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Precautions and Warnings With Bevacizumab

Specific Precautions and Warning With Bevacizumab

Warnings and precautions to be aware of prior to taking bevacizumab include the following:
 
  • The medication has been reported to cause gastrointestinal perforations (holes in the stomach or intestines). This is a serious and potentially life-threatening problem, and can occur at any time, regardless of whether you have just started taking bevacizumab or have been taking it for quite a while. Tell your healthcare provider immediately if you have any signs of a gastrointestinal perforation, such as:
     
    • Constipation
    • Nausea or vomiting
    • Abdominal pain (stomach pain)
    • Fever.
 
  • Bevacizumab can slow down the rate at which wounds heal. Therefore, it is best to stop taking the drug for at least several weeks before having major surgery. However, it is not known exactly how long you should wait after stopping bevacizumab before having surgery, since the drug stays in the body for a long time. In general, bevacizumab should not be started until at least 28 days after a surgery and until the surgical wounds are fully healed.
     
  • The medication increases the risk of bleeding, including serious and life-threatening bleeding. Let your healthcare provider know if you notice any unusual or unexplained bruising or bleeding.
     
  • Bevacizumab appears to increase the risk of high blood pressure, congestive heart failure (CHF), strokes, heart attacks, chest pain, and transient ischemic attacks (TIAs, or "mini-strokes"). Let your healthcare provider know if you have heart disease or a history of such problems.
     
  • In rare cases, bevacizumab can cause reversible posterior leukoencephalopathy syndrome (RPLS), a disorder caused by leaky blood vessels in the brain. Signs of RPLS include:
     
 
  • Bevacizumab can cause kidney damage. Your healthcare provider may need to monitor your kidney function closely while you are taking the drug, especially if you already have kidney disease.
     
  • Bevacizumab is considered a pregnancy Category C medication. This means that it may not be safe for use in pregnant women (see Avastin and Pregnancy).
     
  • It is not known whether bevacizumab passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Avastin and Breastfeeding).
     
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