Black Box Warnings .
severe and sometimes fatal cases, incl. GI bleeding, reported in pts receiving ziv-aflibercept w/ FOLFIRI; monitor s/sx bleeding; do not admin. in pts w/ severe bleeding
reported, incl. fatal cases; D/C if GI perforation occurs
Compromised Wound Healing
severe cases can occur in pts receiving ziv-aflibercept w/ FOLFIRI; D/C if compromised wound healing occurs; D/C >4wk before, restart >4wk after major surgery and when wound fully healed
Adult Dosing .
Dosage forms: IV
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments; D/C >4wk before, restart >4wk after major surgery when wound fully healed
metastatic colorectal CA, refractory
- [4 mg/kg IV x1 on day 1 of 14-day cycle]
- Info: part of multi-drug chemo regimen
- [no adjustment]
- HD: not defined
- [see below]
- mild-mod impairment: no adjustment; severe impairment: not defined
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
- hypersens. to drug/class/compon.
- surgery, major w/in 28 days
- surgical wounds, unhealed
- severe hemorrhage
- recent hemoptysis
- GI perforation
- uncontrolled HTN
- caution if proteinuria
- caution if thromboembolism hx
- caution in pts >65 yo
Drug Interactions .
- thrombogenic effects
- aminocaproic acid
- coagulation factor VIIa
- tranexamic acid
- anti-inhibitor coagulant complex
- antihemophilic factor (factor VIII)/von Willebrand factor complex
- C1 esterase inhibitor
- chorionic gonadotropin
- coagulation factor IX
- darbepoetin alfa
- desogestrel (contraceptive)
- dienogest (contraceptive)
- drospirenone (contraceptive)
- drospirenone (hormone replacement)
- epoetin alfa
- estradiol (contraceptive)
- estradiol (hormone replacement)
- estrogens, conjugated (hormone replacement)
- estrogens, esterified (hormone replacement)
- estropipate (hormone replacement)
- ethinyl estradiol (contraceptive)
- ethinyl estradiol (hormone replacement)
- ethynodiol (contraceptive)
- etonogestrel (contraceptive)
- factor XIII concentrate
- levonorgestrel (contraceptive)
- levonorgestrel (hormone replacement)
- medroxyprogesterone (contraceptive)
- medroxyprogesterone (hormone replacement)
- mestranol (contraceptive)
- methoxy polyethylene glycol-epoetin beta
- norelgestromin (contraceptive)
- norethindrone (contraceptive)
- norethindrone acetate (hormone replacement)
- norgestimate (contraceptive)
- norgestimate (hormone replacement)
- norgestrel (contraceptive)
Adverse Reactions .
- hemorrhage, severe
- GI perforation
- impaired wound healing
- fistula formation
- venous thromboembolism
- nephrotic syndrome
- thrombotic microangiopathy
- febrile neutropenia
- infection, severe
- diarrhea, severe
- reversible posterior leukoencephalopathy syndrome
- hypersensitivity rxn
- ALT, AST incr.
- appetite decr.
- weight loss
- abdominal pain
- Cr incr.
- hand-foot syndrome
- skin hyperpigmentation
- oropharyngeal pain
- rectal hemorrhage
Lactation: Safety Unknown
use effective contraception during and >3mo after D/C in pts of childbearing potential
CBC w/ diff at baseline, then prior to each cycle; BP q2wk; dipstick urinalysis and/or urinary protein creatinine ratio
Metabolism: unknown; CYP450: unknown
Excretion: unknown; Half-life: 6 days
Mechanism of Action
binds and inhibits vascular endothelial growth factor A, decreasing neovascularization and vascular permeability
Manufacturer: sanofi-aventis U.S. LLC
Approximate Retail Price
This information is currently not available for this drug.
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