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Ramucirumab Disease Interactions

There are 8 disease interactions with ramucirumab:

Major

Ramucirumab (Includes Ramucirumab) ↔ Bleeding

Severe Potential Hazard, Moderate plausibility

Applies to: Gastrointestinal Hemorrhage, Bleeding

Ramucirumab may increase the risk of bleeding. Patients have experienced gastrointestinal hemorrhage, including severe and sometimes fatal hemorrhagic events when using this agent. Permanently discontinue ramucirumab in patients experiencing severe bleeding.

Major

Vegfr (Includes Ramucirumab) ↔ Gi Perforation

Severe Potential Hazard, Moderate plausibility

Applies to: Gastrointestinal Obstruction, Gastrointestinal Perforation, History - Radiation Therapy

Inhibitors of vascular endothelial growth factor receptors (VEGFR) may cause gastrointestinal perforation and fistulae. Avoid use of these agents in patients with ovarian cancer who have evidence of recto-sigmoid involvement by pelvic examination or bowel involvement on CT scan or clinical symptoms of bowel obstruction. Permanently discontinue these agents in patients with gastrointestinal perforation.

Moderate

Ramucirumab (Includes Ramucirumab) ↔ Hypothyroidism

Moderate Potential Hazard, Moderate plausibility

Applies to: Hypothyroidism

Hypothyroidism has been reported in patients taking ramucirumab. Therapy with ramucirumab should be administered cautiously to patients with thyroid dysfunction. Baseline laboratory measurement of thyroid function is recommended and if appropriate, treatment per standard medical practice should be given prior to initiation of therapy. Clinical monitoring of thyroid function is recommended during therapy.

Moderate

Ramucirumab (Includes Ramucirumab) ↔ Liver Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Cirrhosis

The effect of hepatic impairment on the clearance of ramucirumab was evaluated in patients with mild and moderate hepatic impairment. No clinically important differences in the clearance of ramucirumab were found between patients with mild or moderate hepatic impairment compared to patients with normal hepatic function. No dose adjustment is recommended for patients with mild or moderate hepatic impairment. No PK data are available from patients with severe hepatic dysfunction.

Moderate

Vegfr (Includes Ramucirumab) ↔ Hypertension

Moderate Potential Hazard, Moderate plausibility

Applies to: Hypertension, Hypertensive Encephalopathy

Inhibitors of vascular endothelial growth factor receptors (VEGFR) have been associated with severe increases in blood pressure. Therapy with these agents should be administered cautiously in patients with preexisting hypertension. Blood pressure should be assessed prior to initiating treatment, regularly during treatment and after discontinuation in patients with bevacizumab -induced or -exacerbated hypertension. Temporarily suspend these agents in patients with severe hypertension that is not controlled with medical management. Discontinue these agents in patients with hypertensive crisis or hypertensive encephalopathy.

Moderate

Vegfr (Includes Ramucirumab) ↔ Pres

Moderate Potential Hazard, Moderate plausibility

Applies to: Posterior Reversible Encephalopathy Syndrome

Posterior Reversible Encephalopathy Syndrome (PRES) has been reported with the use of inhibitors of vascular endothelial growth factor receptors (VEGFR) in clinical studies. PRES is a neurological disorder which can present with headache, seizure, lethargy, confusion, blindness and other visual and neurologic disturbances. It is recommended to discontinue these agents in patients developing PRES. The safety of restarting therapy is not known. Cation is recommended if therapy is reinitiating in patients previously experiencing PRES.

Moderate

Vegfr (Includes Ramucirumab) ↔ Proteinuria

Moderate Potential Hazard, Moderate plausibility

Applies to: Proteinuria, Renal Dysfunction

The incidence and severity of proteinuria is increased in patients taking inhibitors of vascular endothelial growth factor receptors (VEGFR). Therapy with these agents should be administered cautiously in patients with renal dysfunction. Monitoring for proteinuria and hematuria is recommended and perform baseline and periodic urinalyses during treatment, with follow up measurement as clinically indicated. It is recommended to temporarily suspend these agents in patients with moderate to severe proteinuria and to discontinue therapy in patients with nephrotic syndrome.

Moderate

Vegfr (Includes Ramucirumab) ↔ Thromboembolic Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Pulmonary Embolism, Thrombotic/Thromboembolic Disorder, History - Thrombotic/Thromboembolic Disorder

Venous and arterial thromboembolic events (VTE and ATE), some fatal, have been reported with the use of inhibitors of vascular endothelial growth factor receptors (VEGFR). Caution is recommended when using these agents in patients with a reported history of VTE or ATE. These agents should be discontinued in patients with serious or life-threatening VTE or ATE, including pulmonary embolism.

ramucirumab drug Interactions

There are 189 drug interactions with ramucirumab

ramucirumab alcohol/food Interactions

There is 1 alcohol/food interaction with ramucirumab

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2017 Multum Information Services, Inc. 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.

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