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Bevacizumab Dosage

Medically reviewed on June 14, 2018.

Applies to the following strengths: 25 mg/mL

Usual Adult Dose for Colorectal Cancer

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

Duration of therapy: Until disease progression or unacceptable toxicity

Comments:
-Do not administer as an IV push or bolus.
-Do not administer this drug until at least 28 days following surgery and the wound is fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use:
-For first or second line therapy of patients with metastatic carcinoma of the colon or rectum in combination with IV 5-fluorouracil-based chemotherapy
-For second line therapy of patients with metastatic colorectal cancer who have progressed on a first-line bevacizumab-containing regimen, in combination with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy

Usual Adult Dose for Non-Small Cell Lung Cancer

In combination with carboplatin and paclitaxel: 15 mg/kg IV every 3 weeks

Duration of therapy: Until disease progression or unacceptable toxicity

Comments:
-Do not administer as an IV push or bolus.
-Do not administer this drug until at least 28 days following surgery and the wound is fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use: For first-line therapy of unresectable, locally advanced, recurrent, or metastatic non-squamous non-small cell lung cancer in combination with carboplatin and paclitaxel

Usual Adult Dose for Glioblastoma Multiforme

10 mg/kg IV every 2 weeks

Duration of therapy: Until disease progression or unacceptable toxicity

Comments:
-Do not administer as an IV push or bolus.
-Do not administer this drug until at least 28 days following surgery and the wound is fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use: For the treatment of recurrent glioblastoma in adults

Usual Adult Dose for Renal Cell Carcinoma

In combination with interferon alfa: 10 mg/kg IV every 2 weeks

Duration of therapy: Until disease progression or unacceptable toxicity

Comments:
-Do not administer as an IV push or bolus.
-Do not administer this drug until at least 28 days following surgery and the wound is fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use: For metastatic renal cell carcinoma in combination with interferon alfa

Usual Adult Dose for Cervical Cancer

In combination with paclitaxel and cisplatin OR paclitaxel and topotecan: 15 mg/kg IV every 3 weeks

Comments:
-Do not administer as an IV push or bolus.
-Do not administer this drug until at least 28 days following surgery and the wound is fully healed.
-Administer the first infusion over 90 minutes, the second over 60 minutes if first infusion is tolerated, and all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.

Use: For persistent, recurrent, or metastatic carcinoma of the cervix in combination with paclitaxel and cisplatin or paclitaxel and topotecan

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

No dose reductions are recommended for this drug.

If proteinuria develops and is greater than or equal to 2 grams per 24 hours in absence of nephrotic syndrome: Withhold this drug until proteinuria is less than 2 grams per 24 hours.

If a clinically significant infusion reaction occurs that is not severe: Interrupt the infusion and resume at a decreased rate after symptoms resolve.

Discontinue this drug for any of the following:
-Any Grade GI perforation
-Any Grade tracheoesophageal fistula
-Grade 4 fistula
-Fistula formation involving any internal organ
-Wound healing complications requiring medical intervention
-Necrotizing fasciitis
-Grade 3 or 4 hemorrhage
-Recent history of hemoptysis of 2.5 mL or more
-Severe arterial thromboembolism
-Grade 4 venous thromboembolism
-Hypertensive crisis
-Hypertensive encephalopathy
-Severe hypertension
-Any severity of renal toxicity and proteinuria
-Severe infusion reaction
-Any congestive heart failure

Precautions

US BOXED WARNINGS:
GI PERFORATION:
-The incidence of GI perforation (sometimes fatal) in patients receiving this drug ranges from 0.3% to 3%. Discontinue therapy in patients who develop GI perforation.
SURGERY AND WOUND HEALING COMPLICATIONS:
-The incidence of wound healing and surgical complications (sometimes fatal), is increased in patients receiving this drug. Discontinue therapy in patients who develop wound healing complications that require medical intervention. Withhold this drug for at least 28 days prior to elective surgery. Do not administer this drug for at least 28 days after surgery, and until the wound is fully healed.
HEMORRHAGE:
-Severe or fatal hemorrhage, including hemoptysis, GI bleeding, hematemesis, CNS hemorrhage, epistaxis, and vaginal bleeding occur up to 5-fold more frequently in patients receiving this drug. Do not administer this drug to patients with a recent history of hemoptysis. Discontinue therapy in patients who develop Grade 3 or 4 hemorrhage.

CONTRAINDICATIONS:
-None

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-The first dose should be infused over 90 minutes following chemotherapy. If it is well tolerated, the second dose may be infused over 60 minutes. If the 60 minute infusion is well tolerated, all subsequent doses may be infused over 30 minutes.
-Do not administer as an IV push or bolus.

General:
-Do not initiate therapy for at least 28 days following major surgery and the surgical incision is fully healed.
-Prepare, administer, and dispose of this drug according to standard protocols for antineoplastic drugs.
-This drug is not formulated for intravitreal use.

Monitoring:
-Hypersensitivity: Infusion-related reactions
-Cardiovascular: Blood pressure monitoring for hypertension
-Renal: Proteinuria
-Common adverse events: Arterial or venous thromboembolic events, GI perforation, fistulae, delayed wound healing, hemorrhage (including tumor-associated hemorrhage), congestive heart failure, neutropenia, osteonecrosis of the jaw, and reversible posterior leukoencephalopathy syndrome.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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