Avastin 400 mg injection may be prescribed for:

• Colorectal cancer: Used as part of treatment for colorectal cancer, including advanced or metastatic disease.

• Non-small cell lung cancer (NSCLC): Used for unresectable, advanced, metastatic or recurrent non-squamous NSCLC.

• Renal cell carcinoma: Used as part of first-line treatment for advanced or metastatic renal cell carcinoma.

• Glioblastoma: Used for glioblastoma with progressive disease following prior treatment, as a single medicine.

• Ovarian, fallopian tube and primary peritoneal cancer: Used with chemotherapy for certain advanced or recurrent forms of these cancers.

• Cervical cancer: Used in combination with specified chemotherapy regimens for persistent, recurrent or metastatic cervical cancer.

• Hepatocellular carcinoma (HCC): Used with atezolizumab for unresectable or metastatic HCC in patients who have not received prior systemic treatment.

The dose and combination of medicines vary according to the cancer being treated.

Avastin 400mg Injection contains Bevacizumab, which blocks vascular endothelial growth factor (VEGF). VEGF is a protein that helps cancer cells develop new blood vessels.

By binding to VEGF and reducing its activity, Bevacizumab can reduce the formation of new blood vessels that supply a tumour. This can limit the blood supply available to the tumour and help slow its growth.

Avastin 400mg Injection is often given with other anticancer medicines. The prescribing information does not report clinically relevant effects of several commonly co-administered chemotherapy medicines on Bevacizumab pharmacokinetics.

However, certain combinations require particular caution:

• Sunitinib: Combining Bevacizumab with sunitinib has been associated with microangiopathic haemolytic anaemia, a condition involving damage to red blood cells and changes in blood counts.

• Chemotherapy: Avastin may be combined with different chemotherapy regimens depending on the cancer being treated. Your doctor will select the combination and doses.

• Radiotherapy: The safety and effectiveness of combining Avastin with radiotherapy have not been established for all cancer types.

• Tell your doctor about all medicines, supplements and cancer treatments you are receiving before starting Avastin 400mg Injection.

• Store Avastin 400mg Injection in a refrigerator at 2°C to 8°C.

• Keep the vial in its outer carton to protect it from light.

• Do not freeze.

• Do not shake.

• The diluted infusion should be prepared and handled using appropriate aseptic conditions by healthcare professionals.

• Avastin should not be mixed with dextrose or glucose solutions.

Avastin 400mg Injection is given only by intravenous infusion by a qualified healthcare professional. It should not be given as an intravenous push or bolus.

The amount of Avastin required depends on your body weight, cancer type and treatment regimen. Different cancers may require different doses and dosing intervals, so follow the schedule prescribed by your oncologist.

The first infusion is generally administered over 90 minutes. If it is well tolerated, the second infusion may be given over 60 minutes, and subsequent infusions may be given over 30 minutes if earlier infusions are tolerated.

Do not try to administer Avastin 400mg Injection yourself. The vial is for single use and any unused portion should be discarded.

Common side effects

• High blood pressure

• Weakness or fatigue

• Diarrhoea

• Abdominal pain

• Nausea

• Headache

• Joint or muscle pain

• Nosebleeds

• Reduced appetite

• Protein in the urine

• Constipation

• Cough

• Shortness of breath

• Fever

Some side effects may also be related to the chemotherapy medicines given with Avastin.

Serious side effects

• Gastrointestinal perforation: A hole may develop in the stomach or intestine and can cause severe abdominal pain, vomiting or fever.

• Serious bleeding: Avastin can increase the risk of significant bleeding, including bleeding from the lungs.

• Blood clots: Arterial or venous blood clots can occur and may cause symptoms such as chest pain, sudden weakness or breathing difficulty.

• Severe high blood pressure: Very high blood pressure can sometimes lead to serious complications.

• Wound-healing complications: Avastin can interfere with wound healing and may increase complications around surgery.

• Proteinuria and kidney injury: Increased protein in the urine can occur and, rarely, may become severe.

• Severe allergic or infusion-related reactions: These may occur during or shortly after the infusion.

• Posterior reversible encephalopathy syndrome (PRES): This rare neurological condition may cause seizures, severe headache, confusion or changes in vision.

• Fistula formation: Abnormal connections between organs or tissues can rarely develop.

Seek medical attention promptly if you experience severe abdominal pain, unusual or heavy bleeding, coughing up blood, sudden chest pain or breathlessness, severe headache, seizures, confusion or major changes in vision.

• Avastin 400 mg injection should be administered only by a healthcare professional according to the treatment plan prescribed by your oncologist.

• Tell your doctor if you have high blood pressure, bleeding problems, heart disease, kidney problems or a history of blood clots before treatment.

• Blood pressure should be monitored regularly during treatment.

• Your doctor may check your urine for protein before and during treatment.

• Tell your doctor well in advance if you are planning to undergo surgery. Avastin can affect wound healing and may need to be stopped around major surgery.

• Report unusual bleeding, severe abdominal pain, persistent vomiting or symptoms of a blood clot promptly.

• Keep your oncologist informed about all chemotherapy, immunotherapy, targeted medicines and supplements you are taking.

• Avastin 400 mg injection is not formulated for injection into the eye. It should not be used for intravitreal treatment.