Avastin Dosage/Direction for Use

General: Substitution by any other biological medicinal product requires the consent of the prescribing physician.
The safety and efficacy of alternating or switching between Avastin and products that are biosimilar but not deemed interchangeable have not been established. Therefore, the benefit-risk of alternating or switching need to be carefully considered.
Avastin should be prepared by a healthcare professional using aseptic technique (see Special Instructions for Use, Handling and Disposal under Cautions for Usage).
The initial Avastin dose should be delivered over 90 minutes as an intravenous infusion. If the first infusion is well tolerated, the second infusion may be administered over 60 minutes. If the 60-minute infusion is well tolerated, all subsequent infusions may be administered over 30 minutes.
Dose reduction of Avastin for adverse events is not recommended. If indicated, Avastin should either be permanently discontinued or temporarily suspended as described in GENERAL under Precautions.
Avastin is not formulated for intravitreal use (see GENERAL under Precautions).
Metastatic Colorectal Cancer (mCRC): The recommended dose of Avastin, administered as an intravenous infusion, is as follows: First-line treatment: 5 mg/kg of body weight given once every 2 weeks or 7.5 mg/kg of body weight given once every 3 weeks.
Second-line treatment: 5 mg/kg or 10 mg/kg of body weight given once every 2 weeks or 7.5 mg/kg or 15 mg/kg of body weight given once every 3 weeks.
It is recommended that Avastin treatment be continued until progression of the underlying disease. Patients previously treated with Avastin can continue with Avastin treatment following first progression (see Pharmacology: Pharmacodynamics: Clinical/Efficacy Studies: Metastatic Colorectal Cancer (mCRC): ML18147 under Actions).
Locally recurrent or metastatic Breast Cancer (mBC): The recommended dose of Avastin is 10 mg/kg of body weight given once every 2 weeks or 15 mg/kg of body weight given once every 3 weeks as an intravenous infusion.
It is recommended that Avastin treatment be continued until progression of the underlying disease.
Advanced, metastatic or recurrent Non-Small Cell Lung Cancer (NSCLC): First-line treatment of NSCLC in combination with platinum-based chemotherapy: Avastin is administered in addition to platinum-based chemotherapy for up to 6 cycles of treatment followed by Avastin as a single agent until disease progression.
The recommended dose of Avastin when used in addition to cisplatin-based chemotherapy is 7.5 mg/kg of body weight given once every 3 weeks as an intravenous infusion.
The recommended dose of Avastin when used in addition to carboplatin-based chemotherapy is 15 mg/kg of body weight given once every 3 weeks as an intravenous infusion.
First-line treatment of NSCLC with EGFR activating mutations in combination with erlotinib: The recommended dose of Avastin when used in addition to erlotinib is 15 mg/kg of body weight given once every 3 weeks as an intravenous infusion.
It is recommended that the treatment with Avastin in addition to erlotinib is continued until disease progression.
Refer to the full prescribing information for erlotinib for patient selection and posology.
Advanced and/or metastatic Renal Cell Cancer (mRCC): The recommended dose of Avastin is 10 mg/kg of body weight given once every 2 weeks as an intravenous infusion.
It is recommended that Avastin treatment be continued until progression of the underlying disease.
Malignant Glioma (WHO Grade IV)-Glioblastoma: The recommended dose of Avastin, administered as an intravenous infusion is as follows: Newly diagnosed glioblastoma: Avastin (10 mg/kg of body weight given once every 2 weeks) is administered in combination with temozolomide and radiotherapy for 6 weeks.
Following a 4 week treatment break, Avastin (10 mg/kg of body weight given once every 2 weeks) is re-initiated in combination with temozolomide for up to 6 cycles of 4 week duration.
After administration of up to 6 cycles of combined Avastin and temozolomide, Avastin (15 mg/kg of body weight given once every 3 weeks) is continued as a single agent until disease progression.
Treatment of recurrent disease: 10 mg/kg of body weight given once every 2 weeks or 15 mg/kg of body weight given once every 3 weeks. It is recommended that Avastin treatment be continued until progression of the underlying disease.
Epithelial Ovarian, Fallopian Tube and Primary Peritoneal Cancer: The recommended dose of Avastin administered as an intravenous infusion is as follows: Front-line treatment: 15 mg/kg of body weight given once every 3 weeks when administered in addition to carboplatin and paclitaxel for up to six cycles of treatment followed by continued use of Avastin as single agent for 15 months or until disease progression, whichever occurs earlier.
Treatment of recurrent disease: Platinum sensitive: 15 mg/kg of body weight given once every 3 weeks when administered in combination with carboplatin and paclitaxel for 6 cycles and up to 8 cycles followed by continued use of Avastin as a single agent until disease progression.
Alternatively, 15 mg/kg every 3 weeks when administered in combination with carboplatin and gemcitabine for 6 cycles and up to 10 cycles followed by continued use of Avastin as single agent until disease progression.
Platinum resistant: 10 mg/kg body weight given once every 2 weeks when administered in combination with one of the following agents - paclitaxel, topotecan (given weekly) or pegylated liposomal doxorubicin (see Pharmacology: Pharmacodynamics: Clinical/Efficacy Studies: Recurrent Ovarian Cancer: MO22224 (AURELIA) under Actions for chemotherapy regimens).
Alternatively, 15 mg/kg every 3 weeks when administered in combination with topotecan given on days 1-5, every 3 weeks (see Pharmacology: Pharmacodynamics: Clinical/Efficacy Studies: Recurrent Ovarian Cancer: MO22224 (AURELIA) under Actions for chemotherapy regimens).
It is recommended that treatment be continued until disease progression.
Cervical Cancer: Avastin is administered in combination with one of the following chemotherapy regimens: paclitaxel and cisplatin or paclitaxel and topotecan (see Pharmacology: Pharmacodynamics: Clinical/Efficacy Studies: Cervical Cancer: GOG-0240 under Actions for further details on the chemotherapy regimens).
The recommended dose of Avastin is 15 mg/kg of body weight given once every 3 weeks as an intravenous infusion.
It is recommended that Avastin treatment be continued until progression of the underlying disease.
SPECIAL DOSAGE INSTRUCTIONS: Pediatric Use: The safety and efficacy of Avastin in children and adolescents (<18 years) have not been established (see USE IN CHILDREN under Precautions).
Geriatric Use: No dose adjustment is required in patients ≥65 years of age.
Renal impairment: The safety and efficacy of Avastin have not been studied in patients with renal impairment.
Hepatic impairment: The safety and efficacy of Avastin have not been studied in patients with hepatic impairment.
ROUTE OF ADMINISTRATION: Avastin is not formulated for intravitreal use (see GENERAL under Precautions).