ABEVMY - 400MG / 16ML

Category: Monoclonal antibody or Anti-angiogenesis drug
Bevacizumab is sold under the brand name Abevmy 400mg which belongs to vascular endothelial growth factor directed antibody.
Abevmy 400mg consist of human framework regions and murine complementarity-determining regions.
Abevmy 400mg is a combined human monoclonal antibody IgG1, that predicament to and prohibits the biological activity of human vascular endothelial growth factor (VEGF)

INDICATION

Abevmy 400mg is indicated for the treatment
• In combination with 5-fluorouracil chemotherapy administered intravenously, first or second line drug of choice for Metastatic colon or rectal cancer
• Concurrent use with carboplatin and paclitaxel as first line therapy for Non-squamous, non-small cell lung cancer
• Used in the treatment of recurrent Glioblastoma in adults
• Concurrent use with interferon alfa for Metastatic renal cell cancer
• Concurrent use with paclitaxel & cisplatin or paclitaxel & topotecan for Metastatic cervical cancer
• In combination with paclitaxel, pegylated liposomal doxorubicin or topotecan for Epithelial ovarian, fallopian tube or peritoneal cancer

DOSAGE

Key point:
Avoid administrating Abevmy before at least 28 days following surgery and the wound is completely cured
Metastatic colorectal carcinoma:
The Abevmy usual dosage by concomitant with 5-fluorouracil based chemotherapy.
Abevmy 5mg/kg for every 2 weeks IV in concomitant with bolus IFL
Abevmy 10mg/kg for every 2 weeks IV in combination with FOLFOX4
Abevmy 5mg/kg IV for every 2 weeks or Abevmy 7.5 mg/kg as IV every 3 weeks by concurrently take with fluoropyrimidine Irinotecan or fluoropyrimidine oxaliplatin based therapy

Non-small cell lung cancer:

The patient’s regular dosage of Abevmy is 15mg/kg IV for every 3 weeks by interacting with carboplatin and paclitaxel

Glioblastoma:

Abevmy 10mg/kg administered IV for every 2 weeks
Metastatic renal cell cancer:
Concurrent use with interferon alfa.: The usual dose of Abevmy is 10mg/kg IV for every 2 weeks
Metastatic cervical cancer:
The usual dose of Abevmy; Abevmy 15mg/kg given intravenously for every 3 weeks by combining with paclitaxel and cisplatin or with paclitaxel and topotecan
Epithelial ovarian, fallopian tube or peritoneal cancer:
The usual dose of Abevmy for Platinum opposing: 10mg/kg of Abevmy for every 2 weeks by concurrent use with paclitaxel, pegylated liposomal doxorubicin or topotecan
Or The regular dosage of Abevmy; 15mg/kg of Abevmy given through IV for every 3 weeks by combining with topotecan
The usual dose of Abevmy for Platinum responsive; 15mg/kg given IV for 3 weeks in concomitant with carboplatin and paclitaxel for 6 to 8 cycles
The recommended dosage of Abevmy; 15mg/kg of Abevmy given IV for 3 weeks by combining with gemcitabine & carboplatin for 6 to 10 cycles.

Preparation & administration:

Abevmy is intravenous solution
At initial infusion: given IV infusion over 90 minutes
Following infusions: give second infusion over 60 minutes, if tolerated
Administer all following infusion over 30minutes
Abevmy IV infusion is prepared in aseptic condition
Abevmy 400mg containing 16ml solution whereas 100mg containing 4ml
Abevmy dilute into 100ml of 0.9% NS
Do not dilute with dextrose solution
Dispose the remaining drug which is left in a vial under guidance of pharmacist.

MECHANISM OF ACTION

Abevmy 400mg constitute an active ingredient like Bevacizumab which joined to VEGF and will not have communication of VEGF to its receptors like Flt-1 & KDR that present on the surface of the cells.
While this interaction inhibits endothelial cell proliferation and new blood vessel production occurs
Hence in counts discontinuation of metastatic tumor cells growth happens

PHARMACOKINETICS

The pharmacokinetic form of Abevmy is assayed by measuring total serum Bevacizumab concentration.

Distribution:

The volume of distribution is 2.9 (22%) L

Elimination:

The terminal half-life period of Bevacizumab is 20days (11 to 50days)

PRECAUTIONS

Caution with use in the conditions like;
Previously If you have taking or ever had DPD (dihydropyridine dehydrogenase) deficiency of enzyme.Inform the doctor about this then your doctor may preferably inform you avoid taking Abevmy 400mg.
Discuss with the doctor that you have or have ever had renal, hepatic, or cardiac problem
Discuss with the doctor that are you pregnant or plan to become pregnant. Avoid planning to have children while on treatment with Abevmy 100mg. You should use an essential method of conceiving to prevent pregnancy in yourself or your partner during your treatment with Abevmy 400mg. The drug will harm the fetus.
Avoid breast feeding while on treatment with Abevmy 400mg
While using Abevmy 400mg these are some other complications occurred during therapy, care should be taken
Hypertension
Posterior reversible encephalopathy syndrome
Gastrointestinal perforations
Wound healing complications
Hemorrhage
Arterial thromboembolic events
Venous thromboembolic events
Embryo fetal toxicity occurs.

DRUG INTERACTION

While interaction of Abevmy 400mg with paclitaxel & Carboplatin, leads to lowering in exposure of paclitaxel after four cycles of therapy. Interaction of Abevmy 400mg with paclitaxel & Carboplatin leads to increase the paclitaxel exposure at day 6

CONTRAINDICATION

No contraindication occurred

SIDE EFFECTS

Gastrointestinal perforation and fistulae
Surgery and wound healing complication
Hemorrhage
Arterial thromboembolic events
Venous thromboembolic events
Hypertension
Posterior reversible encephalopathy syndrome
Renal injury & Proteinuria
Infusion reactions
Ovarian failure
Congestive heart failure
Neutropenia, mucosal inflammation, infection, neuropathy, Epistaxis, erythrodysesthesia.

STORAGE

Abevmy 400mg vial should be stored at 2 to 8℃ (36 to 46℉)
Single use vial
Discard the left-out medicine under guidance of pharmacist

MISSED DOSE

If patient fail to take the dose or missed the cycle means must consult with oncologist and follow the regular dosing schedule Do not take overdose