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CYRAMZA (RAMUCIRUMAB)
- Gastric cancer
- Liver cell carcinoma
- Metastatic colorectal cancer
- Non-small cell lung cancer
10 mg/mL intravenous solution
- Infuse 8 mg/kg over 60 minute(s) by intravenous route every 2 weeks
Gastric cancer
- Infuse 8 mg/kg over 60 minute(s) by intravenous route every 2 weeks
- Infuse 8 mg/kg over 60 minute(s) by intravenous route every 2 weeks ;If first infusion tolerated, subsequent doses may be administered over 30 minutes
- Infuse 6 mg/kg over 60 minute(s) by intravenous route every 2 weeks ;If first infusion tolerated, subsequent doses may be administered over 30 minutes
- Infuse 5 mg/kg over 60 minute(s) by intravenous route every 2 weeks ;If first infusion tolerated, subsequent doses may be administered over 30 minutes
Liver cell carcinoma
- Infuse 8 mg/kg over 60 minute(s) by intravenous route every 2 weeks
- Infuse 8 mg/kg over 60 minute(s) by intravenous route every 2 weeks ;If first infusion tolerated, subsequent doses may be administered over 30 minutes
- Infuse 6 mg/kg over 60 minute(s) by intravenous route every 2 weeks ;If first infusion tolerated, subsequent doses may be administered over 30 minutes
- Infuse 5 mg/kg over 60 minute(s) by intravenous route every 2 weeks ;If first infusion tolerated, subsequent doses may be administered over 30 minutes
Metastatic colorectal cancer
- Infuse 8 mg/kg over 60 minute(s) by intravenous route every 2 weeks
- Infuse 8 mg/kg over 60 minute(s) by intravenous route every 2 weeks ;If first infusion tolerated, subsequent doses may be administered over 30 minutes
- Infuse 6 mg/kg over 60 minute(s) by intravenous route every 2 weeks ;If first infusion tolerated, subsequent doses may be administered over 30 minutes
- Infuse 5 mg/kg over 60 minute(s) by intravenous route every 2 weeks ;If first infusion tolerated, subsequent doses may be administered over 30 minutes
Non-small cell lung cancer
- Infuse 10 mg/kg over 60 minute(s) by intravenous route on day 1 of a 21-day treatment cycle ; if first infusion tolerated, subsequent dosesmay be administered over 30 minutes
- Infuse 8 mg/kg over 60 minute(s) by intravenous route on day 1 of a 21-day treatment cycle ; if first infusion tolerated, subsequent doses may be administered over 30 minutes
- Infuse 6 mg/kg over 60 minute(s) by intravenous route on day 1 of a 21-day treatment cycle ; if first infusion tolerated, subsequent doses may be administered over 30 minutes
- Infuse 5 mg/kg over 60 minute(s) by intravenous route on day 1 of a 21-day treatment cycle ; if first infusion tolerated, subsequent doses may be administered over 30 minutes
- None
Contraindicated
- None
Severe
Moderate
- None
- Acute myocardial infarction
- Acute thromboembolic stroke
- Gastrointestinal hemorrhage
- Gastrointestinal perforation
- Hemorrhage
- Lactation
- Posterior reversible encephalopathy syndrome
Contraindicated
- Acute arterial thromboembolism
- Child-pugh class A hepatic impairment
- Child-pugh class B hepatic impairment
- Child-pugh class C hepatic impairment
- Hepatic cirrhosis
- Hypertension
- Impaired wound healing
- Invasive surgical procedure
- Pregnancy
- Proteinuria
- Transient cerebral ischemia
Severe
Moderate
- Hypothyroidism
CYRAMZA (RAMUCIRUMAB)
- Gastric cancer
- Liver cell carcinoma
- Metastatic colorectal cancer
- Non-small cell lung cancer
- Hypertension
- Neutropenic disorder
- Palmar-plantar erythrodysesthesia
- Proteinuria
- Diarrhea
- Epistaxis
- Fatigue
- Headache disorder
- Stomatitis
More Frequent
Severe
Less Severe
- Acute arterial thromboembolism
- Gastrointestinal obstruction
- Hypoalbuminemia
- Hyponatremia
- Hypothyroidism
- Thrombocytopenic disorder
- Acute abdominal pain
- Anorexia
- Eye tearing
- Fever
- Nausea
- Peripheral edema
- Skin rash
- Vomiting
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Arterial aneurysm
- Arterial dissection
- Bronchospastic pulmonary disease
- Gastrointestinal hemorrhage
- Gastrointestinal perforation
- Hemangioma
- Hemorrhage
- Hypotension
- Impaired wound healing
- Nephrotic syndrome
- Posterior reversible encephalopathy syndrome
- Supraventricular tachycardia
- Thrombotic thrombocytopenic purpura
Less Severe
- Back pain
- Chest pain
- Chills
- Dyspnea
- Flushing
- Hypoxia
- Paresthesia
- Tremor
- Voice change
- Wheezing
Contraindicated
None
Severe Precaution
Ramucirumab
Potential adverse effects on bone growth, Safety and effectiveness studied and not established as a single agent for solid tumors.
- 1 Day – 18 Years
- Potential adverse effects on bone growth, Safety and effectiveness studied and not established as a single agent for solid tumors.
Management or Monitoring Precaution
None
Ramucirumab
- Severity Level:
D
- Additional Notes: Based on pharmacology, potential for dev tox; weigh risk-benefit
Contraindicated
Ramucirumab
Insuff human data; potentially harmful to infant based on mechanism of action
| General | Excretion Potential | Effect on Infant | Notes |
| Drug should not be given to breast feeding mothers | Unknown | Not known; no or inclusive data | Insuff human data; potentially harmful to infant based on mechanism of action |
Precaution Exists
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
None
No Known Risk
None
- This medication may cause serious (possibly fatal) bleeding. It may also rarely cause a hole to open in the stomach or intestines (gastrointestinal perforation). You should not receive this medication if you have any serious bleeding problems. Tell your doctor right away if you have symptoms of serious side effects, including prolonged bleeding from cuts or gums, persistent/frequent nosebleeds, pink/dark urine, unusual/easy bruising, bloody or black/tarry stools, persistent or severe stomach/abdominal pain, vomit that looks like coffee grounds, coughing up blood, shortness of breath, dizziness/fainting, unusual or persistent tiredness/weakness, severe headache.
| Gastric cancer | |
| C16 | Malignant neoplasm of stomach |
| C16.0 | Malignant neoplasm of cardia |
| C16.1 | Malignant neoplasm of fundus of stomach |
| C16.2 | Malignant neoplasm of body of stomach |
| C16.3 | Malignant neoplasm of pyloric antrum |
| C16.4 | Malignant neoplasm of pylorus |
| C16.5 | Malignant neoplasm of lesser curvature of stomach, unspecified |
| C16.6 | Malignant neoplasm of greater curvature of stomach, unspecified |
| C16.8 | Malignant neoplasm of overlapping sites of stomach |
| C16.9 | Malignant neoplasm of stomach, unspecified |
| Liver cell carcinoma | |
| C22.0 | Liver cell carcinoma |
| Metastatic colorectal cancer | |
| C18 | Malignant neoplasm of colon |
| C18.0 | Malignant neoplasm of cecum |
| C18.1 | Malignant neoplasm of appendix |
| C18.2 | Malignant neoplasm of ascending colon |
| C18.3 | Malignant neoplasm of hepatic flexure |
| C18.4 | Malignant neoplasm of transverse colon |
| C18.5 | Malignant neoplasm of splenic flexure |
| C18.6 | Malignant neoplasm of descending colon |
| C18.7 | Malignant neoplasm of sigmoid colon |
| C18.8 | Malignant neoplasm of overlapping sites of colon |
| C18.9 | Malignant neoplasm of colon, unspecified |
| C19 | Malignant neoplasm of rectosigmoid junction |
| C20 | Malignant neoplasm of rectum |
| C21.8 | Malignant neoplasm of overlapping sites of rectum, anus and anal canal |
| Non-small cell lung cancer | |
| C34 | Malignant neoplasm of bronchus and lung |
| C34.0 | Malignant neoplasm of main bronchus |
| C34.00 | Malignant neoplasm of unspecified main bronchus |
| C34.01 | Malignant neoplasm of right main bronchus |
| C34.02 | Malignant neoplasm of left main bronchus |
| C34.1 | Malignant neoplasm of upper lobe, bronchus or lung |
| C34.10 | Malignant neoplasm of upper lobe, unspecified bronchus or lung |
| C34.11 | Malignant neoplasm of upper lobe, right bronchus or lung |
| C34.12 | Malignant neoplasm of upper lobe, left bronchus or lung |
| C34.2 | Malignant neoplasm of middle lobe, bronchus or lung |
| C34.3 | Malignant neoplasm of lower lobe, bronchus or lung |
| C34.30 | Malignant neoplasm of lower lobe, unspecified bronchus or lung |
| C34.31 | Malignant neoplasm of lower lobe, right bronchus or lung |
| C34.32 | Malignant neoplasm of lower lobe, left bronchus or lung |
| C34.8 | Malignant neoplasm of overlapping sites of bronchus and lung |
| C34.80 | Malignant neoplasm of overlapping sites of unspecified bronchus and lung |
| C34.81 | Malignant neoplasm of overlapping sites of right bronchus and lung |
| C34.82 | Malignant neoplasm of overlapping sites of left bronchus and lung |
| C34.9 | Malignant neoplasm of unspecified part of bronchus or lung |
| C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung |
| C34.91 | Malignant neoplasm of unspecified part of right bronchus or lung |
| C34.92 | Malignant neoplasm of unspecified part of left bronchus or lung |
| C39.9 | Malignant neoplasm of lower respiratory tract, part unspecified |
| 0-9 | A-Z |
|---|---|
| C16 | Malignant neoplasm of stomach |
| C16.0 | Malignant neoplasm of cardia |
| C16.1 | Malignant neoplasm of fundus of stomach |
| C16.2 | Malignant neoplasm of body of stomach |
| C16.3 | Malignant neoplasm of pyloric antrum |
| C16.4 | Malignant neoplasm of pylorus |
| C16.5 | Malignant neoplasm of lesser curvature of stomach, unspecified |
| C16.6 | Malignant neoplasm of greater curvature of stomach, unspecified |
| C16.8 | Malignant neoplasm of overlapping sites of stomach |
| C16.9 | Malignant neoplasm of stomach, unspecified |
| C18 | Malignant neoplasm of colon |
| C18.0 | Malignant neoplasm of cecum |
| C18.1 | Malignant neoplasm of appendix |
| C18.2 | Malignant neoplasm of ascending colon |
| C18.3 | Malignant neoplasm of hepatic flexure |
| C18.4 | Malignant neoplasm of transverse colon |
| C18.5 | Malignant neoplasm of splenic flexure |
| C18.6 | Malignant neoplasm of descending colon |
| C18.7 | Malignant neoplasm of sigmoid colon |
| C18.8 | Malignant neoplasm of overlapping sites of colon |
| C18.9 | Malignant neoplasm of colon, unspecified |
| C19 | Malignant neoplasm of rectosigmoid junction |
| C20 | Malignant neoplasm of rectum |
| C21.8 | Malignant neoplasm of overlapping sites of rectum, anus and anal canal |
| C22.0 | Liver cell carcinoma |
| C34 | Malignant neoplasm of bronchus and lung |
| C34.0 | Malignant neoplasm of main bronchus |
| C34.00 | Malignant neoplasm of unspecified main bronchus |
| C34.01 | Malignant neoplasm of right main bronchus |
| C34.02 | Malignant neoplasm of left main bronchus |
| C34.1 | Malignant neoplasm of upper lobe, bronchus or lung |
| C34.10 | Malignant neoplasm of upper lobe, unspecified bronchus or lung |
| C34.11 | Malignant neoplasm of upper lobe, right bronchus or lung |
| C34.12 | Malignant neoplasm of upper lobe, left bronchus or lung |
| C34.2 | Malignant neoplasm of middle lobe, bronchus or lung |
| C34.3 | Malignant neoplasm of lower lobe, bronchus or lung |
| C34.30 | Malignant neoplasm of lower lobe, unspecified bronchus or lung |
| C34.31 | Malignant neoplasm of lower lobe, right bronchus or lung |
| C34.32 | Malignant neoplasm of lower lobe, left bronchus or lung |
| C34.8 | Malignant neoplasm of overlapping sites of bronchus and lung |
| C34.80 | Malignant neoplasm of overlapping sites of unspecified bronchus and lung |
| C34.81 | Malignant neoplasm of overlapping sites of right bronchus and lung |
| C34.82 | Malignant neoplasm of overlapping sites of left bronchus and lung |
| C34.9 | Malignant neoplasm of unspecified part of bronchus or lung |
| C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung |
| C34.91 | Malignant neoplasm of unspecified part of right bronchus or lung |
| C34.92 | Malignant neoplasm of unspecified part of left bronchus or lung |
| C39.9 | Malignant neoplasm of lower respiratory tract, part unspecified |
Formulary Reference Tool