MVASI Dosage

Generic name: BEVACIZUMAB 100mg in 4mL
Dosage form: injection, solution
Drug class: VEGF/VEGFR inhibitors

Medically reviewed by Drugs.com. Last updated on Oct 31, 2024.

Important Administration Information

Withhold for at least 28 days prior to elective surgery. Do not administer MVASI until at least 28 days following major surgery and until adequate wound healing.

Metastatic Colorectal Cancer

The recommended dosage when MVASI is administered in combination with intravenous fluorouracil-based chemotherapy is:

5 mg/kg intravenously every 2 weeks in combination with bolus-IFL.
10 mg/kg intravenously every 2 weeks in combination with FOLFOX4.
5 mg/kg intravenously every 2 weeks or 7.5 mg/kg intravenously every 3 weeks in combination with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy in patients who have progressed on a first-line bevacizumab product-containing regimen.

First-Line Non-Squamous Non-Small Cell Lung Cancer

The recommended dosage is 15 mg/kg intravenously every 3 weeks in combination with carboplatin and paclitaxel.

Recurrent Glioblastoma

The recommended dosage is 10 mg/kg intravenously every 2 weeks.

Metastatic Renal Cell Carcinoma

The recommended dosage is 10 mg/kg intravenously every 2 weeks in combination with interferon-alfa.

Persistent, Recurrent, or Metastatic Cervical Cancer

The recommended dosage is 15 mg/kg intravenously every 3 weeks in combination with paclitaxel and cisplatin, or in combination with paclitaxel and topotecan.

Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

Stage III or IV Disease Following Initial Surgical Resection

The recommended dosage is 15 mg/kg intravenously every 3 weeks in combination with carboplatin and paclitaxel for up to 6 cycles, followed by MVASI 15 mg/kg every 3 weeks as a single agent for a total of up to 22 cycles or until disease progression, whichever occurs earlier.

Recurrent Disease

Platinum Resistant

The recommended dosage is 10 mg/kg intravenously every 2 weeks in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan (every week).

The recommended dosage is 15 mg/kg intravenously every 3 weeks in combination with topotecan (every 3 weeks).

Platinum Sensitive

The recommended dosage is 15 mg/kg intravenously every 3 weeks, in combination with carboplatin and paclitaxel for 6 to 8 cycles, followed by MVASI 15 mg/kg every 3 weeks as a single agent until disease progression.

The recommended dosage is 15 mg/kg intravenously every 3 weeks, in combination with carboplatin and gemcitabine for 6 to 10 cycles, followed by MVASI 15 mg/kg every 3 weeks as a single agent until disease progression.

Dosage Modifications for Adverse Reactions

Table 1 describes dosage modifications for specific adverse reactions. No dose reductions for MVASI are recommended.

Table 1: Dosage Modifications for Adverse Reactions
Adverse Reaction	Severity	Dosage Modification
Gastrointestinal Perforations and Fistulae	Gastrointestinal perforation, any grade Tracheoesophageal fistula, any grade Fistula, Grade 4 Fistula formation involving any internal organ	Discontinue MVASI
Wound Healing Complications	Any	Withhold MVASI until adequate wound healing. The safety of resumption of bevacizumab products after resolution of wound healing complications has not been established.
Wound Healing Complications	Necrotizing fasciitis	Discontinue MVASI
Hemorrhage	Grade 3 or 4	Discontinue MVASI
Hemorrhage	Recent history of hemoptysis of 1/2 teaspoon (2.5 mL) or more	Withhold MVASI
Thromboembolic Events	Arterial thromboembolism, severe	Discontinue MVASI
Thromboembolic Events	Venous thromboembolism, Grade 4	Discontinue MVASI
Hypertension	Hypertensive crisis Hypertensive encephalopathy	Discontinue MVASI
Hypertension	Hypertension, severe	Withhold MVASI if not controlled with medical management; resume once controlled
Posterior Reversible Encephalopathy Syndrome (PRES)	Any	Discontinue MVASI
Renal Injury and Proteinuria	Nephrotic syndrome	Discontinue MVASI
Renal Injury and Proteinuria	Proteinuria greater than or equal to 2 grams per 24 hours in absence of nephrotic syndrome	Withhold MVASI until proteinuria less than 2 grams per 24 hours
Infusion-Related Reactions	Severe	Discontinue MVASI
	Clinically significant	Interrupt infusion; resume at a decreased rate of infusion after symptoms resolve
	Mild, clinically insignificant	Decrease infusion rate
Congestive Heart Failure	Any	Discontinue MVASI

Preparation and Administration

Preparation

Use appropriate aseptic technique.
Use sterile needle and syringe to prepare MVASI.
Visually inspect vial for particulate matter and discoloration prior to preparation for administration. Discard vial if solution is cloudy, discolored or contains particulate matter.
Withdraw necessary amount of MVASI and dilute in a total volume of 100 mL of 0.9% Sodium Chloride Injection, USP. DO NOT ADMINISTER OR MIX WITH DEXTROSE SOLUTION.
Discard any unused portion left in a vial, as the product contains no preservatives.
Diluted MVASI solution may be stored at 2°C to 8°C (36°F to 46°F) for up to 8 hours, if not used immediately.
No incompatibilities between MVASI and polyvinylchloride or polyolefin bags have been observed.

Administration

Administer as an intravenous infusion.
First infusion: Administer infusion over 90 minutes.
Subsequent infusions: Administer second infusion over 60 minutes if first infusion is tolerated. Administer all subsequent infusions over 30 minutes if second infusion over 60 minutes is tolerated.