Avastin Warnings and Precautions

Prior to taking Avastin, warnings and precautions for the drug should be reviewed with your healthcare provider. This includes telling him or her if you have a history of kidney disease or certain heart conditions, as well as if you are planning on becoming pregnant or breastfeeding. Avastin warnings and precautions also include possibly life-threatening side effects, such as reversible posterior leukoencephalopathy syndrome and gastrointestinal perforations.

Avastin: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Avastin® (bevacizumab) if you have:
 
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding
  • Planning to have surgery.
     
Make sure to tell your healthcare provider about all medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Avastin Warnings and Precautions

Warnings and precautions to be aware of prior to taking Avastin include the following:
 
  • The medication has been reported to cause gastrointestinal perforations (holes in the stomach or intestines). This is a serious and potentially life-threatening problem, and can occur at any time, regardless of whether you just started taking Avastin or have been taking it for quite a while. Tell your healthcare provider immediately if you have any signs of a gastrointestinal perforation, such as:
     
    • Constipation
    • Nausea or vomiting
    • Abdominal pain (stomach pain)
    • Fever.
 
  • Avastin can slow down the rate at which wounds heal. Therefore, it is best to stop taking the drug for at least several weeks before having major surgery. However, it is not known exactly how long you should wait after stopping Avastin before having surgery, since the drug stays in the body for a long time. In general, Avastin should not be started until at least 28 days after a surgery and until the surgical wounds are fully healed.
     
  • The medication increases the risk of bleeding, including serious and life-threatening bleeding. Let your healthcare provider know if you notice any unusual or unexplained bruising or bleeding.
     
  • Avastin appears to increase the risk of high blood pressure, congestive heart failure (CHF), strokes, heart attacks, chest pain, and transient ischemic attacks (TIAs, or "mini-strokes"). Let your healthcare provider know if you have heart disease or a history of such problems.
     
  • In rare cases, Avastin can cause reversible posterior leukoencephalopathy syndrome (RPLS), a disorder caused by leaky blood vessels in the brain. Signs of RPLS include:
     
    • High blood pressure (hypertension)
    • Headaches
    • Seizures
    • Lethargy
    • Confusion
    • Blindness or other vision problems.
 
  • Avastin can cause kidney damage. Your healthcare provider may need to monitor your kidney function closely while you are taking the drug, especially if you already have kidney disease.
     
  • Avastin is considered a pregnancy Category C medication. This means that it may not be safe for use in pregnant women (see Avastin and Pregnancy).
     
  • It is not known whether Avastin passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Avastin and Breastfeeding).
     
(Avastin Warnings and Precautions Continued: Page 2)
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;
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