Generic name: bevacizumab [ bev-a-CIZ-oo-mab ]
Drug class: VEGF/VEGFR inhibitors

Medically reviewed by Philip Thornton, DipPharm. Last updated on Jul 11, 2023.

What is Avastin?

Avastin injection is used in combination with other chemotherapy medications to treat certain types of colon and rectal cancer (cancer that begins in the large intestine), non-small cell lung cancer (NSCLC), glioblastoma (a certain type of cancerous brain tumor), renal cell cancer (RCC, a type of cancer that begins in the kidney), cervical cancer (cancer that begins in the opening of the uterus [womb]), and ovarian (female reproductive organs where eggs are formed), fallopian tube (tube that transports eggs released by the ovaries to the uterus), or peritoneal (layer of tissue that lines the abdomen) cancer.

Avastin is also used in combination with atezolizumab (Tecentriq) to treat hepatocellular carcinoma (HCC) that has spread or cannot be removed by surgery in people who have not previously received chemotherapy.

Avastin belongs to a class of medications called antiangiogenic agents. Bevacizumab works by stopping the formation of blood vessels that bring oxygen and nutrients to tumors. This may slow the growth and spread of tumors.

Warnings

Avastin can make it easier for you to bleed. Seek emergency medical attention if you have any bleeding that will not stop. You may also have bleeding on the inside of your body.

Call your doctor if you have: signs of bleeding in your digestive tract--feeling very weak or dizzy, severe stomach pain, bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds; or signs of bleeding in the brain--sudden numbness or weakness, slurred speech, severe headache, problems with vision or balance.

Avastin can also cause problems with wound healing, which could result in bleeding or infection. Do not use Avastin within 28 days before or after a planned surgery.

Bevacizumab can cause a rare but serious neurologic disorder affecting the brain. Symptoms include headache, confusion, vision problems, feeling very weak or tired, fainting, and seizure (blackout or convulsions). These rare symptoms may occur within hours of your first dose of Avastin, or they may not appear for up to a year after your treatment started. Call your doctor at once if you have any of these side effects.

Some people receiving an Avastin injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your medical caregiver right away if you feel dizzy, nauseated, light-headed, sweaty, itchy, or have a fast heartbeat, chills, wheezing, or chest pain during the injection.

Before taking this medicine

You may not be able to use Avastin if you are being treating with other cancer medicines such as doxorubicin, daunorubicin, or if you have or ever had:

• ovarian cancer with symptoms such as severe stomach pain or pelvic pain;

• slow healing of a skin wound or surgical incision;

• surgery within the past 4 weeks (28 days);

• you plan to have surgery within the next 4 weeks (28 days); or

• coughing up blood or vomit that looks like coffee grounds.

To make sure Avastin is safe for you, tell your doctor if you have ever had:

• diabetes;

• heart problems such as a heart attack, stroke, blood clot or blood clotting disorder;

• high blood pressure;

• bleeding problems or a perforation (a hole or tear) in your esophagus, stomach, or intestines; or

• kidney disease.

Bevacizumab may harm an unborn baby. Do not use if you are pregnant. You may need a pregnancy test to make sure you are not pregnant. Use effective birth control while using Avastin and for at least 6 months after your last dose. Tell your doctor at once if you become pregnant.

Avastin may cause a woman's ovaries to stop working correctly. Symptoms of ovarian failure include 3 or more missed menstrual periods in a row. It may be harder for you to get pregnant while you are using this medicine and after this treatment. Talk to your doctor about your individual risk.

Do not breastfeed while using this medicine and for at least 6 months after your last dose.

How is Avastin given?

Avastin is given as an infusion into a vein. A healthcare provider will give you this injection.

Tell your caregivers right away if you feel dizzy, nauseated, light-headed, sweaty, or have a headache, shortness of breath, or chest pain during the injection.

Avastin is usually given once every 2 or 3 weeks.

Doses are based on weight. Your dose may change if you gain or lose weight.

You may need frequent medical tests and your cancer treatments may be delayed based on the results.

Related/similar drugs

Rybrevant, Opdivo, Keytruda, Yervoy, methotrexate, pembrolizumab, fluorouracil, capecitabine, cisplatin, carboplatin

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your Avastin injection.

What happens if I overdose?

In a medical setting an overdose would be treated quickly.

What should I avoid while receiving Avastin?

Avoid activities that may increase your risk of bleeding or injury. Use extra care while shaving or brushing your teeth.

Avastin side effects

Get emergency medical help if you have signs of an allergic reaction to Avastin: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Some side effects may occur during the injection. Tell your medical caregiver right away if you feel dizzy, nauseated, light-headed, itchy, sweaty, or have a headache, chest tightness, back pain, trouble breathing, or swelling in your face.

Bevacizumab can cause a serious but rare neurologic disorder that affects the brain. Symptoms may occur within hours of your first dose or may not appear for up to a year after your treatment started. Call your doctor at once if you have: extreme weakness or tiredness, headache, confusion, vision problems, fainting, or seizures (blackout or convulsions).

Bevacizumab can cause you to bleed more easily. Call your doctor or seek emergency medical attention if you have:

• easy bruising, unusual bleeding, or any bleeding that will not stop;

• signs of bleeding in your digestive tract - severe stomach pain, bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds; or

• signs of bleeding in the brain - sudden numbness or weakness, slurred speech, severe headache, problems with vision or balance.

Some people taking Avastin have developed a perforation (a hole or tear) or a fistula (an abnormal passageway) in the stomach, intestines, throat, lungs, gallbladder, kidney, bladder, or vagina. Call your doctor if you have severe stomach pain or if you feel like you are choking when you eat or drink.

Also call your doctor if you have:

• slow wound healing;

• skin infection or open sores;

• missed menstrual periods;

• kidney problems - swelling, urinating less, feeling tired or short of breath;

• signs of a blood clot - chest pain, sudden cough or shortness of breath, dizziness, coughing up blood, pain, swelling, or warmth in one leg;

• heart problems - chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating, swelling, rapid weight gain, feeling short of breath; or

• low white blood cell counts - fever, mouth sores, skin sores, sore throat, cough.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common Avastin side effects may include:

• increased blood pressure;

• headache, back pain;

• dry or watery eyes;

• dry or flaky skin;

• stuffy nose, runny nose, sneezing; or

• altered sense of taste.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Avastin?

Tell your doctor about all other cancer treatments you are receiving.

Other drugs may interact with bevacizumab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

Ingredients

Active ingredient: bevacizumab
Inactive ingredients: a,a-trehalose dihydrate, polysorbate 20, sodium phosphate dibasic (anhydrous), sodium phosphate monobasic (monohydrate), and Water for Injection, USP.

Manufacturer

Genentech, Inc, 1 DNA Way South San Francisco, CA 94080, USA.

Avastin Biosimilars

Biosimilar and interchangeable products are biological products that are highly similar to and have no clinically meaningful differences from the reference product.

Reference products

These are biological products that have already been approved by the FDA, against which biosimilar products are compared. There is 1 for Avastin.

Avastin biosimilar products

Biosimilar products can only be dispensed in place of the reference product if the healthcare provider specifically prescribes the biosimilar product by name.

Pharmacy laws for biosimilar prescribing may vary by state

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Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Avastin only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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