Bryxta 400mg (Bevacizumab)

DESCRIPTION

Bevacizumab is a drug sold under the name of Bryxta  and which is categorized as monoclonal anti-body & anti-angiogenesis When Bryxta  concomitant use with human monoclonal antibody IgG1, that circumstance and prohibits the biological action of human vascular endothelial growth factor (VEGF).

INDICATION

Bryxta  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

Bryxta  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 Bryxta  before at least 28 days following surgery and the wound is completely cured
colorectal carcinoma:
Concomitant use with 5-fluorouracil based chemotherapy is the usual dosage of Bryxta : While concomitant use with bolus IFL the dose is 5mg/kg of Bryxta  for every 2 weeks IV.
While in combination with FOLFOX4 the dose is 10mg/kg of Bryxta  for every 2 weeks IV
5mg/kg IV Bryxta  for every 2 weeks or 7.5 mg/kg Bryxta  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 Bryxta  usual dosage is 15mg/kg IV for every 3 weeks by
Glioblastoma:
For every 2 weeks: 10mg/kg of Bryxta  administered IV
Metastatic renal cell cancer:
Concurrent use with interferon alfa: The Bryxta usual dosage is 10mg/kg IV for every 2 weeks
Metastatic cervical cancer:
Combining with paclitaxel and cisplatin or with paclitaxel and topotecan: The drug Bryxta  usual dosage is 15mg/kg of Bryxta  given intravenously for every 3 weeks
Epithelial ovarian, fallopian tube or peritoneal cancer:
Platinum opposing:
Concurrent use with paclitaxel, pegylated liposomal doxorubicin or topotecan: TheBryxta  regular dosage is 10mg/kg of Bryxta  for every 2 weeks
Or Combining with topotecan: The Bryxta  regular dosage 15mg/kg of Bryxta  given through IV for every 3 weeks
Platinum responsive:
concomitant with carboplatin and paclitaxel for 6 to 8 cycles: The drug Bryxta  recommended dosage of is 15mg/kg given IV for 3 weeks
Combining with gemcitabine & carboplatin for 6 to 10 cycles: The Bryxta  recommended dosage is 15mg/kg of Bryxta  given IV for 3 weeks
Preparation & administration:
Bryxta  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
Bryxta  IV infusion is prepared in aseptic condition
Bryxta  400mg containing 16ml solution whereas 100mg containing 4ml
Bryxta  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 Bryxta , care should be taken
Arterial thromboembolic events: cessation of treatment with Bryxta  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 Bryxta  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 Bryxta  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 Bryxta  is contraindicated which produce fetal harm.
Ovarian failure: The patients who are receiving Bryxta  may have a chance of getting ovarian failure.
Congestive heart failure: the drug combination with anthracycline based chemotherapy, treatment with Bryxta  must not be used.
Bryxta  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, erythrodysesthesia.

DRUG INTERACTION

While interaction of Bryxta  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 Bryxta  may occur hypersensitivity.

PREGNANCY 

Pregnancy category: D
While administrating Bryxta  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.

LACTATION

Bryxta  is excreted into breast milk taking account on this, discussion should do 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.