparation

Use appropriate aseptic technique.
Use sterile needle and syringe to prepare VEGZELMA.
Visually inspect vial for particulate matter and discoloration prior to preparation for administration. Discard vial if solution is cloudy, discolored, or contains particulate matter.
Withdraw necessary amount of VEGZELMA and dilute in a total volume of 100 mL of 0.9% Sodium Chloride Injection, USP. DO NOT ADMINISTER OR MIX WITH DEXTROSE SOLUTION.
Discard any unused portion left in a vial, as the product contains no preservatives.
Diluted VEGZELMA solution may be stored at 2°C to 8°C (36°F to 46°F) for up to 24 hours, or at room temperature up to 30°C (86°F) for up to 4 hours, if not used immediately.
No incompatibilities between VEGZELMA and polyolefin (polypropylene and polyethylene) bag have been observed.

Administration

Administer as an intravenous infusion.
First infusion: Administer infusion over 90 minutes.
Subsequent infusions: Administer second infusion over 60 minutes if first infusion is tolerated. Administer all subsequent infusions over 30 minutes if second infusion over 60 minutes is tolerated.