Ramucirumab

Indications & Dose:

Treatment of advanced gastric cancer or gastrooesophageal junction adenocarcinoma in combination with paclitaxel in patients with disease progression after prior platinum and fluoropyrimidine chemotherapy

BY INTRAVENOUS INFUSION

Adult: 8 mg/kg on days 1 and 15 of a 28 day cycle dose to be administered prior to paclitaxel infusion consult product literature for dose adjustments due to sideeffects and infusion-related reactions

Treatment of advanced gastric cancer or gastrooesophageal junction adenocarcinoma as monotherapy in patients with disease progression after prior platinum or fluoropyrimidine chemotherapy and for whom treatment in combination with paclitaxel is not appropriate

BY INTRAVENOUS INFUSION

Adult: 8 mg/kg every 2 weeks consult product literature for dose adjustments due to side-effects and infusion related reactions

Treatment of metastatic colorectal cancer in combination with FOLFIRI (irinotecan, fluorouracil and folinic acid) in patients with disease progression on or after prior therapy with bevacizumab, oxaliplatin and a fluoropyrimidine

BY INTRAVENOUS INFUSION

Adult: 8 mg/kg every 2 weeks dose to be administered prior to FOLFIRI administration consult product literature for dose adjustments due to side-effects and infusion-related reactions

Treatment of locally advanced or metastatic non small cell lung cancer in combination with docetaxel in patients with disease progression after platinum based chemotherapy

BY INTRAVENOUS INFUSION

Adult: 10 mg/kg on day 1 of a 21 day cycle dose to be administered prior to docetaxel infusion consult product literature for dose adjustments due to sideeffects and infusion-related reactions

Contraindications:

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Side Effects:

Common or very common Abdominal pain . diarrhoea . epistaxis . gastro-intestinal haemorrhage . headache . hypertension . hypoalbuminaemia . hypokalaemia . hyponatraemia . leucopenia . malaise . mucosal inflammation . neutropenia . palmar-plantar erthyrodysaesthesia syndrome . peripheral oedema . proteinuria . stomatitis .thrombocytopenia

Frequency not known Arterial thromboembolic events (permanently discontinue if severe). fistula (permanently discontinue). gastro-intestinal perforation (permanently discontinue). infusion-related reactions . intestinal obstruction .rash . sepsis (in combination with paclitaxel)

CONCEPTION AND CONTRACEPTION Manufacturer advises effective contraception during treatment and for up to 3 months after treatment in women of childbearing potential.

PREGNANCY Avoid unless potential benefit outweighs risk-no information available.

BREAST FEEDING Discontinue breast-feeding during treatment and for at least 3 months after treatment-no information available.

HEPATIC IMPAIRMENT Caution in severe cirrhosis, cirrhosis with hepatic encephalopathy, cirrhosis with clinically significant ascites, or hepatorenal syndrome-use only if potential benefit outweighs risk of progressive hepatic failure.

Cautions:

Elective surgery-discontinue treatment for at least 4 weeks prior to surgery . hypertension-must be controlled before initiation . impaired wound healing-discontinue treatment until wound fully healed . pretreatment is recommended to minimise the development of adverse reactions (consult product literature).risk of bleeding

Precautions:

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Interaction:

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Warnings:

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Adverse Effects:

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Lactations:

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Special Precautions:

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Counselling:

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Side Effects Or Adverse Reactions:

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Patient And Carer Advice:

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