Ramucirumab

Other Names: CyramzaTM

About This Drug

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

Possible Side Effects

  • High blood pressure
  • Loose bowel movements (diarrhea)

Note: Each of the side effects above was reported in 10% or greater of patients treated with ramucirumab. Not all possible side effects are included above. You may have different side effects if you are receiving ramucirumab in combination with other chemotherapy agents.

Warnings and Precautions

  • Abnormal bleeding which can very rarely 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.
  • Perforation -a hole in your stomach, small and/or large intestine.
  • Slow wound healing 
  • Blood clots and events such as stroke and heart attack, which can be life-threatening. 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 
  • 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 after your infusion. If this happens, call 911 for emergency care.
  • 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), have 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, seizures or coma. If you start to have any of these symptoms let your doctor know right away.
  • Severe high blood pressure
  • Your kidneys may be affected causing protein in your urine 
  • Patients with existing liver condition called cirrhosis may have worsening symptoms
  • Changes in your thyroid function

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

  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Ramucirumab may cause slow wound healing. It should not be given before surgery. If you must have emergency surgery or have an accident that results in a wound, tell the doctor that you are on ramucirumab. 

Treating Side Effects

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended). 
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid). 
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping. 
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea 
  • Infusion reactions may occur after your infusion. If this happens, call 911 for emergency care.

Food and Drug Interactions

  • There are no known interactions of ramucirumab with food and other medications.
  • Tell your doctor and pharmacist about all the prescription and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
  • 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 higher 
  • Chills
  • Confusion and/or agitation
  • Seizures
  •  Hallucinations 
  • Trouble understanding or speaking 
  • Blurry vision or changes in your eyesight 
  • A headache that does not go away
  • Numbness or lack of strength to your arms, legs, face, or body 
  • Easy bleeding or bruising 
  • Wheezing and/or trouble breathing 
  • 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.
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools ( bright red, or black/tarry)
  • Coughing up blood 
  • Fatigue that interferes with your daily activities
  • Unexplained weight gain
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Severe abdominal pain that does not go away
  • Decreased urine 
  • Signs of infusion reaction: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. 
  • Your leg or arm is swollen, red, warm and/or painful
  • 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 3 months after treatment. Let your doctor know right away if you think you may be pregnant
  • Breastfeeding warning: Women should not breastfeed during treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: In women, 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: June 2018

This patient information was developed by Via Oncology, LLC © 2018. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs.

Ask your own doctor or health care provider any specific medical questions that you have. CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.