Uses

Ramucirumab is used to treat various types of cancers. It works by slowing or stopping the growth of cancer cells.

How To Use

This medication is given by slow injection (usually over 30 minutes or 60 minutes) into a vein by a health care professional. It is given as directed by your doctor, usually every 2 weeks or every 3 weeks.

Infusion reactions may happen while you are receiving ramucirumab. To prevent these side effects, your doctor will also prescribe medications (such as antihistamines, acetaminophen) for you to receive before each injection. Carefully follow your doctor's instructions. Tell your doctor right away if you have any symptoms of infusion reactions such as shaking, back pain/spasms, chest tightness, chills, flushing, rapid heartbeat, dizziness, or skin tingling/burning.

The dosage is based on your medical condition, weight, and response to treatment.

You should receive this medication regularly to get the most benefit from it. To help you remember, mark your calendar to keep track of when to receive the next dose.

Side Effects

See also How to Use section.

Diarrhea, headache, nausea, vomiting, mouth sores, or weakness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

• signs of kidney problems (such as change in the amount of urine, swelling hands/ankles/feet)
• redness/blisters/swelling/pain on the palms of your hands or soles of your feet
• slow wound healing

Get medical help right away if you have any very serious side effects, including:

• chest/jaw/left arm pain
• shortness of breath
• unusual sweating
• weakness on one side of the body
• trouble speaking
• confusion
• sudden vision changes
• seizure
• sudden/severe back pain or headache

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high. Your doctor may control your blood pressure with medication.

This medication may cause serious (possibly fatal) bleeding. It may also rarely cause a hole to open in the stomach or intestines (gastrointestinal perforation). Tell your doctor right away if you have symptoms such as stomach/abdominal pain that doesn't go away, easy bleeding/bruising, bloody or black/tarry stools, vomit that looks like coffee grounds, coughing up blood, lightheadedness, unusual tiredness/weakness.

This medication may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse. Tell your doctor right away if you have any signs of infection (such as sore throat that doesn't go away, fever, chills, cough).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before receiving ramucirumab, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• high blood pressure
• kidney disease
• liver disease
• recent surgery
• recent injuries/wounds
• bleeding/blood problems (such as bleeding of the stomach/intestines)
• blood vessel problems (such as an aneurysm or a tear/break in the aorta or other blood vessels)

Ramucirumab can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.

Tell your health care professional that you are using ramucirumab before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

Before having surgery or any medical procedure, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This medication may cause wounds to heal slowly or poorly. Before having surgery, talk with your doctor about the risks and benefits of this medication. Your doctor may tell you to temporarily stop treatment with this medication at least 28 days before surgery. Ask your doctor for specific instructions about when to stop and when to restart treatment with ramucirumab. Tell your doctor right away if you have wounds that are not healing well.

This medication may decrease fertility in women of childbearing age. Ask your doctor for details.

Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using ramucirumab. Ramucirumab may harm an unborn baby. Your doctor should order a pregnancy test before you start this medication. Ask about reliable forms of birth control while using this medication and for 3 months after the last dose. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.

It is unknown if this medication passes into breast milk. Because of the possible risk to the infant, breastfeeding is not recommended while using this medication and for 2 months after the last dose. Consult your doctor before breastfeeding.

Drug Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Alberta residents can call PADIS (Poison and Drug Information Service) 24 hours a day at 1-800-332-1414. Canada residents can call a provincial poison control center.

Notes

Lab and/or medical tests (such as blood pressure, urine protein, complete blood count, liver/thyroid function) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

Missed Dose

It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.

If you have questions about missing a dose or you don't have more medication, contact your healthcare provider or pharmacist.

Storage

Not applicable. This medication is given in a hospital or clinic and will not be stored at home.

Medical Alert

Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).