Drug Interactions between antithrombin (recombinant) and ramucirumab

MONITOR CLOSELY: Coadministration of ramucirumab and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Ramucirumab can cause bleeding, including severe and sometimes fatal hemorrhagic complications. In one clinical study, the incidence of severe bleeding was 3.4% for ramucirumab versus 2.6% for placebo.

MANAGEMENT: Concomitant use of ramucirumab and medications that interfere with platelet function or coagulation should be approached cautiously. Close clinical and laboratory observation for bleeding complications is recommended. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools. Ramucirumab should be permanently discontinued in patients who experience severe bleeding.