Avastin

Avastin is considered an antitumor agent that refers to monoclonal antibodies.

During the application of the drug, there is a decrease in the metastatic progression of pathology and microvascular permeability in all sorts Malignant neoplasms, especially those relating to the breast in women, the colon, as well as the pancreas and prostate gland.

On this page you will find all information about Avastin: the full instructions for use on this medication, average prices in pharmacies, complete and incomplete analogs of the drug, as well as reviews of people who have already used Avastin. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

Antitumor drug. Monoclonal antibodies.

Conditions of leave from pharmacies

It is released in pharmacies only on prescription.

Price list

How much does Avastin cost? The average price in pharmacies is at the level of38 000 rubles.

Form of release, composition and packaging

Avastin is produced in the form of concentrates, which are used for the preparation of infusion solutions:

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A solution of 100 mg / 4 ml in glass bottles;
A solution of 400 mg / 16 ml in glass bottles.

The active substance of Avastin is bevacizumab.

Auxiliary substances of the drug are alpha-trehalose dihydrate, sodium dihydrogen phosphate, sterile water, sodium hydrogenphosphate, polysorbate 20.

pharmachologic effect

Antitumor drug. Avastin (bevacizumab) is a humanized recombinant hyperchimeric monoclonal antibody that selectively binds with a biologically active vascular endothelial growth factor (VEGF) and neutralizes it. Avastin inhibits the binding of the vascular endothelial growth factor to its type 1 and 2 receptors (Flt-1, KDR) on the surface of endothelial cells, which leads to a decrease in vascularization and inhibition of tumor growth.

Bevacizumab contains fully human framework regions with complementarity determining regions of the hyperchimeric mouse antibody that bind to VEGF. Bevacizumab is produced by recombinant DNA technology in a system for expression represented by Chinese hamster ovary cells. Bevacizumab consists of 214 amino acids and has a molecular weight of about 14, 00 daltons.

The introduction of bevacizumab leads to suppression of metastatic progression of the disease and a decrease in microvascular permeability at various tumors of the person, including a cancer of a colon, a mammary gland, a pancreas and a prostate.

What helps Avastin?

The main indications for the appointment of Bisacodyl are such conditions / diseases:

Ineffective treatment of breast cancer with other drugs.
Therapy of tumor diseases in ophthalmology.
Metastatic cancer with lesions of the large intestine (colorectal), with combined treatment using various fluoropyrimidine derivatives.
Inoperable metastatic lung lesions. In this case, the drug is used in conjunction with platinum preparations.
Metastatic or advanced kidney cancer. In this case, alpha-2a interferons are added to the first-line therapy.
Cancer of the fallopian tube, ovaries or primary tumors of the peritoneum. A combination pharmacotherapy with paclitaxel or carboplatin is beneficial.

Contraindications

Contraindications to the use of the drug are the following conditions:

Pregnancy;
Breastfeeding period;
Children under 18 years of age (efficacy and safety not established).
Hypersensitivity to bevacizumab or any other component of the drug, cell-based preparations ovaries of Chinese hamster or to other recombinant human or closely related to human antibodies;
Renal and hepatic insufficiency (efficacy and safety of use not established).

FROMcautionshould prescribe a drug with arterial thromboembolism in history; diabetes mellitus; patients over the age of 65; with congenital hemorrhagic diathesis and acquired coagulopathy; admission anticoagulants for the treatment of thromboembolism prior to initiation of Avastin®; clinically significant cardiovascular disease (ischemic heart disease or chronic heart failure in history); arterial hypertension; venous thromboembolism; wound healing; bleeding / hemoptysis; gastrointestinal perforation in the anamnesis; syndrome of posterior reversible encephalopathy; neutropenia; proteinuria.

Pregnancy

The drug is contraindicated for use in pregnancy and during lactation.

Men and women of childbearing age during treatment with Avastin and at least 6 months after the end of treatment should use reliable methods of contraception.

Avastin can interfere with fertility in women. In most patients, fertility was restored after Avastin discontinued therapy. The long-term effects of Avastin therapy on fertility are unknown.

Breastfeeding is not recommended during treatment with Avastin and, for at least 6 months after the end of Avastin therapy.

Instructions for use Avastin

The instructions for use indicate that the administration of the Avastin concentrate solution is carried out intravenously. Only jet injection is shown. Bolus infusion should not be allowed. Dose reduction with side effects does not occur. The first dose should be administered within one and a half hours. With good tolerability, the duration of the subsequent infusion is reduced to an hour or half an hour.

Standard dosing regimes:

Diagnosis	Dosage of the preparation (mg / kg)	Multiplicity of infusions	Notes
Metastatic colorectal cancer (first line of therapy)	5 ,	every 14 days every 21 days	Therapy is carried out for a long time
Metastatic colorectal cancer (second line of therapy)	10 15	every 14 days every 21 days	Therapy is carried out for a long time. When the disease progresses against the background of drug therapy, discontinue the course
Metastatic cancer in mammology	10 15	every 14 days every 21 days	Therapy is carried out for a long time. When the disease progresses against the background of drug therapy, discontinue the course
Lung cancer (common, metastatic, inoperable, recurrent non-squamous)	, 15	every 21 days, every 21 days	in combination with cisplatin in combination with carboplatin. First, combined chemotherapy with platinum preparations (6 courses), followed by monotherapy with Avastin
Renal cell carcinoma (common, metastatic)	10	Every 14 days	Therapy is carried out for a long time. When the disease progresses against the background of drug therapy, discontinue the course
Epithelial ovarian cancer, primary peritoneal cancer, fallopian tube cancer (first line of therapy)	15	Every 21 days	Combination with paclitaxel, carboplatin (6 courses), then monotherapy with Avastin. Treatment can be conducted prior to the progression of the disease
Epithelial ovarian cancer, primary peritoneal cancer, fallopian tube cancer (disease recurrence)	15	Every 21 days	Combined use with gemcitabine, carboplatin (6-10 courses), then monotherapy with Avastin

Doses for adolescents, patients with kidney pathologies are not defined.

The solution should be prepared in aseptic conditions only by medical personnel. Dissolve Avastin with glucose solutions is unacceptable. For breeding requires physical. solution in an amount such that the final concentration of bevacizumab was 1.4-16.5 mg / ml.

The medical worker should analyze the ready solution for mechanical inclusions, uncharacteristic coloring. Because of the lack of preservatives, the drug can not be stored in ready-made form, as an exception, storage within 24 hours at a temperature of 2-8 degrees Celsius is permissible. Waste from preparation of the preparation, the remnants of the medicinal product must be disposed of in accordance with the rules for disposal. It is possible to combine the solution with polyvinylchloride and polyolefin packages, infusion systems.

Side effects

The most common side effects when taking the drug: high blood pressure, weakness, loss of strength, diarrhea, abdominal pain. The most serious of these are perforation of the gastrointestinal tract, hemorrhage, arterial thromboembolism.

According to the general experience of application Avastin can cause the following side effects:

Respiratory organs - shortness of breath, nasal congestion, bleeding, hypoxia, pulmonary thromboembolism.
Skin - dryness, discoloration, inflammation, palmar-plantar syndrome.
Nervous system - defeat of peripheral neurons, taste distortions, headache, stroke, drowsiness, syncope.
Vision - lacrimation, impaired visual function.
Cardiovascular system - high blood pressure, blood clots, bleeding.
Hemopoietic system - decrease in the number of leukocytes, neutrophils, platelets, anemia.
Gastrointestinal organs - diarrhea, nausea, vomiting, constipation, rectal bleeding, anorexia, perforation of the gastrointestinal tract, intestinal obstruction, abdominal pain and other disorders.
Musculoskeletal system - pain in the joints or muscles, muscle weakness.
Excretory system - proteinuria, urinary tract infections.

Injection of the drug itself may be very painful for some patients. In addition, Avastin can cause fatigue, fever, inhibition. Possible the appearance of pain in various parts of the body, the development of secondary infections, abscesses, dehydration.

Overdose

Whenever bevacizumab was administered at a maximum dose of 20 mg / kg every 2 weeks, IV patients in several patients had a severe migraine headache (migraine). In case of an overdose, it is possible to enhance the listed dose-dependent side effects.

Additionally

Therapy with Avastin is carried out under the supervision of an oncologist or a doctor who is familiar with the antitumor treatment.

With perforation of the gastrointestinal tract, the drug is canceled.

If a patient is treated with taxanes and anthracyclines for six months, Avastin therapy in combination with capecitabine is not recommended.

Reviews about Avastin

The patients' opinions are different, but many people note the progress and decrease in the size of the tumor, but unfortunately, there is no question of a full recovery. Most often, patients complain of side effects - headaches, blood pressure jumps, ophthalmology recorded cases of deterioration of vision, up to its complete loss.

Analogues

Avastin does not have structural analogs for the active substance. Analogues for the pharmacological group (antineoplastic agents monoclonal antibodies):