Generic Name: ziv-aflibercept (ZIV a FLIB er sept)
Brand Names: Zaltrap

What is Zaltrap?

Zaltrap (ziv-aflibercept) is made from a human antibody fragment. It works by keeping new blood vessels from forming in a fast-growing tumor.

Zaltrap is used in combination with other medications to treat colorectal cancer.

Zaltrap is usually given after other cancer medications have been tried without successful treatment.

Ziv-aflibercept may also be used for purposes not listed in this medication guide.

Important information

You should not use Zaltrap if you are allergic to ziv-aflibercept, or if you have severe bleeding or uncontrolled hypertension (high blood pressure).

Before you receive Zaltrap, tell your doctor if you have high blood pressure, open sores or skin wounds, or if you have had surgery or dental work within the past 4 weeks.

Slideshow: 2014 Update: First Time Brand-to-Generic Switches

You should not breast-feed while you are using Zaltrap.

Zaltrap may cause serious and sometimes fatal bleeding. Call your doctor at once if you have any signs of unusual bleeding, including easy bruising, bloody stools, coughing up blood, or feeling light-headed or short of breath.

If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using Zaltrap. You may need to stop using the medicine at least 4 weeks before your surgery.

Before taking this medicine

You should not use Zaltrap if you are allergic to ziv-aflibercept, or if you have:

  • severe bleeding; or

  • untreated or uncontrolled hypertension (high blood pressure).

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

  • high blood pressure;

  • open sores or skin wounds; or

  • if you have had surgery or dental work within the past 4 weeks.

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

See also: Pregnancy and breastfeeding warnings (in more detail)

Use birth control to prevent pregnancy while you are receiving Zaltrap, and for at least 3 months after your treatment ends, whether you are a man or a woman.

This medication may affect fertility (your ability to have children), whether you are a man or a woman.

It is not known whether ziv-aflibercept passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using Zaltrap.

Older adults may be more likely to have severe diarrhea or get dehydrated while receiving Zaltrap.

How should I take Zaltrap?

Zaltrap is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Zaltrap must be given slowly, and the IV infusion can take at least 1 hour to complete.

Zaltrap is usually given every other week. Follow your doctor's instructions.

If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using Zaltrap. You may need to stop using the medicine at least 4 weeks before your surgery.

You will need regular medical tests to be sure this medication is not causing harmful effects. Your blood pressure will also need to be checked often. Visit your doctor regularly.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your Zaltrap injection.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Zaltrap side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Zaltrap: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • feeling light-headed or short of breath, trouble concentrating;

  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • any bleeding that will not stop;

  • any wound that will not heal;

  • severe or ongoing vomiting or diarrhea;

  • feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;

  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

  • sudden numbness or weakness, especially on one side of the body;

  • sudden severe headache, confusion, change in mental status, problems with speech or balance, vision loss, seizure (convulsions);

  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;

  • pain or burning when you urinate;

  • rectal pain, foul-smelling vaginal discharge, pain or swelling in your lower stomach, problems with urination or bowel movements;

  • puffy eyes, swelling in your ankles or feet, weight gain, urine that looks foamy; or

  • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious Zaltrap side effects may include:

  • stomach pain, mild diarrhea;

  • loss of appetite, weight loss;

  • mild headache;

  • feeling tired; or

  • hoarse voice.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Zaltrap?

There may be other drugs that can interact with Zaltrap. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about Zaltrap.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Zaltrap only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 1.02. Revision Date: 2013-05-15, 8:43:15 AM.

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