Bevacizumab Injection

IMPORTANT NOTICE:

Bevacizumab injection is available as different products that are biologic medications (medications made from living organisms).These biologic products are considered to be"biosimilar" to bevacizumab injection which means they work just as well and are just as safe touse as bevacizumab injection. Bevacizumab injection mentioned in the monograph below refersto any of these products.

WHY is this medicine prescribed?

Bevacizumab injection products are used to treat a variety of solid tumors.This includes certain lung, kidney, liver, brain, colon, rectal, female reproductive organ or peritoneal (tissue that lines the abdomen) cancers. Bevacizumab injection products are in a class of medications called antiangiogenic agents. They work by stopping the formation of blood vessels that bring oxygen and nutrients to tumors. This may slow the growth and spread of tumors.

Are there OTHER USES for this medicine?

Bevacizumab injection products are also sometimes used to treat wet age-related macular degeneration (AMD; an ongoing disease of the eye that causes loss of the ability to see straight ahead and may make it more difficult to read, drive, or perform other daily activities) and diabetic macular edema (an eye disease caused by diabetes that can lead to vision loss). Talk to your doctor about the risks of using bevacizumab injection products to treat your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Bevacizumab injection products come as a solution (liquid) to be slowly injected intravenously (into a vein) by a doctor or nurse in a hospital or medical facility. It is given once every 2 or 3 weeks. The schedule depends on the condition you have, the other medications you are using, and how your body responds to treatment.

It should take 90 minutes for you to receive your first dose of a bevacizumab injection product. A doctor or nurse will watch you closely to see how your body reacts to bevacizumab. If you do not have any serious problems when you receive your first dose of a bevacizumab injection product, it will usually take 30 to 60 minutes for you to receive each of your remaining doses of the medication.

Bevacizumab injection products may cause serious reactions during infusion of the medication. If you experience any of the following symptoms, tell your doctor immediately: difficulty breathing or shortness of breath, chills, shaking, sweating, headaches, chest pain, dizziness, feeling faint, flushing, itching, rash, or hives. Your doctor may need to slow down your infusion, or delay or stop your treatment if you experience these or other side effects.

What SPECIAL PRECAUTIONS should I follow?

Before receiving a bevacizumab injection product,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor if you have ever been treated with radiation therapy to your pelvis; and if you have or have ever had bleeding problems, diabetes, high blood pressure, heart failure, angina (chest pain that comes at rest with no obvious cause), heart attack, stroke or transient ischemic attacks (TIA), or blood clots in your lungs or legs. Also, tell your doctor if you have recently coughed up blood.

• you should know that bevacizumab injection products may cause infertility in women (difficulty becoming pregnant); however, you should not assume that you cannot get pregnant. Tell your doctor if you are pregnant or plan to become pregnant. You should use birth control to prevent pregnancy during your treatment with a bevacizumab injection product and for at least 6 months after your final dose. If you become pregnant while receiving a bevacizumab injection product, call your doctor. Bevacizumab may harm the fetus.

• tell your doctor if you are breastfeeding. You should not breastfeed during your treatment with a bevacizumab injection product and for at least 6 months after your final dose.

• you should know that this medication may cause ovarian failure which may decrease fertility in women. Talk to your doctor about the risks of receiving bevacizumab injection products.

• tell your doctor if you have recently had surgery or if you plan to have surgery, including dental surgery. If you are scheduled to have surgery, your doctor will stop your treatment with an bevacizumab injection product at least 28 days before the surgery. If you have recently had surgery, you should not receive a bevacizumab injection product until at least 28 days have passed and until the area has completely healed.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

If you miss an appointment to receive a dose of a bevacizumab injection product, call your doctor as soon as possible.

What SIDE EFFECTS can this medicine cause?

Bevacizumab injection products may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness
• loss of appetite
• heartburn
• change in ability to taste food
• diarrhea
• weight loss
• sores in the mouth
• voice changes
• increased or decreased tears
• stuffy or runny nose
• muscle, joint, or back pain
• trouble sleeping
• dry skin

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• nosebleeds or bleeding from your gums; coughing up or vomiting blood or material that looks like coffee grounds; unusual bleeding or bruising; increased menstrual flow or vaginal bleeding; pink, red, or dark brown urine; or red or tarry black bowel movements
• sudden headache, dizziness, or weakness; slow or difficult speech; or sudden weakness or numbness of the face, arm or leg
• chest pain or discomfort; pain in the arms, shoulders, neck, jaw, stomach, or upper back; feeling light-headed or faint; or shortness of breath
• shortness of breath; difficulty breathing; swelling of the hands, feet, ankles or lower legs; or fast, irregular, or pounding heartbeat
• seizures, extreme tiredness, confusion, or change in vision or loss of vision
• sore throat, fever, chills, and other signs of infection
• swelling of the face, eyes, stomach, hands, feet, ankles, or lower legs; unexplained weight gain; or foamy urine
• pain, tenderness, warmth, redness, or swelling in one leg only; sudden chest pain; shortness of breath; or coughing up blood
• rash or redness, itching, or scaling of the skin
• stomach pain, constipation, nausea, vomiting, shivering, or fever

Bevacizumab injection products may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor. Your doctor will check your blood pressure and test your urine regularly during your treatment with a bevacizumab injection product.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.