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Ziv-aflibercept Side Effects

For the Consumer

Applies to ziv-aflibercept: intravenous solution

As well as its needed effects, ziv-aflibercept may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking ziv-aflibercept, check with your doctor or nurse immediately:

More common:
  • Anxiety
  • black, tarry stools
  • bladder pain
  • bleeding gums
  • blood in the urine or stools
  • bloody nose
  • blurred vision
  • chest pain
  • confusion
  • cough or hoarseness
  • decreased urination
  • difficult, burning, or painful urination
  • dizziness or lightheadedness
  • dry mouth
  • excessive thirst
  • fainting
  • fever or chills
  • frequent urge to urinate
  • headache
  • hoarseness
  • lower back or side pain
  • nervousness
  • pain or swelling around the rectum
  • pale skin
  • pinpoint red spots on the skin
  • pounding in the ears
  • slow or fast heartbeat
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • sudden shortness of breath or troubled breathing
  • sunken eyes
  • swollen glands
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • voice changes
  • wrinkled skin

Minor Side Effects

Some ziv-aflibercept side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Less common:
  • Abdominal or stomach pain
  • decreased appetite
  • diarrhea
  • lack or loss of strength
  • redness, swelling, or pain of the skin
  • runny nose
  • scaling of the skin on the hands and feet
  • swelling or inflammation of the mouth
  • tingling of the hands and feet
  • ulceration of the skin

For Healthcare Professionals

Applies to ziv-aflibercept: intravenous solution


Cardiovascular side effects have included hypertension (41%), deep vein thrombosis (9%), and angina pectoris.[Ref]


Dermatologic side effects have included palmar-plantar erythrodysesthesia syndrome (11%), skin hyperpigmentation (11%), compromised wound healing (0.3%), and catheter site infection.[Ref]


Gastrointestinal side effects have included diarrhea (69%), stomatitis (50%), abdominal pain (27%), abdominal pain upper (11%), hemorrhoids (6%), rectal hemorrhage (5%), proctalgia (5%), gastrointestinal hemorrhage (3%), fistulas formation (1.5%), gastrointestinal perforation (0.8%), and tooth infection.[Ref]


General side effects have included fatigue (48%) and asthenia (18%).[Ref]


Genitourinary side effects have included urinary tract infections (9%) and hematuria (3%).[Ref]


Hematologic side effects have included leukopenia (78%), neutropenia (67%), and thrombocytopenia (48%).[Ref]


Hypersensitivity reactions have included severe hypersensitivity reactions (0.3%).[Ref]


Immunologic side effects have included the development of anti-product antibody (3.1%).[Ref]


Metabolic side effects have included decreased appetite (32%), decreased weight (32%), and dehydration (9%).

Laboratory abnormalities have included increased AST (62%) and increase ALT (50%).[Ref]

Nervous system

Nervous system side effects have included headache (22%), reversible posterior leukoencephalopathy syndrome (0.5%), transient ischemic attack, and cerebrovascular accident.[Ref]


Other side effects have included post-procedural hemorrhage (3%).[Ref]


Renal side effects have included proteinuria (62%), increased serum creatinine (23%), and nephrotic syndrome (0.5%).[Ref]


Respiratory side effects have included epistaxis (28%), dysphonia (25%), dyspnea (12%), oropharyngeal pain (8%), rhinorrhea (6%), pulmonary embolism (5%), pulmonary hemorrhage, hemoptysis, nasopharyngitis, upper respiratory tract infection, and pneumonia.[Ref]


1. "Product Information. Zaltrap (ziv-aflibercept)." sanofi-aventis , Bridgewater, NJ.

It is possible that some side effects of ziv-aflibercept may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided 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. This 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 safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.