Ramucirumab (ra-mue-SIR-ue-mab)

Treats cancer, including stomach, colon, rectal, liver, and lung cancer.

Brand Name(s):

Cyramza

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through an IV placed in a vein. This medicine must be given slowly, so the needle will have remain in place for at least 60 minutes.
• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine.
• You may also receive other medicines (including allergy medicine, fever medicine, steroids) to help prevent unwanted effects to the injection.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how ramucirumab works. Tell your doctor if you are using aspirin or NSAIDs.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant. If you are female and able to get pregnant, your doctor may give you a pregnancy test before you start using this medicine to make sure you are not pregnant. Use an effective form of birth control during treatment and for at least 3 months after your last dose.
• Do not breastfeed during treatment with this medicine and for at least 2 months after the last dose.
• Tell your doctor if you have kidney disease, liver disease (including cirrhosis), blood clotting problems, high blood pressure, thyroid problems, or a recent heart attack or stroke. Tell your doctor if you had a recent surgery.
• This medicine may cause the following problems:
  • Increased risk of bleeding or blood clotting problems
  • High blood pressure
  • Infusion reactions
  • Increased risk of gastrointestinal perforation (hole in stomach or bowels), which could be life-threatening
  • New or worsening liver disease
  • Brain condition called posterior reversible encephalopathy syndrome (PRES)
  • Kidney disease
• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may cause slow wound healing.
• Talk with your doctor before receiving this medicine if you plan to have children. Some women who use this medicine have become infertile (unable to have children).
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Bloody, black, or tarry stools, severe stomach pain or cramps
• Change in how much or how often you urinate, cloudy urine
• Chest pain that may spread, trouble breathing, unusual sweating, fainting
• Confusion, seizure, extreme drowsiness
• Dark urine, pale stools, nausea, vomiting, loss of appetite, yellow skin or eyes
• Fast, slow, or pounding heartbeat
• Fever, chills, cough, sore throat, body aches
• Lightheadedness, dizziness, fainting
• Numbness or weakness in your arm or leg, or on one side of your body, pain in your lower leg (calf)
• Pain, itching, burning, swelling, or a lump under your skin where the needle is placed
• Sudden or severe headache, problems with vision, speech, or walking
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Diarrhea
• Hair loss
• Increased eye tearing
• Lack or loss of strength, tiredness
• Sores or white patches on your lips, mouth, or throat

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088