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
- 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)
- 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.
Join Now to View Patient Handouts!
Create a FREE Epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.