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Trade name

Cyramza^®

What Ramucirumab is and what it is used for?

• Ramucirumab is a monoclonal antibody that binds to VEGF receptor-2 (VEGFR2) and blocks the binding of VEGF-A, VEGF-C and VGEF-D. By blocking the activation of VEGFR2, ramucirumab inhibits the development of new blood vessels and helps cut off the blood supply, thereby reducing oxygen and nutrients to the tumor. This may interfere with cancer cell growth.
• Ramucirumab can be given alone or in combination with other medicines to treat certain cancers that has spread to other part of the body, including gastric cancer, colorectal cancer and non-small cell lung cancer.

How Ramucirumab is given?

• It is given as an infusion into the vein over 1 hour.

What should I know while receiving Ramucirumab?

• An allergic or infusion reaction may happen during or shortly after the infusion, causing fever and chills, breathing difficulties, swelling of throat or face, or hives. Tell your nurse right away if you feel unwell during an infusion.
• Do not receive this drug when you are pregnant or breastfeeding.
• Men and women should use effective contraception during treatment and for at least 3 months after the treatment ends.
• Do not receive any kind of vaccination without doctor's approval.
• You will be checked regularly by your doctor to make sure you have enough blood cells and have adequate organ functions to receive this medicine. The timing and dosing of your treatment may be changed based on the test results or other side effects.
• There are many drugs may affect how ramucirumab works. Tell your doctor about all the medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
• The existing health problems may affect the use of ramucirumab. Let your doctor know if you have any other medical problems, especially if you have thyroid disorder, have heart, liver or kidney problems, or have any unhealed wound.
• If you need surgery, tell the surgeon ahead of time that you are using ramucirumab. You may need to stop this drug at least 28 days before surgery and may be restarted based on adequate wound healing.

Common side effects

• High blood pressure

Tell your doctor if you have problems with blood pressure. Your doctor will monitor your blood pressure and may prescribe medications if necessary. Seek medical help at once if you suddenly hit with a severe headache or have blurred vision.

• Swelling in the hands or feet

This is more common in patients receiving combination therapy. Tell your doctor if your hands, arms, legs, or feet feel puffy or tender. The doctor may give medicines to reduce your symptoms and suggest ways to prevent fluid buildup.

• Diarrhea

Talk to your doctor and ask for advice. Drinking plenty of water and dietary changes can improve diarrhea.

• Loss of appetite

Try to eat in small quantities and have frequent meals. If your appetite does not get any better after a few days, tell your doctor.

• Weakness and fatigue

Try to pace yourself and rest as much as possible. Seek medical advice if fatigue does not go away when you rest and sleep.

• Headache

Talk to the doctor if this is bothering you, they can give you medicine to relieve pain.

Less common side effects

• Rash

A rash can be itchy, red, or painful. Tell your doctor about any skin changes that you have, they can give you medicines and advices that help you feel better.

• Protein in the urine

This is more common in patients receiving combination therapy. This condition means your kidney is not working well. Talk to the doctor if you have persistently bubbly or foamy urine.

• Bleeding risk

Ramucirumab can increase the risk of bleeding. Let your doctor know if any unusual bleeding occurs or if you find unexplained nosebleed or have blood in the sputum.

• Delayed wound healing

Be careful when using sharp objects. Talk to your doctor if you have an unhealed wound or have any wound problems.

Rare but important side effects

• Arterial thrombotic events

Ramucirumab can cause blood clots in your arteries. It is rare but can lead to serious conditions, including heart attack or stroke. The doctor would stop your treatment if a patient develops a severe blood clot in the arteries.

• Bleeding in the digestive tract

Rarely, ramucirumab can cause a hole in digestive tract. Seek medical help at once if you have severe pain or cramps in the abdomen, blood or tarry stools, throwing up blood, or vomit that looks like coffee grounds.

More Information

• Drink at least 6 to 8 glasses of water every day can help make your recovery a smoother process.
• Alcohol and cigarettes may interfere with certain medicines or worsen side effects from chemotherapy treatment. It is wise to avoid alcohol and cigarette smoking during cancer treatment. If you have any problem about drinking alcohol and smoking, you should check with your doctor.