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The safety information for Avastin (bevacizumab) is crucial for understanding the potential risks and precautions associated with its use. Patients and healthcare providers should take note of the following:

• Gut Injuries and Fistulas: Although rare, some individuals may experience serious gut injuries or fistulas, particularly those who have undergone pelvic radiation or are being treated for cervical cancer. Most gut tears occur within two months of starting Avastin, and fistulas typically develop within six months. Be vigilant for symptoms such as high fever, intense stomach pain, or severe constipation, and inform your healthcare provider immediately if they occur.

• Surgery and Wound Healing: Avastin can impede wound healing. Inform your healthcare provider if surgery is planned, as Avastin should be discontinued at least a month before and after surgery until wounds are fully healed.

• Serious Bleeding: There is an increased risk of severe bleeding in various parts of the body, including the lungs, stomach, and brain. Immediate medical attention is required if bleeding occurs.

• Serious Blood Clots: Avastin may elevate the risk of blood clots, which can lead to stroke or heart attack. Individuals with a history of blood clots, high cholesterol, smoking habits, or high blood pressure should be particularly cautious. Symptoms like chest pain, breathing difficulties, or leg swelling need urgent medical evaluation.

• High Blood Pressure: Regular monitoring of blood pressure is essential, as Avastin can cause hypertension. Treatment may be adjusted if blood pressure becomes uncontrollable.

• Posterior Reversible Encephalopathy Syndrome (PRES): Although exceedingly rare, PRES is a potential side effect. Symptoms such as headaches, confusion, or vision problems should be reported to your provider.

• Kidney Problems: The risk of kidney issues exists, potentially manifesting from two weeks to three years after starting treatment. Regular kidney function tests are necessary, and any changes in urination should be discussed with your provider.

• Infusion Reactions: Serious reactions can occur during or after Avastin infusions, including chest pain or trouble breathing. Immediate medical attention is crucial if these symptoms arise.

• Harm to an Unborn Baby: Avastin may harm an unborn child. Women of childbearing potential should use contraception during treatment and for six months after the last dose. Notify your provider if pregnancy occurs during this period.

• Potential Fertility Issues: There is a possibility that Avastin could affect female fertility. Discuss fertility preservation options with your provider if future childbearing is a consideration.

• Heart Problems: If you have previously received anthracycline-based chemotherapy, notify your healthcare provider due to the increased risk of heart failure. Symptoms like difficulty breathing or swelling should be reported immediately.

This information is vital for ensuring safe and informed use of Avastin. Always discuss any concerns or symptoms with your healthcare provider.

Common side effects:

• Nosebleeds
• Headaches
• High blood pressure
• Runny nose
• Increased protein levels in urine
• Changes in taste
• Dry skin
• Difficulty stopping bleeding
• Dry eyes or excessive tearing
• Back pain
• Peeling and blistering skin

Less common but important to monitor:

• Infusion reactions (trouble breathing, itching, swelling, or fast heartbeat)

Serious side effects:

• Gastrointestinal issues (tears in the gut with fever, chills, intense stomach pain, or bloating)
• Fistulas (skin irritation, discharge, swelling, or redness around the anus, blood in the stool)
• Serious bleeding episodes (unusual bleeding, easy bruising, chest pain, coughing, black, tarry stools)
• Blood clots (affecting lungs, heart, or legs)
• Dangerously high blood pressure (anxiety, blurry vision, confusion, nausea)
• Kidney problems (nausea, vomiting, fatigue, reduced urination, cloudy urine)