Avastin

Avastin is antineoplastic means and treats monoclones. Use of drug promotes suppression of metastatic progressing of a disease and reduction of microvascular permeability at different types of a tumor (cancer milk, prostatic, a pancreas, a colon).

Form of release and structure

Avastin release in the form of the concentrate intended for preparation of solution for infusions can have light brown coloring or to be colourless. Active agent of a medicine is бевацизумаб.

This drug is produced in packagings with concentration of a bevazumab in bottles of 100 mg / 4 ml and 400 mg / 16 ml.

Indications to use

According to the instruction Avastin is appointed at:

• Metastatic or local and recurrent breast cancer;
• Widespread inoperable metastatic or recurrent not planocellular not small-celled cancer of a lung;
• Widespread and/or metastatic nephrocellular cancer;
• Metastatic colorectal cancer;
• Glioblastoma recurrence.

Avastin's use in ophthalmology is caused by its efficiency at treatment of a wet form of an age macular degeneration, macular hypostasis, a tumor in okolomakulyarny area, a diabetic retinopathy and some other diseases of eyes which are related to the pathological growth of blood vessels. Results of introduction of injections of Avastin to a vitreous prove effectiveness of such procedure and its good tolerance patients with a proliferative diabetic retinopathy. The effect of use of Avastin in ophthalmology consists in stabilization of a subretinal neovascular membrane. Side effects from administration of drug in a vitreous are minimum.

Contraindications

According to the instruction Avastin it is not necessary to apply to treatment of the patients having hypersensitivity to drug components, and also pregnant women and the nursing women. Therapy by Avastin is contraindicated to children and persons with a renal and liver failure as efficiency and safety of use of a medicine concerning such patients is not established. All above-mentioned contraindications are urgent also at use of this medicine in ophthalmology.

Route of administration and dosage

Administration of drug is intravenously struyno strictly forbidden, Avastin only intravenously kapelno is allowed to enter. Cultivation of necessary quantity of a concentrate up to the required volume happens to the help of 0,9% of solution of sodium of chloride, at the same time all rules of sterility are surely considered. The prepared structure has to contain a bevatsizumab within 1,4-16,5 mg/ml. The initial dose of Avastin is entered after chemotherapy in the form of intravenous infusion within 90 minutes, use of the subsequent doses is possible as later, and to chemotherapy. If the patient transferred the first infusion well, then time of introduction of the second is reduced to 60 minutes, and at preservation of positive reactions the subsequent infusions of Avastin are carried out within 30 minutes. In case of the undesirable phenomena it is necessary to stop Avastin's use completely or temporarily.

Standard dosing

At a metastatic colorectal cancer:

• As drug of the first line: 5 mg on 1 kg of body weight of 1 times in 2 weeks, or 7.5 mg on 1 kg of body weight of 1 times in 3 weeks intravenously, slowly.
• As drug of the second line from 5 to 10 mg on kilogram of body weight once in two weeks, intravenously, slowly.

At a local and recurrent or metastatic breast cancer on 10 mg on 1 kilogram of body weight once in two weeks intravenously, slowly.

At widespread inoperable, recurrent or metastatic not planocellular cancer of a lung Avastin appoint in a dosage from 7,5 to 15 mg to kilogram of body weight once in three weeks, depending on in addition to what type of chemotherapy drug is appointed.

At widespread and/or metastatic nephrocellular cancer drug appoint in a dose 10 mg to kilogram of body weight once in two weeks intravenously, slowly.

At a glioblastoma (a glioma of the IV degree of a zlokachestvennost) Avastin appoint in a dose 10 mg to kilogram of body weight once in two weeks intravenously, slowly.

At epithelial cancer of an ovary, uterine tube, and also at primary cancer of a peritoneum medicine appoint in a dose 15 mg to kilogram of body weight once in three weeks intravenously, slowly.

As drug of the first line Avastin is appointed in addition to a karboplatin and a paklitaksel, at the same time the maximum duration of a course of chemotherapy makes 6 cycles then Avastin's use continues in the form of monotherapy.

The general duration of treatment by this drug makes 15 months. At emergence of symptoms of progressing of a disease treatment by Avastin should not be continued.

At a recurrent tumor Avastin is appointed in a complex with karboplatiny and gemcitabine (a course of 6-10 cycles), further use of medicine happens as monotherapy.

Side effects

Comments on Avastin demonstrate that the most serious side reactions are shown in the form of perforation of digestive tract, hemorrhage, including pulmonary bleedings or a pneumorrhagia, and also an arterial thromboembolism. It is also often possible to meet complaints to increase in arterial pressure, diarrhea, an abdominal pain, weakness or an adynamy. In the instruction to Avastin, in addition to mentioned, the following possible manifestations of side reactions are specified introduction of a medicine:

• Increase in arterial pressure, arterial thromboembolism, deep vein thrombosis, congestive heart failure, bleeding;
• Neutropenia, leukopenia, febrile neutropenia, thrombocytopenia, anemia;
• Lock, diarrhea, vomiting, nausea, rectal bleeding, anorexia, stomatitis;
• Impassability of intestines, gastrointestinal frustration, abdominal pain, perforation of digestive tract;
• Rhinitis, nasal bleeding, asthma, hypoxia, pulmonary thromboembolism;
• Xeroderma, change of its color, exfoliative dermatitis, palmar and bottom syndrome;
• The raised dacryagogue, disturbance of visual function;
• Arthralgia, mialgiya, muscular weakness;
• Proteinuria, infection of urinary tract;
• Adynamy, fervescence, the increased fatigue, pains of various localization, abscess, dehydration, sepsis.

Decrease in level of hemoglobin, emergence of a hyperglycemia, leukopenia, hypopotassemia, thrombocytopenia is also possible.

Special instructions

During therapy by drug Avastin, and not less than half a year after it, women and men of childbearing age shall use reliable contraceptives. Despite contents in instructions to Avastin of all necessary information, appointment, preparation of solution and its dosage have to be carried out only by the experienced profile doctor.

Avastin according to pharmaceutical characteristics is incompatible with dextrose solution.

Analogs

To Avastin's analogs, relatives on the influence mechanism belonging to one pharm. the subgroup can carry: Вектибикс, Gertseptin, Kempas, MabThera, Erbituks, Arzerra, Removab, Peryeta, Gertseptin lyophilisate, Rituksimab, Atsellbiya, MabThera.

There are no drug analogs on active active ingredient.

Terms and storage conditions

According to the instruction Avastin it is necessary to store in the dark place, at a temperature of 2-8 °C. Ready solution is considered suitable for use within a day.