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Ramucirumab is available as an IV injection that contains 100 mg/10 mL (10 mg/mL) or 500 mg/50 mL (10 mg/mL).

Ramucirumab is a VEGF inhibitor and is used for the following:

• Advanced or metastatic stomach cancer, after first-choice treatments no longer work, by itself or together with paclitaxel (Taxol)
• Metastatic non-small cell lung cancer (NSCLC) with certain EGFR mutations, together with erlotinib (Tarceva) as first-choice treatment
• Metastatic NSCLC, together with docetaxel (Taxotere) after first-choice treatments no longer work
• Metastatic colon cancer, together with chemotherapy after first-choice treatment’s stop working
• Advanced liver cancer after treatment with Nexavar (sorafenib)

Ramucirumab is a targeted therapy that works by blocking VEGF receptors. The VEGF receptor is a protein on the surface of cells in the body. It helps cells connect with blood vessels, which supply nutrients needed for the cells to grow and divide. By blocking the VEGF receptor, Ramucirumab stops tumors from getting nutrients and growing.

• Your specific dose of Ramucirumab will depend on your weight and the cancer you’re getting treatment for:
• Stomach cancer, colon cancer, or liver cancer: The typical dose is 8 mg/kg as an infusion through the vein every 2 weeks
• NSCLC: The typical dose is 10 mg/kg as an infusion through the vein every 2 to 3 weeks, depending on what other anticancer medications you’re taking

Ramucirumab is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you.

Common side effects of Ramucirumab:

• Fatigue
• Low blood cell counts
• Diarrhea
• Bloody nose
• Swelling in the arms and legs
• High blood pressure
• Mouth sores

Serious side effects are rare with Ramucirumab. Contact your healthcare provider immediately if you experience any of the following.

• Severe bleeding: lightheadedness, black or bloody stools, coughing up blood or vomit that looks like coffee grounds
• Stomach or intestinal injury: severe vomiting, diarrhea, abdominal pain that doesn’t go away
• Blood clots in the arteries: chest pain, sudden severe headaches, trouble breathing, sudden changes in speech or vision
• High blood pressure: severe headache, lightheadedness, confusion
• Posterior reversible encephalopathy syndrome: headache, feeling sluggish or confused, blindness
  Infusion-related reactions: chest pain, tremors, back pain, chills, trouble breathing, feeling flushed

The following medications may interact with Ramucirumab:

• No clinically meaningful changes in the exposure of either Ramucirumab or its concomitant drugs in the approved
• combinations, including paclitaxel, docetaxel, irinotecan (or its active metabolite, SN-38), and erlotinib were observed in patients with solid tumors

Various FDA-approved generic manufacturers

Based on its mechanism of action, Ramucirumab can cause fetal harm when administered to pregnant women. Women should use effective contraception during treatment with Ramucirumab and for 3 months after the last dose

• Cyramza