Avastin (bevacizumab)

Avastin uses

The Food and Drug Administration (FDA) approves prescription drugs such as Avastin to treat certain conditions. Avastin may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Avastin for glioblastoma

Avastin is FDA-approved to treat recurrent glioblastoma. This cancer is a type of aggressive brain cancer. With recurrent glioblastoma, the cancer responded to past treatments, but it has come back after a period of time.

Glioblastomas grow quickly inside the brain. But they rarely spread to other parts of the body. Glioblastomas belong to a group of tumors called astrocytomas. (The name “astrocytoma” comes from the cells that these tumors start in, which are called astrocytes.)

Effectiveness for glioblastoma

In a clinical study of people with recurrent glioblastoma, researchers looked at whether Avastin combined with the chemotherapy drug lomustine was more effective than treatment with lomustine alone. In the study, people who took Avastin with lomustine had better outcomes compared with people who took only lomustine.

Specifically, half of the people taking Avastin with chemotherapy went at least 4.2 months without their tumor progressing. In comparison, half of the people taking lomustine alone went at least 1.5 months without their tumor progressing.

Avastin for ovarian cancer

Avastin is FDA-approved to treat cancer in your ovaries, fallopian tubes, or peritoneum (lining inside your abdomen). It’s important to note that certain cancers in the fallopian tubes and peritoneum can be so similar to ovarian cancer that they’re sometimes labeled as ovarian cancer.

For this use, Avastin is used in the following situations:

• Stage three (3) and stage four (4) cancer. In these stages, the cancer has spread from the area where it started to other parts of your body. For this use, Avastin is given after the cancer has already been treated with surgery. At the start of treatment, Avastin is used with two chemotherapy drugs called carboplatin and paclitaxel (Abraxane). (Chemotherapy describes traditional drugs used to treat cancer.) After a period of time, Avastin is used on its own.
• Recurrent cancer that’s resistant to certain treatments made with platinum. With recurrent cancer, the cancer responded to past treatment, but it has come back after a period of time. With resistance, the cancer no longer responds to certain treatments. For this use, Avastin is given to people who used up to two chemotherapy drugs in the past. And Avastin is used in combination with certain other drugs. For example, it’s given with paclitaxel, topotecan (Hycamtin), or liposomal doxorubicin (Doxil).
• Recurrent cancer that responds to certain treatments made with platinum. For this use, Avastin is given in combination with certain chemotherapy drugs. For example, it’s given with either both carboplatin and gemcitabine or both carboplatin and paclitaxel. After a period of time, Avastin is used on its own.

To learn more about ovarian cancer, see our hub on this condition.

Effectiveness for ovarian cancer

In a clinical study, researchers looked to see whether adding Avastin to chemotherapy was more effective in treating ovarian cancer than using chemotherapy alone in people who already had surgery.

The researchers found that, on average, cancer progressed more slowly in people who took Avastin with chemotherapy than it did in people who took only chemotherapy. For example, half of the people taking Avastin lived 18.2 months or more before their cancer progressed. In comparison, half of the people using chemotherapy alone lived 12 months or more before their cancer progressed.

For additional results from clinical studies of people with ovarian, fallopian tube, or peritoneal cancers, see the drug’s prescribing information.

Avastin for colon cancer

Avastin is FDA-approved to treat colon cancer. This condition is also called colorectal cancer or bowel cancer. Specifically, Avastin is approved to treat metastatic colon cancer. With metastatic colon cancer, the cancer has spread out of your colon into other parts of your body.

For this use, Avastin is used in the following situations:

• First-line treatment. With first-line treatment, Avastin is the first drug used to treat the condition. For this use, Avastin is given in combination with a chemotherapy regimen that includes the drug fluorouracil and is given by intravenous (IV) infusion.* (Chemotherapy describes traditional drugs used to treat cancer.)
• Second-line treatment. With second-line treatment, Avastin is given after past treatment didn’t work for the condition. For this use, Avastin is given in combination with a chemotherapy regimen that includes the drug fluorouracil and is given by IV infusion.
• Second-line treatment after first-line treatment that included bevacizumab† didn’t work for the condition. For this use, Avastin is given in combination with a chemotherapy regimen that includes a group of drugs called fluoropyrimidines, with either irinotecan (Camptosar, Onivyde) or oxaliplatin (Eloxatin). Fluorouracil is an example of a fluoropyrimidine.

Avastin is not approved as an adjuvant treatment for colon cancer. (Adjuvant treatment is given to lower the risk of cancer coming back after it’s already been treated with surgery.)

To learn more about colon cancer, see this list of articles.

* With IV infusion, the drug is injected into your vein over a period of time.
† Bevacizumab is the active drug in Avastin and its biosimilars. For more information, see the “Avastin generic or biosimilar” section below.

Effectiveness for colon cancer

One clinical study looked at whether combining Avastin with chemotherapy was more effective in treating colon cancer than using chemotherapy alone. People in the study received first-line therapy with either Avastin and chemotherapy or a placebo and chemotherapy. (A placebo is a treatment with no active drug.)

The researchers found that people with bowel cancer who took Avastin with chemotherapy lived longer than did people who took the placebo. Specifically, half of the people taking Avastin lived at least 20.3 months. In comparison, half of the people taking the placebo lived at least 15.6 months.

For additional results from clinical studies of people with colon cancer, see the drug’s prescribing information.

Avastin for lung cancer

Avastin is FDA-approved to treat a specific type of lung cancer called non-squamous non-small cell lung cancer (NSCLC). Non-squamous NSCLC doesn’t affect certain cells in your lungs called squamous cells. (These are flat cells that line the airways in your lungs.)

Compared with small cell lung cancer (SCLC), NSCLC is typically a less aggressive form of lung cancer.

Avastin is specifically approved to treat non-squamous NSCLC that’s:

• locally advanced (spread to nearby areas or lymph nodes),
• unable to be treated with surgery, and
• either recurrent (has responded to past treatment, but has come back after a period of time) or metastatic (has spread out of your lungs to other parts of your body)

For this use, Avastin is used as a first-line treatment. (With first-line treatment, it’s the first drug given to treat the condition.) It’s given in combination with two chemotherapy drugs called carboplatin and paclitaxel. (Chemotherapy describes traditional drugs used to treat cancer.)

For more information about lung cancer, including NSCLC, see our hub on this topic.

Effectiveness for lung cancer

In clinical studies, researchers compared treatment with Avastin and chemotherapy with chemotherapy alone in people with non-squamous NSCLC. In some studies, a placebo (treatment with no active drug) was given with chemotherapy.

In these studies, people taking Avastin with chemotherapy lived longer than did people taking chemotherapy alone or chemotherapy with a placebo. The people taking Avastin also had slower worsening of their cancer.

Specifically, half of the people taking Avastin with chemotherapy lived at least 12.3 months. In comparison, half of the people who didn’t take Avastin lived at least 10.3 months.

Avastin for cervical cancer

Avastin is FDA-approved to treat cervical cancer. This type of cancer starts in your cervix, which is the lower part of the uterus that separates the uterus from the vagina.

Specifically, Avastin is approved to treat cervical cancer that’s:

• metastatic (has spread from your cervix to other parts of your body), or
• persistent (continues to grow even during or after treatment), or
• recurrent (responded to past treatment, but has come back after a period of time)

For this use, Avastin is given in combination with certain chemotherapy drugs. For example, it’s given with either both paclitaxel and cisplatin or both paclitaxel and topotecan.

To find out more about cervical cancer, see this list of articles.

Effectiveness for cervical cancer

In a clinical study, researchers looked at whether using Avastin with chemotherapy was more effective in treating cervical cancer than using chemotherapy alone.

The study showed that people taking Avastin with chemotherapy had better outcomes than did people taking chemotherapy alone. For example, half of the people taking Avastin lived at least 16.8 months. In comparison, half of the people using chemotherapy alone lived at least 12.9 months.

Avastin for kidney cancer

Avastin is FDA-approved to treat metastatic kidney cancer. Metastatic kidney cancer has spread out of your kidney into other parts of your body.

For this use, Avastin is given in combination with a drug called interferon alfa.

Effectiveness for kidney cancer

In a clinical study, researchers looked to see whether using Avastin with interferon alfa was more effective in treating kidney cancer than using interferon alfa with a placebo. (A placebo is a treatment that doesn’t contain any active drug.)

The study showed that people taking Avastin with interferon alfa had better overall outcomes than did people taking interferon alfa and the placebo. In particular, half of the people using Avastin with interferon alfa lived for at least 10.2 months without their cancer worsening. In comparison, half of the people using the placebo with interferon alfa went at least 5.4 months without their cancer worsening.

Avastin for liver cancer

Avastin is FDA-approved to treat liver cancer that’s either:

• unable to be treated with surgery, or
• metastatic (has spread from your liver to other parts of your body)

For this use, Avastin is given to people who haven’t taken a systemic treatment for their cancer. (Systemic treatment affects your whole body.) And it’s used in combination with a drug called atezolizumab (Tecentriq).

For more information about liver cancer, see this list of articles.

Effectiveness for liver cancer

Avastin has been found effective for treating liver cancer. In fact, guidelines from the American Society of Clinical Oncology recommend Avastin in combination with atezolizumab as a first-line treatment option for liver cancer. (With first-line treatment, Avastin is the first drug used to treat the condition.)

For results from clinical studies of people with liver cancer, see Avastin’s prescribing information.

Off-label uses for Avastin

In addition to the uses listed above, Avastin may be used off-label for other conditions. Off-label drug use is when a drug that’s approved for one condition is used for a different one that’s not approved. Below are examples of off-label uses for Avastin.

Avastin for age-related macular degeneration

Avastin isn’t FDA-approved to treat age-related macular degeneration (AMD). But sometimes the drug is used off-label to treat this condition.

AMD causes problems such as blurred vision or a blind spot. There are “wet” and “dry” forms of AMD. Avastin has been used off-label to treat wet AMD. With this condition, your body makes abnormal blood vessels in an area inside your eye that leak fluid into your eye.

In fact, one clinical study found that Avastin was as effective as ranibizumab (Lucentis) in treating wet AMD. (Lucentis is a brand-name drug that’s approved to treat this condition.) And a review of clinical studies reported that Avastin was similar in safety when compared to Lucentis.

It’s important to note that both infection and eye pain after Avastin injections are possible side effects when the drug is used for AMD. Retinal hemorrhage (bleeding in your retina) is another possible side effect of Avastin. But keep in mind that retinal hemorrhage can also be a symptom of macular edema. (Macular edema, which is swelling inside your eye, is related to macular degeneration.)

If you have questions about using Avastin for AMD, talk with your doctor.

Avastin for radiation necrosis

Avastin isn’t approved to treat radiation necrosis. But sometimes the drug is used off-label for this condition.

Radiation necrosis is a possible side effect of radiation therapy (also called radiotherapy). Radiation therapy is used to treat a variety of cancers, including glioblastomas (a type of brain cancer).

In a review of clinical studies, Avastin was effective in treating radiation necrosis affecting the brain. But more research is needed to know the appropriate dosage of Avastin for this condition. And more research is needed to know how long the drug should be used for radiation necrosis.

If you’d like to know more about treatment options for radiation necrosis, talk with your doctor.

Avastin for breast cancer

Avastin isn’t currently FDA-approved to treat breast cancer. But sometimes it’s used off-label for this condition.

It’s important to note that back in 2008, Avastin was FDA-approved to treat breast cancer. However, in 2011, the FDA withdrew this approval. The FDA stated that the information available didn’t show Avastin to be safe and effective in treating breast cancer.

In 2008, Avastin was approved under a special FDA program called Accelerated Approval Program. This program allows drugs that treat serious health conditions and fill unmet medical needs to get approved faster than usual. But when these drugs are approved, the drug manufacturer must still complete follow-up clinical studies to confirm the results of early studies.

In this case, both the Oncology Drugs Advisory Committee and the FDA looked at early study results versus follow-up study results of breast cancer treatment with Avastin. Both organizations agreed that the follow-up studies didn’t show the drug was as effective as the earlier studies had suggested.

However, Avastin may still be used off-label for breast cancer treatment. Some clinical studies that looked at Avastin as a breast cancer treatment found that the drug offers some benefit.

If you have questions about using Avastin for breast cancer, talk with your doctor.

Avastin for diabetic retinopathy

Avastin isn’t FDA-approved to treat diabetic retinopathy, but sometimes it’s used off-label for this condition.

With diabetic retinopathy, blood vessels in your retina (an area inside your eye) become damaged from diabetes. Although the condition usually begins with mild vision problems, it can lead to blindness if it’s not treated.

One clinical study found that Avastin improved diabetic retinopathy. Avastin also slowed the disease from worsening in people who took the drug.

It’s important to note that both infection and eye pain after Avastin injections are possible side effects when the drug is used for treating diabetic retinopathy.

If you have questions about treatment options for diabetic retinopathy, talk with your doctor.

Avastin for endometrial cancer

Avastin isn’t FDA-approved to treat endometrial cancer, but sometimes it’s used off-label for this condition. With endometrial cancer, the lining of your uterus (called the endometrium) is affected.

One clinical study found that Avastin, when used in combination with the chemotherapy drugs paclitaxel and carboplatin, may improve overall survival in people with endometrial cancer. (Chemotherapy describes traditional drugs used to treat cancer.) Overall survival describes the length of time that people live after their condition is diagnosed or treatment is started.

However, Avastin used in combination with the chemotherapy drugs ixabepilone and carboplatin did not improve overall survival in people with endometrial cancer.

In this study, Avastin didn’t significantly improve people’s progression-free survival (PFS). (PFS describes the length of time that someone’s cancer doesn’t grow or spread.) The study also showed that side effects from Avastin were very common in people with endometrial cancer.

But another study showed that Avastin did improve PFS in people with endometrial cancer.

If you have questions about using Avastin for endometrial cancer, talk with your doctor.

Avastin generic or biosimilar

Avastin contains the active drug bevacizumab, which is a biologic. Biologic medications are made from living cells.

Although there isn’t a generic form of bevacizumab, there are biosimilar forms available called Alymsys, Mvasi, Vegzelma, and Zirabev.

It isn’t possible to make an exact copy of biologics. Biosimilars are similar to a brand-name biologic medication, such as Avastin. Biosimilars are considered to be just as safe and effective as their parent drug.

A generic medication, on the other hand, is an exact copy of a brand-name medication that’s made from chemicals.

Avastin side effects

Avastin can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Avastin. These lists do not include all possible side effects.

For more information on the possible side effects of Avastin, see this article. You can also talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Avastin, you can do so through MedWatch.

Mild side effects

The mild side effects* of Avastin can include:

• changes in taste
• changes in the way your voice sounds
• back pain
• minor bleeding, such as nosebleeds
• problems with tear production
• dry skin
• headache
• high blood pressure
• rhinitis (runny or stuffy nose)

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Avastin. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Avastin’s prescribing information.

Serious side effects

Serious side effects from Avastin aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• Thromboembolic events (conditions that are caused by blood clots inside a blood vessel), including:
  • heart attack, which happens when a clot blocks blood flow to your heart muscle
  • stroke, which happens when a clot blocks blood flow to your brain
  • mini-stroke, which happens when a clot temporarily blocks blood flow to your brain
  • angina, a type of chest pain that’s caused by blocked blood flow to your heart muscle
  • pulmonary embolism, which is a blood clot that’s formed inside your lung
  • deep vein thrombosis, which is a blood clot that’s formed inside a deep vein, such as in your leg
• Gastrointestinal perforation (rupture in your bowel) or gastrointestinal fistulae (abnormal openings in your digestive tract). Symptoms can include:
  • fever or chills
  • diarrhea
  • nausea and vomiting
  • severe or unusual pain in your abdomen
  • changes in your usual schedule of bowel movements
• Posterior reversible encephalopathy syndrome (PRES), which is a condition that’s caused by swelling in your brain. Symptoms can include:
  • blindness
  • confusion
  • increased blood pressure
  • feeling tired or lacking energy
  • headache
  • seizures
• Kidney damage, which may cause proteinuria (high levels of protein in your urine). Symptoms can include:
  • bloating
  • fluid retention (swelling)
  • high blood pressure
  • urine that looks foamy
  • weight gain
• Severe infusion reaction (an immune system reaction that may occur when you have a drug infused into your body). Symptoms can include:
  • chest pain
  • diaphoresis (excessive sweating)
  • feeling cold and shivering
  • headache
  • hypertensive crisis (severe high blood pressure)
  • wheezing
  • anaphylaxis and similar severe allergic reactions
• Heart failure. Symptoms can include:
  • bloating
  • fluid retention
  • feeling tired
  • fatigue
  • long lasting cough
  • shortness of breath
  • wheezing
• Early menopause in females* using the drug who haven’t gone through menopause yet. Symptoms may include:
  • lack of periods
  • changes in your mood
  • trouble sleeping
  • vaginal dryness

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Other serious side effects, which are explained in more detail below in “Side effect details,” include:

• allergic reaction
• severe high blood pressure
• exfoliative dermatitis (a type of rash that causes peeling skin and discoloration over large areas of your body)
• hemorrhage (severe bleeding)

Side effect details

You may wonder how often certain side effects occur with Avastin. Here’s some detail on several of the side effects Avastin may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Avastin. But it’s not known for sure how many people have had an allergic reaction to Avastin.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have a severe allergic reaction to Avastin. But call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

High blood pressure

It’s possible to have high blood pressure (hypertension) while you’re taking Avastin. Across several clinical studies, 12% to 42% of people who took Avastin with chemotherapy had high blood pressure during treatment. (Chemotherapy describes traditional drugs used to treat cancer.)

In the same studies, 5% to 18% of people who took Avastin with chemotherapy had high blood pressure that required treatment or hospitalization.

In comparison, in those same studies, 2% to 14% of people who took a placebo (no active drug) with chemotherapy had high blood pressure. And 0.5% to 9% of people who took a placebo with chemotherapy had high blood pressure that required treatment or hospitalization.

While taking Avastin, you should regularly monitor your blood pressure. If your blood pressure increases, let your doctor know right away. They’ll recommend ways to manage your blood pressure, which may include using medications called antihypertensives.

Severe high blood pressure

Some people have dangerously high blood pressure readings while taking Avastin. This condition is known as hypertensive crisis. It occurs when either:

• your systolic blood pressure (the top number in your blood pressure reading) is greater than 180 mmHg, or
• your diastolic blood pressure (the bottom number in your blood pressure reading) is greater than 120 mm Hg

When your blood pressure rises this high, it can cause damage to organs in your body, such as your brain, eyes, heart, or kidneys. When organ damage occurs, the condition is known as a hypertensive emergency.

Hypertensive emergency can be life threatening. You should call 911 if you have any of the following symptoms:

• blurry vision or other vision changes
• chest pain
• confusion or mental slowness
• nausea or vomiting
• numbness or weakness in your arms, face, or legs
• seizure
• severe headache

If you have a hypertensive emergency while you’re taking Avastin, your doctor will recommend that you stop using the drug. And they’ll work with you to choose a different cancer treatment.

Blurry vision

Although possible, it’s very unlikely that you’ll have blurry vision while you’re taking Avastin.

One clinical study looked at using Avastin for kidney cancer. In this study, 337 people took Avastin with another drug called interferon alfa. Only 8 of the people had blurry vision. In this same study, 304 people took a placebo (no active drug) along with interferon alfa. None of these people had blurry vision.

Blurry vision wasn’t reported by people taking Avastin in any other clinical studies of the drug.

However, blurry vision can be a sign of other side effects of Avastin. For example, blurry vision can be a symptom of high blood pressure, including severe high blood pressure.

Because of this, you should call your doctor right away if you have blurry vision while you’re taking Avastin. Your doctor will recommend whether or not you need medical treatment for your blurry vision.

Rash

It’s possible to have a certain type of rash called exfoliative dermatitis while you’re taking Avastin. With this condition, you may have peeling and discoloration of your skin over large areas of your body. Symptoms of exfoliative dermatitis can also include:

• dry skin
• itchy skin
• skin that looks or feels rough and scaly

In one clinical study, exfoliative dermatitis occurred in 23% of people who took Avastin with the chemotherapy drugs carboplatin and paclitaxel. This side effect occurred in 16% of people who took only carboplatin and paclitaxel.

Exfoliative dermatitis is a serious condition that will likely require treatment in a hospital. If you have any symptoms of exfoliative dermatitis, call your doctor right away.

Minor bleeding, such as nosebleeds

Avastin has caused minor bleeding, such as nosebleeds, in people taking the drug. In fact, during clinical studies, nosebleeds were reported by 5% to 55% of people taking Avastin as part of their cancer treatment. In comparison, nosebleeds occurred in 0% to 14% of people who didn’t take Avastin.

If you have minor bleeding, such as a nosebleed, while you’re taking Avastin, call your doctor. They’ll let you know how to manage this side effect.

Severe bleeding

Avastin has also caused severe bleeding (called hemorrhage). In some cases, the bleeding has been fatal. During clinical studies, severe bleeding that required treatment or hospitalization occurred in 0.4% to 7% of people taking Avastin as part of their cancer treatment. In comparison, severe bleeding that required treatment or hospitalization occurred in only 0.3% to 1% of people who didn’t take Avastin.

Symptoms of a severe bleed can include:

• heavy bleeding from your gums
• coughing up blood or having bloody phlegm
• feeling dizzy or weak
• shortness of breath
• skin that’s paler than usual
• rectal bleeding or having blood in your stool
• unusual vaginal bleeding in females* using the drug
• vomiting blood, or having vomit that’s black and looks like coffee grounds

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Varices are a possible complication of liver cancer, which Avastin is used to treat. (Varices are swollen blood vessels around your esophagus.) In some cases, varices may burst and cause severe bleeding.

If you’re taking Avastin for liver cancer, your doctor will check you for varices within 6 months of starting the drug. It isn’t known whether Avastin is effective for treating liver cancer in people who have had bleeding caused by varices. And it isn’t known for sure whether having varices raises your risk of severe bleeding with Avastin.

If you have bleeding caused by varices while taking Avastin, your doctor may prescribe another treatment for you.

If you have any symptoms of severe bleeding, call your doctor right away. But if your symptoms feel life threatening, call 911 or have someone take you to the nearest emergency room.

Avastin use with other drugs

Depending on the condition that’s being treated, Avastin is often used with other medications, including chemotherapy. (Chemotherapy describes traditional drugs used to treat cancer.)

Examples of chemotherapy medications and regimens that may be used with Avastin include:

• capecitabine (Xeloda)
• carboplatin
• cisplatin
• liposomal doxorubicin (Doxil)
• FOLFOX, which is a chemotherapy regimen that’s made up of:
  • fluorouracil
  • leucovorin calcium (folinic acid)
  • oxaliplatin (Eloxatin)
• FOLFIRI, which is a chemotherapy regimen that’s made up of:
  • fluorouracil infusion
  • irinotecan (Camptosar, Onivyde)
  • leucovorin calcium (folinic acid)
• gemcitabine
• IFL, which is a chemotherapy regimen that’s made up of:
  • fluorouracil bolus injection*
  • irinotecan
  • leucovorin calcium (folinic acid)
• interferon alfa
• irinotecan
• trifluridine/tipiracil (Lonsurf)
• paclitaxel (Abraxane)
• oxaliplatin
• topotecan (Hycamtin)

When it’s used to treat liver cancer, Avastin is given in combination with atezolizumab (Tecentriq).

* With a bolus injection, all of the drug that’s prescribed is given as one single dose.

Alternatives to Avastin

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Avastin, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed below are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for glioblastoma

Examples of other drugs that may be used to treat glioblastoma (a type of brain cancer) include:

• chemotherapy drugs, such as:
  • carmustine (Bicnu)
  • temozolomide (Temodar)
  • vincristine
• immunotherapy drugs, such as:
  • bevacizumab-maly (Alymsys)
  • bevacizumab-awwb (Mvasi)
  • bevacizumab-adcd (Vegzelma)
  • bevacizumab-bvzr (Zirabev)

Note: Bevacizumab is the active drug in Avastin. These immunotherapy drugs listed as alternatives here and in some of the lists below are biosimilars of Avastin. The different letters appearing at the end of each version of bevacizumab indicate that each biosimilar is distinct from the others. For more information about biosimilars, see the “Avastin generic or biosimilar” section above.

Alternatives for ovarian cancer

Examples of other drugs that may be used to treat ovarian cancer include:

• chemotherapy drugs, such as:
  • bleomycin
  • carboplatin
  • cyclophosphamide (Cytoxan)
  • cisplatin
  • etoposide
  • paclitaxel (Abraxane)
  • vincristine
• targeted therapies, such as:
  • niraparib (Zejula)
  • olaparib (Lynparza)
  • rucaparib (Rubraca)
• immunotherapy drugs, such as:
  • bevacizumab-maly (Alymsys)
  • bevacizumab-awwb (Mvasi)
  • bevacizumab-adcd (Vegzelma)
  • bevacizumab-bvzr (Zirabev)

Alternatives for colon cancer

Examples of other drugs that may be used to treat colon cancer include:

• chemotherapy drugs, such as:
  • capecitabine (Xeloda)
  • fluorouracil
  • irinotecan (Camptosar, Onivyde)
  • oxaliplatin (Eloxatin)
• immunotherapy drugs, such as:
  • pembrolizumab (Keytruda)
  • bevacizumab-maly (Alymsys)
  • bevacizumab-awwb (Mvasi)
  • bevacizumab-adcd (Vegzelma)
  • bevacizumab-bvzr (Zirabev)
• targeted therapies, such as:
  • cetuximab (Erbitux)
  • panitumumab (Vectibix)
  • ramucirumab (Cyramza)
  • regorafenib (Stivarga)
  • ziv-aflibercept (Zaltrap)

Alternatives for lung cancer

Examples of other drugs that may be used to treat lung cancer include:

• chemotherapy drugs, such as:
  • carboplatin
  • docetaxel
  • liposomal doxorubicin (Doxil)
  • gemcitabine
  • paclitaxel
• immunotherapy drugs, such as:
  • nivolumab (Opdivo)
  • pembrolizumab (Keytruda)
  • bevacizumab-maly (Alymsys)
  • bevacizumab-awwb (Mvasi)
  • bevacizumab-adcd (Vegzelma)
  • bevacizumab-bvzr (Zirabev)
• targeted therapies, such as:
  • afatinib (Gilotrif)
  • alectinib (Alecensa)
  • brigatinib (Alunbrig)
  • cetuximab (Erbitux)
  • erlotinib (Tarceva)
  • necitumumab (Portrazza)
  • ramucirumab (Cyramza)

Alternatives for cervical cancer

Examples of other drugs that may be used to treat cervical cancer include:

• chemotherapy drugs, such as:
  • bleomycin
  • topotecan (Hycamtin)
• immunotherapy drugs, such as:
  • pembrolizumab (Keytruda)
  • bevacizumab-maly (Alymsys)
  • bevacizumab-awwb (Mvasi)
  • bevacizumab-adcd (Vegzelma)
  • bevacizumab-bvzr (Zirabev)

Alternatives for kidney cancer

Examples of other drugs that may be used to treat kidney cancer include:

• chemotherapy drugs
  • cisplatin
  • 5-fluorouracil
  • gemcitabine
• immunotherapy drugs, such as:
  • ipilimumab (Yervoy)
  • nivolumab (Opdivo)
  • pembrolizumab (Keytruda)
  • bevacizumab-maly (Alymsys)
  • bevacizumab-awwb (Mvasi)
  • bevacizumab-adcd (Vegzelma)
  • bevacizumab-bvzr (Zirabev)
• targeted therapies, such as:
  • axitinib (Inlyta)
  • everolimus (Afinitor)
  • sorafenib (Nexavar)
  • sunitinib (Sutent)

Alternatives for liver cancer

Examples of other drugs that may be used to treat liver cancer include:

• immunotherapy drugs, such as:
  • ipilimumab (Yervoy)
  • nivolumab (Opdivo)
  • pembrolizumab (Keytruda)
• targeted therapies, such as:
  • cabozantinib (Cabometyx)
  • lenvatinib (Lenvima)
  • ramucirumab (Cyramza)
  • regorafenib (Stivarga)
  • sorafenib (Nexavar)

Avastin vs. Temodar

You may wonder how Avastin compares with other medications that are prescribed for similar uses. Here we look at how Avastin and Temodar are alike and different.

Ingredients

Avastin contains the drug bevacizumab. It’s a monoclonal antibody, which is a type of drug that’s made from immune system cells. Bevacizumab belongs to a class of medications known as vascular endothelial growth factor (VEGF) inhibitors. (A medication class is a group of medications that work in a similar way.)

Temodar, on the other hand, contains the drug temozolomide. It’s a chemotherapy drug. (Chemotherapy describes traditional drugs used to treat cancer.) Temodar works to treat cancer by attacking rapidly multiplying cells in your body, which includes cancer cells. (Cells that multiply are making more cells.)

Uses

Avastin is FDA-approved to treat the following cancers in adults in certain situations:

• recurrent* glioblastoma (a type of brain cancer)
• certain forms of cancer that affect your fallopian tubes, ovaries, or peritoneum (lining inside your abdomen)
• metastatic colorectal cancer
• certain forms of non-small cell lung cancer (NSCLC)
• certain forms of cervical cancer
• metastatic kidney cancer
• certain forms of liver cancer

* With recurrent cancer, the cancer responded to past treatment, but it has come back after a period of time.
† With metastatic cancer, the cancer has spread from the area where it started to other parts of your body.

For more information about the conditions Avastin treats, see the “Avastin uses” section above.

Temodar is approved for use in adults to treat these conditions:

• newly diagnosed glioblastoma
• refractory* anaplastic astrocytoma (another type of brain cancer)

* With refractory cancer, the cancer either doesn’t respond at all to treatment or stops responding to treatment after a period of time.

In addition, Temodar is used off-label to treat recurrent glioblastoma. With off-label use, a drug that’s approved to treat one condition is used to treat another condition.

Drug forms and administration

Avastin comes as a solution that’s given by healthcare professionals as an intravenous (IV) infusion. (With an IV infusion, the drug is injected into your vein over a period of time.)

Temodar comes as a solution that can be given as an IV infusion by healthcare professionals.

Side effects and risks

Avastin and Temodar have some similar side effects, and others that are different. Below are examples of side effects caused by these medications.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Avastin, with Temodar, or with both drugs (when taken individually).

• Can occur with Avastin:
  • bleeding, such as nosebleeds
  • problems with tear production
  • high blood pressure
  • rhinitis (runny or stuffy nose)
• Can occur with Temodar:
  • blurry vision
  • constipation
  • diarrhea
  • fatigue
  • hair loss
  • loss of appetite
  • nausea or vomiting
• Can occur with both Avastin and Temodar:
  • changes in taste
  • back pain
  • dry skin
  • headache

Serious side effects

These lists contain examples of serious side effects that can occur with Avastin, with Temodar, or with both drugs (when taken individually).

• Can occur with Avastin:
  • thromboembolic events (conditions that are caused by blood clots inside a blood vessel)
  • severe high blood pressure
  • early menopause in females* using the drug who haven’t gone through menopause yet
  • heart failure
  • kidney damage
  • posterior reversible encephalopathy syndrome (PRES), a condition that’s caused by swelling in your brain
  • gastrointestinal perforation (rupture in your bowel) or gastrointestinal fistulae (abnormal openings in your digestive tract)
  • severe infusion reaction (an immune system reaction that may occur when you have a drug infused into your body)
  • exfoliative dermatitis, which is a rash that causes peeling skin and discoloration over large areas of your body
  • hemorrhage (severe bleeding)
• Can occur with Temodar:
  • myelodysplastic syndrome (MDS), which is a type of blood cancerconvulsions
  • aplastic anemia (low level of red blood cells that’s caused by damaged cells in your bone marrow)
  • neutropenia (low level of neutrophils, which are a type of white blood cell)
  • thrombocytopenia (low platelet level)
  • pneumocystis pneumonia (a type of lung infection)
  • severe liver damage
• Can occur with both Avastin and Temodar:
  • severe allergic reaction

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Effectiveness

Avastin and Temodar have different approved uses, but they’re both used to treat glioblastoma, which is a certain type of brain cancer.

These drugs haven’t been directly compared in clinical studies. But separate clinical studies have found both Avastin and Temodar to be effective for treating glioblastomas.

Most likely, Avastin and Temodar haven’t been directly compared with each other. This is because they tend to be used in different ways when treating glioblastoma. Typically, Avastin is used after someone has already been given Temodar, but their cancer worsened with Temodar. However, sometimes Avastin and Temodar are used in combination for glioblastoma treatment.

Costs

Avastin contains the active drug ingredient bevacizumab. It’s available as the biosimilar* forms called Alymsys, Mvasi, Vegzelma, and Zirabev.

Temodar contains the drug temozolomide, which is available as a generic medication.

The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

* A biosimilar is a medication that’s similar to a brand-name biologic medication, such as Avastin. Biologic medications are made from living cells. It isn’t possible to make an exact copy of these medications. A generic medication, on the other hand, is an exact copy of a brand-name medication that’s made from chemicals. Biosimilars are considered to be just as safe and effective as their parent drug.

Avastin vs. Eylea

You may wonder how Avastin compares with other medications that are prescribed for similar uses. Here we look at how Avastin and Eylea are alike and different.

Ingredients

Avastin contains the active drug bevacizumab. It’s a monoclonal antibody, which is a type of drug that’s made from immune system cells. Bevacizumab belongs to a class of medications known as vascular endothelial growth factor (VEGF) inhibitors. (A medication class is a group of medications that work in a similar way.)

Eylea contains the active drug aflibercept. Aflibercept is also a VEGF inhibitor.

Uses

Avastin is FDA-approved to treat the following cancers in adults in certain situations:

• recurrent* glioblastoma (a type of brain cancer)
• certain forms of cancer that affect your fallopian tubes, ovaries, or peritoneum (lining inside your abdomen)
• metastatic† colorectal cancer
• certain forms of non-small cell lung cancer (NSCLC)
• certain forms of cervical cancer
• metastatic kidney cancer
• certain forms of liver cancer

* With recurrent cancer, the cancer responded to past treatment, but it has come back after a period of time.
† With metastatic cancer, the cancer has spread from the area where it started to other parts of your body.

For more information about the conditions Avastin treats, see the “Avastin uses” section above.

In addition, Avastin is sometimes used off-label to treat age-related macular degeneration (AMD). (Off-label use is when a drug that’s approved to treat one condition is used to treat another condition.) AMD causes problems such as blurred vision or a blind spot.

Avastin is also sometimes used off-label to treat diabetic retinopathy. With this condition, blood vessels in your retina (an area inside your eye) become damaged from diabetes. Although the condition usually begins with mild vision problems, it can lead to blindness if it’s not treated.

Eylea is approved for use in adults with the following conditions:

• AMD
• macular edema (swelling) following retinal vein occlusion (RVO), which is a blocked vein in your retina
• diabetic macular edema (swelling in your eye that’s caused by diabetes)
• diabetic retinopathy (damage to your retina that’s caused by diabetes)

In addition, Eylea is approved to treat retinopathy of prematurity in infants. With this condition, atypical blood vessels grow in the retinas of babies born prematurely.

Both drugs are used to treat certain eye disorders, including macular degeneration and diabetic retinopathy. However, unlike Eylea, Avastin is used off-label for these conditions. (Eylea is approved to treat these eye-related conditions.)

Alternatives

In addition to Eylea, other drugs are also approved to treat certain eye conditions. For example, among other uses, ranibizumab (Lucentis) is approved to treat wet* AMD and macular edema.

And drugs other than Avastin are used off-label for eye-related conditions. For example, ziv-aflibercept (Zaltrap) is used off-label to treat AMD and diabetic retinopathy.

*With wet AMD, your body makes abnormal blood vessels in an area inside your eye that leak fluid or blood into your eye.

Drug forms and administration

Avastin comes as a solution that’s given by healthcare professionals as an intravenous (IV) infusion. (With an IV infusion, the drug is injected into your vein over a period of time.) However, for off-label treatment of wet AMD, Avastin is given by healthcare professionals as an intravitreal injection. (With an intravitreal injection, the drug is injected into your eye.)

Eylea also comes as a solution that’s given as an intravitreal injection by specially trained doctors.

Costs

Avastin and Eylea are both brand-name drugs.

Avastin contains the active drug ingredient bevacizumab. It’s available as the biosimilar* forms called Alymsys, Mvasi, Vegzelma, and Zirabev. Eylea comes only as a brand-name drug.

Your cost may vary based on how often you receive each drug. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

* A biosimilar is a medication that’s similar to a brand-name biologic medication, such as Avastin. Biologic medications are made from living cells. It isn’t possible to make an exact copy of these medications. A generic medication, on the other hand, is an exact copy of a brand-name medication that’s made from chemicals. Biosimilars are considered to be just as safe and effective as their parent drug.

Common questions about Avastin

Here are answers to some frequently asked questions about Avastin.

Does Avastin cause hair loss?

In clinical studies, people taking Avastin didn’t report hair loss. However, hair loss is a common side effect of some of the chemotherapy drugs that are used with Avastin. (Chemotherapy describes traditional drugs used to treat cancer.)

If you have concerns about hair loss during your cancer treatment, talk with your doctor. They can recommend ways to help manage this side effect.

Is Avastin a chemotherapy drug?

No, Avastin isn’t a chemotherapy drug. (Chemotherapy describes traditional drugs used to treat cancer.)

Avastin contains the drug bevacizumab. It’s a monoclonal antibody, which is a type of drug that’s made from immune system cells. Bevacizumab belongs to a class of medications known as vascular endothelial growth factor (VEGF) inhibitors. (A medication class is a group of medications that work in a similar way).

Avastin works on VEGF, which is a certain substance made by cells in your body. Usually, VEGF helps your body make new blood vessels, such as after an injury. But because cancer cells make much more VEGF than healthy cells make, Avastin works mostly on cancer cells.

Chemotherapy drugs, on the other hand, work by attacking rapidly multiplying cells in your body. (Cells that multiply are making more cells.) Chemotherapy affects all cells that multiply quickly, which includes both healthy cells and cancer cells.

Depending on the type of cancer that’s being treated, Avastin is often used in combination with chemotherapy drugs.

Is Avastin an immunotherapy drug?

Yes, Avastin is an immunotherapy drug. Immunotherapy drugs work by helping your immune system to fight cancer.

The active drug in Avastin, called bevacizumab, is a monoclonal antibody. It’s a type of drug made from immune system cells. Monoclonal antibody drugs are a type of immunotherapy.

Avastin is designed to seek out specific traits on cancer cells. And the drug works with your immune system to fight the cancer cells based on these traits.

How long can Avastin be used to treat brain cancer?

It depends. According to the drug’s manufacturer, Avastin treatment can be continued as long as you aren’t having severe or very bothersome side effects.

However, if your cancer worsens during Avastin treatment, your doctor may recommend that you stop taking the drug.

If you have questions about how long you should take Avastin for brain cancer, talk with your doctor.

When can I start using Avastin after I’ve had surgery?

According to the drug’s manufacturer, you’ll need to wait at least 28 days after having surgery before you start Avastin treatment. And before Avastin can be used, any wounds you have must be fully healed.

If you have questions about using Avastin around the time of surgery, talk with your doctor.

Will Avastin affect my ability to become pregnant after treatment?

Yes, that’s possible. One clinical study looked at 179 females* who hadn’t reached menopause yet. These females received chemotherapy, either with or without Avastin.

In the study, 34% of females taking Avastin with chemotherapy had early menopause. (With early menopause, your ovaries stop ovulating like usual.) However, only 2% of females taking chemotherapy without Avastin reported this side effect.

Of the females taking Avastin with chemotherapy who had early menopause, 22% regained their ovarian function after stopping Avastin.

If you’re concerned about Avastin’s effect on your fertility, talk with your doctor. They can discuss with you the risks and benefits of treatment.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Avastin dosage

The Avastin dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using Avastin to treat
• your age
• other medical conditions you may have
• whether you’re using Avastin with chemotherapy (traditional drugs used to treat cancer)

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, your doctor will determine the best dosage to fit your needs.

For more information about Avastin’s dosage, see this article.

Drug forms and strengths

Avastin comes as a solution inside single-dose vials. It’s given by healthcare professionals as an intravenous (IV) infusion. With an IV infusion, the drug is injected into your vein over a period of time.

Avastin is available in two vial sizes: 4-milliliter (mL) vials that hold 100 milligrams (mg) of drug and 16 mL vials that hold 400 mg of drug.

Dosage for glioblastoma

For recurrent* glioblastoma,† the recommended dose of Avastin is 10 mg of drug per kilogram of body weight (mg/kg). This dose is given once every 2 weeks. Your doctor will recommend how long treatment should be continued.

* With recurrent cancer, the cancer responded to past treatment, but it has come back after a period of time.
† Glioblastoma is a type of brain cancer.

Dosage for ovarian cancer

When used to treat ovarian cancer following surgery, the recommended dose of Avastin is 15 mg of drug per kilogram of body weight (mg/kg). This dose is given once every 3 weeks. It’s given in combination with two chemotherapy drugs: carboplatin and paclitaxel. This treatment regimen is continued for up to six 3-week cycles.

After this period of time, Avastin may be used without chemotherapy. For this phase of treatment, the recommended dosage of Avastin is still 15 mg/kg given once every 3 weeks.

Avastin can be given for up to a total of twenty-two 3-week cycles with or without chemotherapy. But it may be stopped sooner if your cancer worsens during treatment.

For recurrent* ovarian cancer treatment, there are several different possibilities for Avastin dosages. Possible dosages are as follows:

• For cancers that respond to chemotherapy drugs made with platinum, the recommended dose of Avastin is 15 mg/kg. This dose is given once every 3 weeks. For the first six to ten 3-week cycles of treatment, Avastin is used in combination with the chemotherapy drugs carboplatin and paclitaxel or carboplatin and gemcitabine. After six to ten cycles of treatment, Avastin is given alone at a dosage of 15 mg/kg once every 3 weeks. Avastin treatment is continued until your cancer worsens.
• For cancers that are resistant† to chemotherapy drugs made with platinum, the recommended dose of Avastin is 10 to 15 mg/kg. It’s given once every 2 to 3 weeks. Avastin is used in combination with either paclitaxel, liposomal doxorubicin, or topotecan. Your doctor will recommend how long treatment should be continued.

* With recurrent cancer, the cancer responded to past treatment, but it has come back after a period of time.
† With resistance, the cancer no longer responds to certain treatments.

Dosage for colon cancer

The recommended dosage of Avastin for metastatic* colon cancer depends on which chemotherapy drugs Avastin is used with. These recommended dosages are as follows:

• For people receiving Avastin with IFL,† the recommended dose of Avastin is 5 mg of drug per kilogram of body weight (mg/kg). This dose is given once every 2 weeks.
• For people receiving Avastin with FOLXFOX-4,‡ the recommended dose of Avastin is 10 mg/kg. This dose is given once every 2 weeks.

Either of the following dosages are prescribed for this purpose if colon cancer worsened after treatment with a regimen that included a bevacizumab drug:

• 5 mg/kg given once every 2 weeks
• 7.5 mg/kg given once every 3 weeks

And this dosage should be used in combination with a chemotherapy regimen that includes a group of drugs called fluoropyrimidines, with either irinotecan (Camptosar, Onivyde) or oxaliplatin (Eloxatin). Fluorouracil is an example of a fluoropyrimidine.

Your doctor will recommend how long Avastin treatment should be continued for colon cancer.

* With metastatic cancer, the cancer has spread from the area where it started to other parts of your body.
† IFL is a chemotherapy regimen that’s made up of irinotecan, leucovorin, and fluorouracil.
‡ FOLXFOX-4 is a chemotherapy regiment that’s made up of oxaliplatin, folinic acid, and fluorouracil.

Dosage for lung cancer

The recommended dose of Avastin for non-squamous non-small cell lung cancer (NSCLC) is 15 mg of drug per kilogram of body weight (mg/kg). This dose is given once every 3 weeks. It’s used in combination with two chemotherapy drugs: carboplatin and paclitaxel.

Your doctor will recommend how long Avastin treatment should be continued for lung cancer.

Dosage for cervical cancer

The recommended dose of Avastin for cervical cancer is 15 mg of drug per kilogram of body weight (mg/kg). This dose is given once every 3 weeks. And it’s used in combination with either:

• paclitaxel and cisplatin, or
• paclitaxel and topotecan

Your doctor will recommend how long Avastin treatment should be continued for cervical cancer.

Dosage for kidney cancer

The recommended dose of Avastin for kidney cancer is 10 mg of drug per kilogram of body weight (mg/kg). This dose is given once every 2 weeks. And it’s used in combination with a drug called interferon alfa.

Your doctor will recommend how long Avastin treatment should be continued for kidney cancer.

Dosage for liver cancer

The recommended dose of Avastin for liver cancer is 15 mg of drug per kilogram of body weight (mg/kg). This dose is given once every 3 weeks. And it’s used in combination with a drug called atezolizumab (Tecentriq).

Your doctor will recommend how long Avastin treatment should be continued for kidney cancer.

What if I miss a dose?

If you miss an appointment for one of your Avastin doses, call your doctor’s office right away. The medical staff can help you reschedule your appointment to receive your dose of the drug.

To help make sure that you don’t miss appointments for your doses, try setting a reminder on your phone for your appointment.

Will I need to use this drug long term?

Avastin is meant to be used as a long-term treatment. If you and your doctor determine that Avastin is safe and effective for you, you’ll likely take it long term.

How Avastin is given

Avastin is only given by healthcare professionals. You’ll receive Avastin as an intravenous (IV) infusion. With an IV infusion, the drug is injected into your vein over a period of time.

During Avastin treatment, your first infusion will last about 90 minutes. Then your second infusion will last about 60 minutes. If you don’t have any problems with the first two infusions, your next infusions will each last about 30 minutes.

How often Avastin is given

How often you receive an Avastin infusion depends on the condition you’re using it to treat.

For most people, Avastin is given every 2 to 3 weeks. Your doctor will recommend how long you’ll need to continue receiving Avastin. For more information about how often you’ll receive Avastin, see the “Avastin dosage” section above.

To help make sure that you don’t miss appointments for your doses, try setting a reminder on your phone for your appointment.

Avastin and alcohol

It isn’t known whether it’s safe to drink alcohol during Avastin treatment. It’s also not known how much alcohol is safe to consume when you’re using Avastin.

There haven’t been any interactions reported between Avastin and alcohol. But alcohol can interact with some chemotherapy drugs that may be used with Avastin.

If you drink alcohol, talk with your doctor about whether it’s safe for you to drink it while you’re taking Avastin.

Avastin interactions

There haven’t been any significant drug interactions reported with Avastin and other medications, herbs, supplements, or foods.

However, before taking Avastin, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

How Avastin works

Avastin is approved to treat several different types of cancer.

This drug contains the medication bevacizumab. It’s a monoclonal antibody, which is a type of drug that’s made from immune system cells. Bevacizumab belongs to a class of medications known as vascular endothelial growth factor (VEGF) inhibitors. (A medication class is a group of medications that work in a similar way.)

VEGF is a substance that’s made by cells in your body, including cancer cells. This substance stimulates new blood vessels to be made. In fact, VEGF is a major factor in helping cancer tumors to form new blood vessels.

It’s believed that cancer cells make more VEGF than healthy cells do. And the new blood vessels that form help deliver nutrients and oxygen to tumor cells. This leads to rapid growth of tumors and helps them spread into other parts of your body. It also encourages the original tumor to keep growing.

By inhibiting (blocking) VEGF, Avastin stops tumor cells from creating new blood vessels. This stops the cancer from worsening inside your body.

How long does it take to work?

Avastin begins working as soon as you take your first dose. But you may not feel any different after you’ve taken a dose, because the drug doesn’t treat any symptoms caused by your cancer.

Instead, Avastin works over time to both kill cancer cells and slow their growth in your body.

While you’re taking Avastin, your doctor will order certain tests to monitor how well Avastin is working for you. If you’d like to know more about the tests you’ll need to have, talk with your doctor.

How long does Avastin last in your body?

After you stop taking Avastin, the drug will last in your body for about 3 to 4 months. But this length of time can vary from person to person. And it will depend on things like the dose of Avastin you used and how long you took the drug.

Avastin cost

As with all medications, the cost of Avastin can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Avastin at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Your insurance plan may require you to get prior authorization before approving coverage for Avastin. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know whether your plan will cover Avastin.

If you’re not sure whether you’ll need to get prior authorization for Avastin, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Avastin, or if you need help understanding your insurance coverage, help is available.

Genentech, Inc., the manufacturer of Avastin, offers programs that may help lower the cost of the drug. For example, if you have insurance coverage for Avastin, you may qualify for copay assistance or other ways to save on the drug. And if you don’t have insurance coverage, you may have access to other financial assistance options.

For more information about these programs, and to find out whether you’re eligible for support, visit the manufacturer’s website.

Avastin and pregnancy

Avastin may cause harm to developing fetuses if it’s used during pregnancy.

In animal studies, Avastin caused low birth weights in offspring exposed to the drug during pregnancy. And Avastin use also increased the risk of certain fetal complications, such as skeletal deformities. However, animal studies don’t always predict what will happen in humans.

Avastin hasn’t been extensively studied in clinical trials of pregnant women. But according to the drug’s manufacturer, there have been post-marketing reports of problems with fetuses when Avastin was used in pregnancy. (Post-marketing reports give information about a drug after the drug has been released onto the market.) But these reports don’t say for sure how much Avastin increases the risk of fetal problems.

If you’re pregnant, talk with your doctor before taking Avastin. They’ll discuss with you the risks and benefits of using Avastin. They may recommend that you use a different cancer drug during pregnancy.

Avastin and birth control

Avastin may cause harm to fetuses if it’s used during pregnancy. If you’re sexually active and you can become pregnant, talk with your doctor about your birth control needs while you’re using Avastin.

Note: Sex and gender exist on spectrums. Use of the terms “male” and “female” below refers to sex assigned at birth.

For females using Avastin

If you’re a female taking Avastin who’s able to become pregnant, you should use an effective form of birth control during treatment. And you should continue to use birth control for at least 6 months after your last dose of Avastin.

For males using Avastin

The manufacturer of Avastin hasn’t given birth control recommendations for males using the drug. If you’re a male using Avastin and you’re sexually active with someone who’s able to become pregnant, talk with your doctor about your birth control needs while using this drug.

Avastin and breastfeeding

It’s not known whether Avastin is safe to use while breastfeeding. This is because it’s not known whether the drug:

• passes into breast milk
• has any effect on children who are breastfed
• changes the way your body makes breast milk

The manufacturer of Avastin recommends that you do not breastfeed during Avastin treatment. And you should continue to avoid breastfeeding for at least 6 months after your last dose of the drug.

If you have questions about breastfeeding while you’re taking Avastin, talk with your doctor. They can recommend safe and healthy ways to feed your child.

Avastin precautions

Before taking Avastin, talk with your doctor about your health history. Avastin may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• Surgical wounds or problems with wound healing. Avastin should not be used within 28 days before having an elective surgery. (This is surgery that’s scheduled in advance because it isn’t a medical emergency.) And it shouldn’t be used for at least 28 days after having surgery. Following surgery, the drug shouldn’t be used until your surgical wound is fully healed. Talk with your doctor about any surgeries you’ve had or are planning to have while you’re using Avastin.
• Pregnancy. Avastin may cause harm to fetuses if it’s used during pregnancy. For more information, please see the “Avastin and pregnancy” section above.
• Breastfeeding. The manufacturer of Avastin recommends that the drug not be used by anyone who is breastfeeding. For more information, please see the “Avastin and breastfeeding” section above.

Note: For more information about the potential negative effects of Avastin, see the “Avastin side effects” section above.