Indications & Uses
Cyramza is indicated for:
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
For intravenous infusion only. Do not administer as an intravenous push or bolus. Premedicate before each infusion. Gastric Cancer: Administer Ramucirumab 8 mg/kg every 2 weeks as a single agent or in combination with weekly paclitaxel. Non-Small Cell Lung Cancer: Administer Ramucirumab 10 mg/kg every 2 weeks with daily erlotinib. Administer Ramucirumab 10 mg/kg on Day 1 of a 21-day cycle prior to docetaxel. Colorectal Cancer: Administer Ramucirumab 8 mg/kg every 2 weeks prior to FOLFIRI. Hepatocellular Carcinoma: Administer Ramucirumab 8 mg/kg every 2 weeks.
Side Effects
The most common adverse reactions observed in single agent Cyramza-treated gastric cancer patients at a rate of ≥10% and ≥2% higher than placebo were hypertension and diarrhea.The most common adverse reactions observed in patients treated with Cyramza with paclitaxel at a rate of ≥30% and ≥2% higher than placebo with paclitaxel were fatigue/asthenia, neutropenia, diarrhea, and epistaxis.The most common adverse reactions observed in patients treated with Cyramza with erlotinib at a rate of ≥30% and ≥2% higher than placebo with erlotinib were, infections, hypertension, stomatitis, proteinuria, alopecia, and epistaxis. The most common laboratory abnormalities at a rate of ≥30% and ≥2% higher difference in incidence between arms were increased alanine aminotransferase, increased aspartate aminotransferase, anemia, thrombocytopenia, and neutropenia.The most common adverse reactions observed in patients treated with Cyramza with docetaxel at a rate of ≥30% and ≥2% higher than placebo with docetaxel were neutropenia, fatigue/asthenia, and stomatitis/mucosal inflammation.The most common adverse reactions observed in patients treated with Cyramza with FOLFIRI at a rate of ≥30% and ≥2% higher than placebo with FOLFIRI were diarrhea, neutropenia, decreased appetite, epistaxis, and stomatitis.The most common adverse reactions observed in single agent Cyramza-treated HCC patients at a rate of ≥15% and ≥2% higher than placebo were fatigue, peripheral edema, hypertension, abdominal pain, decreased appetite, proteinuria, nausea, and ascites. The most common laboratory abnormalities at a rate of ≥30% and a ≥2% higher difference in incidence between arms were thrombocytopenia, hypoalbuminemia, and hyponatremia.
Cautions & Contraindications
Warnings & Precautions
Hemorrhage: Cyramza increases the risk of hemorrhage and gastrointestinal hemorrhage, including severe and fatal events. Permanently discontinue Cyramza in patients who experience severe bleeding.Gastrointestinal Perforations: Cyramza increases the risk of gastrointestinal perforation, which can be fatal. Permanently discontinue Cyramza in patients who experience a gastrointestinal perforation.Impaired Wound Healing: Withhold Cyramza for 28 days prior to elective surgery. Do not administer Cyramza for at least 2 weeks following a major surgical procedure and until adequate wound healing. The safety of resumption of Cyramza after resolution of wound healing complications has not been established.Arterial Thromboembolic Events (ATEs): Serious and sometimes fatal ATEs can occur with Cyramza. Permanently discontinue Cyramza in patients who experience an ATE.Hypertension: Monitor blood pressure and treat hypertension. Withhold Cyramza for severe hypertension. Permanently discontinue Cyramza for hypertension that cannot be controlled with antihypertensive therapy and for hypertensive crisis or hypertensive encephalopathy.Infusion-Related Reactions (IRR): Monitor for signs and symptoms during infusion. Reduce the infusion rate for Grade 1 or 2 IRR and permanently discontinue for Grade 3 or 4 IRR.Worsening of Pre-existing Hepatic Impairment: New onset or worsening encephalopathy, ascites or hepatorenal syndrome can occur in patients with Child-Pugh B or C cirrhosis.Posterior Reversible Encephalopathy Syndrome: Permanently discontinue Cyramza.Proteinuria Including Nephrotic Syndrome: Monitor for proteinuria. Withhold Cyramza for urine protein levels greater than or equal to 2 g per 24 hours. Permanently discontinue Cyramza for urine protein levels greater than 3 g per 24 hours or nephrotic syndrome.Thyroid Dysfunction: Monitor thyroid function during treatment.Embryo-Fetal Toxicity: Can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception.