Avastin instructions for use

Avastin belongs to the class of monoclonal antibodies, which are used for the treatment of tumor diseases.

Active ingredient: Bevacizumab.

pharmachologic effect

Avastin is a recombinant humanized antibody that not only binds, but also neutralizes the biochemical effects of endothelial growth factor, which leads to disruption of the blood supply to the tumor and the death of its cells. In addition, the use of Avastin inhibits the progression of metastatic lesions emanating from organs such as the pancreas, colon, prostate, and mammary gland.

Pharmacokinetics

The drug has a very low clearance (ie, slowly excreted from the body) and a long half-life. This makes it possible to maintain the optimal therapeutic concentration of the drug in the blood for 2-3 weeks after a single infusion over a long time interval.

The use of Avastin in elderly patients without concomitant diseases can be carried out according to the standard scheme without dose adjustment.

The possibility of using Avastin in patients with hepatic and renal insufficiency has not been studied.

With a low serum albumin concentration, the activity of the drug and its half-life may increase significantly.

Indications for use

• Metastatic cancer with a lesion of the colon (colorectal), with the combined treatment with various derivatives of fluoropyrimidine.
• Inoperable metastatic lesions of the lungs. In this case, the drug is used in conjunction with platinum preparations.
• Metastatic or advanced kidney cancer. In this case, alpha-2a interferons are added to first-line therapy.
• Cancer of the fallopian tube, ovarian or primary peritoneal tumors. Combined pharmacotherapy with paclitaxel or carboplatin is advisable.
• The ineffectiveness of the treatment of breast cancer with other drugs.
• Therapy of tumor diseases in ophthalmology.

Dosage and recommended dose

The drug is used only in the hospital under the supervision of a chemotherapist. If possible, the therapy of malignant tumors should be carried out before the progression and the moment of generalization of the process.

The starting dose of Avastin is administered intravenously slowly over 90 minutes, and the patient’s condition is monitored. In the event that the patient underwent the infusion satisfactorily, the subsequent drip infusions are carried out somewhat faster - in 60 minutes. If the patient tolerates this rate of drug administration satisfactorily, then at a subsequent infusion time can be limited to 30 minutes.

Important! Avastin should not be injected into the vein in a vein, as this will cause a high incidence of serious adverse reactions. It is also impossible to dilute the concentrate with glucose solution.

With tumor lesions of the large intestine, the dose of the drug is 5 mg / kg body weight, while Avastin is administered 1 time in 14 days.

In case of neoplastic lung diseases, the dose of Avastin is selected on the basis of 7.5 mg / kg body weight. At the beginning of the course of tumor treatment, the described drug is used only in combination with platinum drugs, after a while they switch to monotherapy with Avastin. The frequency of administration of monoclonal antibodies is 1 time in 3 weeks.

With kidney lesions, the dose is calculated as follows: 10 mg / kg of body weight, while infusion is carried out 1 time in 2 weeks.

When tumors of the female genital or peritoneum Avastin at the beginning of treatment is combined with chemotherapy for 6 cycles. Then monoclonal antibody therapy is carried out for 15 months, the dose is 15 mg / kg body weight. The multiplicity of the introduction - 1 time in 21 days.

With metastatic breast cancers, Avastin dose is 10-15 mg / kg body weight. In this case, the drug is administered 1 time in 3 weeks.

Application in pediatric practice: at present, data on the safety profile of Avastin in children is not available.

Terms of preparation of the solution for infusion: due to the fact that antimicrobial reagents are not added to the vial with antibodies, the solution must be prepared immediately before use with strict observance of aseptic rules.

The concentrate is diluted only (!) With a physiological solution of sodium chloride to the 100 ml mark on the vial. In the event that a larger volume of infusion is required, dilution to the 200 ml mark is acceptable.

If the drug remains in the vial after intravenous infusion, it is strictly prohibited to use it for subsequent administration.

Side effects

• Perforation of the hollow organ of the gastrointestinal tract (in patients with neoplastic diseases of the large intestine).
• Bleeding in various vascular basins (most often - pulmonary with a similar localization of the tumor site).
• Thromboembolic complications.
• Arterial hypertension.
• The appearance of protein in the urine (dose-dependent effect).
• Severe fatigue.
• Nausea, abdominal pain, diarrhea.
• Accession of infectious diseases.
• Violation of the sensitivity of the limbs.
• Reducing the number of leukocytes, hemoglobin and red blood cells.
• Hyperglycemia.
• Hypokalemia.

Contraindications

• During pregnancy and breastfeeding.
• Metastasis of the tumor in the brain, not amenable to surgical treatment.
• Hypersensitivity to the components of the drug.

Use during pregnancy and lactation

Given the fact that the mechanism of action of Avastin is based on the suppression of the development of blood vessels, the use of this drug during pregnancy can lead to fetal death at any time.

Monoclonal antibodies can penetrate into breast milk and have undesirable effects on the body of the newborn, and therefore breastfeeding during the period of treatment should be stopped, restarting no earlier than 6 months after the last infusion.

Conception of the child should be planned no earlier than 6 months after the end of the course of therapy with Avastin.

Overdose

When the drug was infused at a dose of 20 mg / kg, a number of patients had complaints of migraine. In such cases, symptomatic pharmacotherapy is recommended. Avastin has no specific antidotes.

Drug interactions

The drug can be combined with other anticancer agents.

The efficacy and safety profile of Avastin during radiotherapy has not been studied.

Release form

Concentrate for the preparation of an infusion solution. Available in vials with a capacity of 4 or 16 ml, containing 100 or 400 mg of the active substance, respectively.

Pharmacy vacation terms

Strictly by prescription.

Storage conditions

The drug is suitable for 2 years. At the same time, the concentrate should be stored at a temperature from 2 ⁰ С to 8 ⁰ С. It is impossible to freeze the contents of the bottle.

Analogs

Analogues of Avastin on the active substance does not currently exist. Mechanisms of action for similar drugs include drugs: Arzerra, Acellbia, Vectibix, Herceptin, Campas, Lucentis, Mabthera, Perietha, Removab, Rituximab and Erbitux.

Price Avastin

Avastin concentrate for solution for infusion, 4 ml bottle - from 20,000 rubles.

Avastin concentrate for solution for infusion, bottle 16 ml - from 55,000 rubles.