Description: Antineoplastic Agent, Monoclonal Antibody; Vascular Endothelial Growth Factor (VEGF) Inhibitor; Vascular Endothelial Growth Factor Receptor 2 (VEGFR2) Inhibitor
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Ramucirumab, Cyramza is a recombinant monoclonal antibody which inhibits vascular endothelial growth factor receptor 2 (VEGFR2) with high affinity. When bound, it blocks receptor ligands VEGF-A, VEGF-C, and VEGF-D to inhibit activation of VEGFR2. VEGFR2 blockage results in inhibiting ligand-induced proliferation and migration of endothelial cells, reduced tumor vascularity and growth
Indications For Use
Colorectal cancer, metastatic; Gastric cancer, advanced or metastatic; Hepatocellular carcinoma, advanced or relapsed/refractory; Non-small cell lung cancer, metastatic
Before starting Ramucirumab, Cyramza make sure your physician is aware of any allergies or medications you currently take, if you are pregnant, or breastfeeding. Ramucirumab, Cyramza use has been associated with rare but serious adverse events such as arterial thrombotic events, bone marrow suppression, gastrointestinal perforation, hemorrhage, hepatotoxicity, hypertension, infusion reactions, posterior reversible encephalopathy syndrome, proteinuria, nephrotic syndrome, thyroid dysfunction, and wound healing impairment.
IV: 8-10 mg/kg once every 2 weeks as a single agent, or in combination with appropriate agents depending on indication it is being used for. Continue ramucirumab until disease progression or unacceptable toxicity.
Pharmacist Tips On Using
How to Take: Administer initial infusion over 60 minutes and if tolerated you may administer subsequent infusions over 30 minutes. The the use of a 0.22-micron protein-sparing filter is recommended. Flush the line with NS after infusion is complete. Monitor for infusion reaction. Reduce infusion rate (by 50%) for grade 1 or 2 infusion reaction and discontinue permanently for grade 3 or 4 infusion reaction. Store intact vials in original package to protect from light at 2°C to 8°C (36°F to 46°F).
You Need to Avoid: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information. Do not administer as an IV push or bolus. Do not infuse in the same IV line with solutions other than NS, or with electrolytes or other medications. Do not shake prior to administration and do not allow product to freeze.
Hypertension, peripheral edema, hypoalbuminemia, hypocalcemia, hyponatremia, abdominal pain, decreased appetite, diarrhea, nausea, proteinuria, neutropenia, thrombocytopenia, ascites, fatigue, headache, insomnia, epistaxis
Note this is not a complete list of side effects, only the most common
Frequently Asked Questions
What do I do if side effects are intolerable?
If side effects are causing a lot of distress speak to your physician as soon as possible to discuss options.
Why would my physician prescribe a medication with such serious side effects?
Your physician takes the most recent clinical guidelines to make evidence-based decisions on what medication is appropriate in which situations. Your current medications, your allergies, age, cost of medication, comorbid conditions and many other factors will further complicate or limit which medications are appropriate. This medication is used for certain forms of cancer and your physician has determined the benefits outweigh the risks. Furthermore, they will be monitoring your bloodwork and symptoms closely to avoid many of the serious side effects and will keep you on the lowest effective dosage for the shortest amount of time possible.