Select therapeutic use:

Bladder, kidney, and other urologic cancers:

Indications for AVASTIN:

Metastatic renal cell carcinoma (mRCC) in combination with interferon alfa.

Adult Dosage:

Give by IV infusion. Infuse 1st dose over 90mins; if tolerated, infuse 2nd dose over 60mins, and subsequent doses over 30mins. 10mg/kg every 2 weeks with interferon alfa.

Children Dosage:

<18yrs: not established.

AVASTIN Warnings/Precautions:

Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. HCC patients: assess for presence of varices within 6 months of therapy initiation. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Discontinue if GI perforation, tracheoesophageal fistula, Grade 4 fistula, or fistula formation involving any organ. Wound healing complications: withhold for ≥28 days prior to elective surgery; do not give for ≥28 days after major surgery and until adequate healing. Discontinue if necrotizing fasciitis, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event, Grade 4 venous thromboembolic event (including pulmonary embolism), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, severe infusion-related reactions, or CHF develops; withhold if severe hypertension or proteinuria ≥2g/24hrs (resume when <2g/24hrs) occurs. History of arterial thromboembolism. Diabetes. Monitor BP every 2–3 weeks. Monitor proteinuria by dipstick urine analysis; if ≥2+, do further assessment with a 24-hour urine collection. Elderly. Increased risk of ovarian failure (premenopausal women). Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after the last dose. Pregnancy. Nursing mothers: not recommended (during and for 6 months after the last dose).

AVASTIN Classification:

Vascular endothelial growth factor (VEGF) inhibitor.

AVASTIN Interactions:

Increased risk of CHF and decline in LVEF with concomitant anthracycline-based therapy (not indicated use).

Adverse Reactions:

Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, rectal hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis; GI perforation and fistulae, wound healing complications, necrotizing fasciitis, hemorrhage, non-GI fistula formation, arterial or venous thromboembolic events, PRES, infusion-related reactions, ovarian failure, neutropenia, infection.

Generic Drug Availability:

NO

How Supplied:

Single-dose vial (4mL, 16mL)—1, 10

CNS cancers:

Indications for AVASTIN:

Recurrent gliobastoma in adults.

Adult Dosage:

Give by IV infusion. Infuse 1st dose over 90mins; if tolerated, infuse 2nd dose over 60mins, and subsequent doses over 30mins. 10mg/kg every 2 weeks.

Children Dosage:

<18yrs: not established.

AVASTIN Warnings/Precautions:

Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. HCC patients: assess for presence of varices within 6 months of therapy initiation. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Discontinue if GI perforation, tracheoesophageal fistula, Grade 4 fistula, or fistula formation involving any organ. Wound healing complications: withhold for ≥28 days prior to elective surgery; do not give for ≥28 days after major surgery and until adequate healing. Discontinue if necrotizing fasciitis, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event, Grade 4 venous thromboembolic event (including pulmonary embolism), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, severe infusion-related reactions, or CHF develops; withhold if severe hypertension or proteinuria ≥2g/24hrs (resume when <2g/24hrs) occurs. History of arterial thromboembolism. Diabetes. Monitor BP every 2–3 weeks. Monitor proteinuria by dipstick urine analysis; if ≥2+, do further assessment with a 24-hour urine collection. Elderly. Increased risk of ovarian failure (premenopausal women). Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after the last dose. Pregnancy. Nursing mothers: not recommended (during and for 6 months after the last dose).

AVASTIN Classification:

Vascular endothelial growth factor (VEGF) inhibitor.

AVASTIN Interactions:

Increased risk of CHF and decline in LVEF with concomitant anthracycline-based therapy (not indicated use).

Adverse Reactions:

Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, rectal hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis; GI perforation and fistulae, wound healing complications, necrotizing fasciitis, hemorrhage, non-GI fistula formation, arterial or venous thromboembolic events, PRES, infusion-related reactions, ovarian failure, neutropenia, infection.

Generic Drug Availability:

NO

How Supplied:

Single-dose vial (4mL, 16mL)—1, 10

Colorectal and other GI cancers:

Indications for AVASTIN:

Metastatic colorectal carcinoma (mCRC), in combination with 5-FU-based chemotherapy for first- or second-line treatment; or in combination with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based therapy for second-line treatment in patients who have progressed on a first-line Avastin-containing regimen. Limitations of use: not for adjuvant treatment of colon cancer. In combination with atezolizumab for the treatment of unresectable or metastatic hepatocellular carcinoma (HCC) in patients who have not received prior systemic therapy.

Adult Dosage:

Give by IV infusion. Infuse 1st dose over 90mins; if tolerated, infuse 2nd dose over 60mins, and subsequent doses over 30mins. mCRC: 5mg/kg (when used with bolus-IFL) or 10mg/kg (when used with FOLFOX-4) once every 2 weeks until disease progression detected; 5mg/kg every 2 weeks or 7.5mg/kg every 3 weeks (when used with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based therapy). HCC: 15mg/kg (after administration of atezolizumab 1200mg) every 3 weeks until disease progression or unacceptable toxicity.

Children Dosage:

<18yrs: not established.

AVASTIN Warnings/Precautions:

Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. HCC patients: assess for presence of varices within 6 months of therapy initiation. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Discontinue if GI perforation, tracheoesophageal fistula, Grade 4 fistula, or fistula formation involving any organ. Wound healing complications: withhold for ≥28 days prior to elective surgery; do not give for ≥28 days after major surgery and until adequate healing. Discontinue if necrotizing fasciitis, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event, Grade 4 venous thromboembolic event (including pulmonary embolism), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, severe infusion-related reactions, or CHF develops; withhold if severe hypertension or proteinuria ≥2g/24hrs (resume when <2g/24hrs) occurs. History of arterial thromboembolism. Diabetes. Monitor BP every 2–3 weeks. Monitor proteinuria by dipstick urine analysis; if ≥2+, do further assessment with a 24-hour urine collection. Elderly. Increased risk of ovarian failure (premenopausal women). Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after the last dose. Pregnancy. Nursing mothers: not recommended (during and for 6 months after the last dose).

AVASTIN Classification:

Vascular endothelial growth factor (VEGF) inhibitor.

AVASTIN Interactions:

Increased risk of CHF and decline in LVEF with concomitant anthracycline-based therapy (not indicated use).

Adverse Reactions:

Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, rectal hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis; GI perforation and fistulae, wound healing complications, necrotizing fasciitis, hemorrhage, non-GI fistula formation, arterial or venous thromboembolic events, PRES, infusion-related reactions, ovarian failure, neutropenia, infection.

Generic Drug Availability:

NO

How Supplied:

Single-dose vial (4mL, 16mL)—1, 10

Gynecologic Cancers:

Respiratory and thoracic cancers:

Indications for AVASTIN:

First-line treatment of unresectable, locally advanced, recurrent or metastatic non-squamous, non-small cell lung cancer (NSCLC), in combination with carboplatin and paclitaxel.

Adult Dosage:

Give by IV infusion. Infuse 1st dose over 90mins; if tolerated, infuse 2nd dose over 60mins, and subsequent doses over 30mins. 15mg/kg every 3 weeks with carboplatin/paclitaxel.

Children Dosage:

<18yrs: not established.

AVASTIN Warnings/Precautions:

Do not administer if recent history of hemoptysis of ≥ ½-teaspoon of red blood. HCC patients: assess for presence of varices within 6 months of therapy initiation. Avoid in ovarian cancer if evidence of recto-sigmoid involvement by pelvic exam, bowel involvement on CT scan, or symptoms of bowel obstruction. Discontinue if GI perforation, tracheoesophageal fistula, Grade 4 fistula, or fistula formation involving any organ. Wound healing complications: withhold for ≥28 days prior to elective surgery; do not give for ≥28 days after major surgery and until adequate healing. Discontinue if necrotizing fasciitis, Grade 3 or 4 hemorrhage, severe arterial thromboembolic event, Grade 4 venous thromboembolic event (including pulmonary embolism), hypertensive crisis or encephalopathy, posterior reversible encephalopathy syndrome (PRES), nephrotic syndrome, severe infusion-related reactions, or CHF develops; withhold if severe hypertension or proteinuria ≥2g/24hrs (resume when <2g/24hrs) occurs. History of arterial thromboembolism. Diabetes. Monitor BP every 2–3 weeks. Monitor proteinuria by dipstick urine analysis; if ≥2+, do further assessment with a 24-hour urine collection. Elderly. Increased risk of ovarian failure (premenopausal women). Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after the last dose. Pregnancy. Nursing mothers: not recommended (during and for 6 months after the last dose).

AVASTIN Classification:

Vascular endothelial growth factor (VEGF) inhibitor.

AVASTIN Interactions:

Increased risk of CHF and decline in LVEF with concomitant anthracycline-based therapy (not indicated use).

Adverse Reactions:

Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, rectal hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis; GI perforation and fistulae, wound healing complications, necrotizing fasciitis, hemorrhage, non-GI fistula formation, arterial or venous thromboembolic events, PRES, infusion-related reactions, ovarian failure, neutropenia, infection.

Generic Drug Availability:

NO

How Supplied:

Single-dose vial (4mL, 16mL)—1, 10