Drug Interaction Report

Ramucirumab can cause bleeding and gastrointestinal perforation. Combining it with other medications that also have these effects such as bismuth subsalicylate may increase the risk. In clinical studies, treatment with ramucirumab alone has been associated with severe and sometimes fatal hemorrhage. Rarely, gastrointestinal perforation has occurred, which is a potentially fatal condition and medical emergency where a hole forms all the way through the stomach or intestine. Except for daily low-dose aspirin to prevent heart attacks, chronic use of other similar analgesics (also known as nonsteroidal anti-inflammatory drugs, or NSAIDs) during treatment with ramucirumab has not been studied. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.