Bevacizumab

Other Names: Avastin®

About this drug

Bevacizumab is used to treat cancer. It is given in the vein (IV).

Possible Side Effects

  • Nosebleed
  • Headache
  • Teary eyes
  • Runny/stuffy nose
  • Changes in the way food and drinks taste
  • Bleeding in your rectum
  • Protein in your urine, which can affect how your kidneys work
  • Dry skin
  • A red skin rash which can be peeling or scaling
  • Back pain
  • High blood pressure

Note: Each of the side effects above was reported in 10% or greater of patients treated with bevacizumab. Not all possible side effects are included above. 

Warning and Precautions

  • Perforation or fistula- an abnormal hole in your stomach, intestine, esophagus, or other organ, which may be life-threatening.
  • Slow wound healing
  • Abnormal bleeding which may be life threatening - symptoms may be coughing up blood, throwing up blood (may look like coffee-grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding. 
  • Blood clots and events such as stroke and heart attack. A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause trouble breathing, pain when breathing, and/or chest pain. 
  • Severe high blood pressure
  • Changes in your central nervous system can happen. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, hallucinations (see or hear things that are not there), trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, or coma. If you start to have any of these symptoms let your doctor know right away. 
  • Protein in your urine, which can cause kidney failure.
  • While you are getting this drug in your vein (IV), you may have a reaction to the drug. Sometimes you may be given medication to stop or lessen these side effects. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. These reactions may happen for 24 hours after your infusion. If this happens, call 911 for emergency care. 
  • In women, changes in your ovaries may happen that may cause menstrual bleeding to become irregular or stop, and may impair fertility. 

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team. 

Important Information 

  • Bevacizumab may cause slow wound healing. It should not be given within 28 days of surgery or any test or any procedure requiring conscious sedation. If you must have emergency surgery or have an accident that results in a wound, tell the treating doctor that you are on bevacizumab. Call your cancer doctor as soon as possible for further orders.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or nurse about the necessary precautions to take during this time. 

Treating Side Effects

  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain. 
  • Taking good care of your mouth may help food taste better and improve your appetite. 
  • If you have a nose bleed, sit with your head tipped slightly forward. Apply pressure by lightly pinching the bridge of your nose between your thumb and forefinger. Call your doctor if you feel dizzy or faint or if the bleeding doesn't stop after 10 to 15 minutes. 
  • To help with dry skin, moisturize your skin several times a day.
  • Avoid sun exposure and apply sunscreen routinely when outdoors. 
  • If you do get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you. 
  • Infusion reactions may happen for 24 hours after your infusion. If this happens, call 911 for emergency care. 

Food and Drug Interactions

  • There are no known interactions of bevacizumab with food. Bevacizumab may interact with other medicines.
  • Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs, and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor’s help.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Wheezing and/or trouble breathing
  • Difficulty swallowing
  • Easy bleeding or bruising 
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools (bright red, or black/tarry)
  • Coughing up blood
  • Confusion and/or agitation 
  • Headache that does not go away
  • Nose bleed that doesn't stop bleeding after 10-15 minutes
  • Feeling dizzy or lightheaded
  • Blurry vision or changes in your eyesight
  • Numbness or lack of strength to your arms, legs, face, or body
  • Nausea that stops you from eating or drinking or isn't relieved by prescribed medicine
  • Throwing up more than 3 times a day
  • Pain in your abdomen that does not go away
  • Signs of infusion reaction: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. 
  • Pain that does not go away or is not relieved by prescribed medicine
  • Your leg is swollen, red, warm, and/or painful
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • If you think you may be pregnant 

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 6 months after treatment. Let your doctor know right away if you think you may be pregnant. 
  • Breastfeeding warning: Women should not breast feed during treatment because this drug could enter the breast milk and cause harm to a breast feeding baby. 
  • Fertility warning: This drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on egg banking. 

Revised November 2017