Alymsys Dosage

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

Medically reviewed by Drugs.com. Last updated on Apr 17, 2024.

Important Administration Information

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

Metastatic Colorectal Cancer

The recommended dosage when Alymsys 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

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).

Dosage Modifications for Adverse Reactions

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

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

Preparation and Administration

Preparation

Use appropriate aseptic technique.
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 Alymsys 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.
Store diluted Alymsys solution at 2°C to 8°C (36°F to 46°F) for up to 12 hours.
No incompatibilities between Alymsys and polyvinylchloride or polyolefin bags 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.