Bevarest 100mg (Bevacizumab)

DESCRIPTION

Bevacizumab is a drug sold under the name of Bevarest and which is categorized as monoclonal anti-body & anti-angiogenesis

When Bevarest concomitant use with human monoclonal antibody IgG1, that circumstance and prohibits the biological action of human vascular endothelial growth factor (VEGF)

INDICATION

Bevarest is indicated for the treatment of some of the conditions like Metastatic colon or rectal cancer Non-squamous, non-small cell lung cancer Glioblastoma Metastatic renal cell cancer Metastatic cervical cancer Epithelial ovarian, fallopian tube or peritoneal cancer

MECHANISM OF ACTION

Bevarest comprises an active compound like Bevacizumab which binds to VEGF and avoid the communication of VEGF to its receptors like Flt-1 & KDR) present on the surface of the cells This interaction prevents endothelial cell multiplication and new blood vessel production occurs Hence in counts cessation of metastatic cancer cells development happens

 PHARMACOKINETICS

DISTRIBUTION

The volume of distribution is 2.9 (22%) L

ELIMINATION

The Bevacizumab half-life period is 20days (11 to 50days)

DOSAGE MANAGEMENT

KEY POINT

Avoid administration of Bevarest before at least 28 days following surgery and the wound is completely cured

METASTATIC COLORECTAL CARCINOMA

Concomitant use with 5-fluorouracil based chemotherapy is the usual dosage of Bevarest : While concomitant use with bolus IFL the dose is 5mg/kg of Bevarest for every 2 weeks IV. While in combination with FOLFOX4 the dose is 10mg/kg of Bevarest for every 2 weeks IV 5mg/kg IV Bevarest for every 2 weeks or 7.5 mg/kg Bevarest as IV every 3 weeks by concurrently used with fluoropyrimidine Irinotecan or fluoropyrimidine oxaliplatin based therapy

NON-SMALL CELL LUNG CANCER

While combining with carboplatin and paclitaxel : The Bevarest usual dosage is 15mg/kg IV for every 3 weeks by

GLIOBLASTOMA

For every 2 weeks : 10mg/kg of Bevarest administered IV

METASTATIC CERVICAL CANCER

Combining with paclitaxel and cisplatin or with paclitaxel and topotecan : The drug Bevarest usual dosage is 15mg/kg of Bevarest given intravenously for every 3 weeks

METASTATIC RENAL CELL CANCER

Concurrent use with interferon alfa : The Bevarest usual dosage is 10mg/kg IV for every 2 weeks

EPITHELIAL OVARIAN, FALLOPIAN TUBE OR PERITONEAL CANCER

Platinum opposing: Concurrent use with paclitaxel, pegylated liposomal doxorubicin or topotecan :The Bevarest regular dosage is 10mg/kg of Bevarest for every 2 weeks Or Combining with topotecan : The Bevarest regular dosage 15mg/kg of Bevarest given through IV for every 3 weeks Platinum responsive concomitant with carboplatin and paclitaxel for 6 to 8 cycles : The drug Bevarest recommended dosage of is 15mg/kg given IV for 3 weeks Combining with gemcitabine & carboplatin for 6 to 10 cycles : The Bevarest recommended dosage is 15mg/kg of Bevarest given IV for 3 weeks

PREPARATION & ADMINISTRATION

Bevarest is intravenous solution At initial infusion: given IV infusion over 90 minutes Following infusions: give second infusion over 60 minutes, if tolerated Administer all following infusion over 30minutes Bevarest IV infusion is prepared in aseptic condition Bevarest 400mg containing 16ml solution whereas 100mg containing 4ml Bevarest dilute into 100ml of 0.9% NS Do not dilute with dextrose solution Dispose the remaining portion of medicine which is left in a vial

PRECAUTIONS

There are some complications occurred during treatment with Bevarest , care should be taken Arterial thromboembolic events: cessation of treatment with Bevarest in patients who are suffered with severe ATE. Venous thromboembolic events: Toxicity Incidence should be detected; If severe condition therapy should be stopped. Hemorrhage: While on Bevarest treatment some Serious hemorrhages will occur like GI hemorrhage, hemoptysis, Hematemesis, CNS hemorrhage, nose bleeding & vaginal bleeding. Hence Discontinue the treatment. Hypertension: Bp is increased in patients who are receiving Bevarest therapy, must be frequently check up with blood pressure and provided with alternative medication for correct the pressure.

In hypertension crisis or encephalopathy should be discontinue the treatment. Posterior reversible encephalopathy syndrome Embryo fetal toxicity occurs : During pregnancy condition Bevarest is contraindicated which produce fetal harm. Ovarian failure: The patients who are receiving Bevarest may have a chance of getting ovarian failure. Congestive heart failure: the drug combination with anthracycline based chemotherapy, treatment with Bevarest must not be used. Bevarest treatment should be stopped while CHF occurs.

SIDE EFFECTS

Gastrointestinal perforation and fistulae
Surgery and wound healing complication
Hemorrhage
Arterial thromboembolic events
Venous thromboembolic events
Hypertension
Posterior reversible encephalopathy syndrome
Renal injury & Proteinuria
Infusion reactions
Ovarian failure
Congestive heart failure
Neutropenia, mucosal inflammation, infection, neuropathy, Epistaxis, erythrodysaesthesia

DRUG INTERACTION

While interaction of Bevarest with paclitaxel & carboplatin, causes reduce in exposure of paclitaxel after four cycles of treatment.

Interaction with paclitaxel &carboplatin cause to increase the paclitaxel exposure at day 6

CONTRAINDICATIONS

No contraindication occurred In some case the patients who are contraindicated to any component of Bevarest may occur hypersensitivity.

PREGNANCY & LACTATION

Pregnancy category: D While administrating Bevarest in pregnant women, positive evidence on fetal risk depends on human studies but potential benefits by using the drug may have common risk against fetus. Bevarest is excreted into breast milk taking account on this, discussion should done on whether to discontinue the breast feeding or the drug. The drug is risky during mother breast feeding to their infants.

STORAGE 

The drug stored at 2 to 8°C (36 to 46°F) Single use vial Dispose the left out vial under the guidance of pharmacists.

MISSED DOSE

The dose missed by patient should have the dose immediately before the next dose timing reaches or leave the missed dose and continue the regular schedule.
Remember do not have double dose at a time
Please consult with doctor for further details.