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Chemotherapy and other systemic treatment regimens may change due to COVID-19. Find out more at Systemic Treatment Regimens During COVID-19.

ramucirumab

( RA-mue-SIR-ue-mab )
Funding:
New Drug Funding Program
  • Ramucirumab - Advanced or Metastatic Gastric Cancer or Gastroesophageal Junction Adenocarcinoma
Other Name(s): Cyramza®
Appearance: solution mixed into larger bags of fluids

Medication Information Sheet
ramucirumab (RA-mue-SIR-ue-mab)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Cyramza®

Appearance:
solution

mixed into larger bags of fluids

What is this medication for?
  • For treating stomach cancer, usually in combination with another medication.

What should I do before I have this medication?
  • Tell your doctor and pharmacist if you have or had significant medical condition(s), especially if you have or had:
    • liver, kidney or heart problems,
    • recent surgery, injury or bleeding,
    • stomach problems, such as Crohn's, colitis or ulcers,
    • or if you have any allergies.
  • People with cancer have a higher risk of getting other cancers or developing blood clots. Some cancer medications may increase these risks, especially if used for a long period of time. Discuss any concerns about this medication with your health care team.
How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding
     
  • If there is ANY chance that you or your partner may become pregnant, you and your partner together must: 

    Use 2 effective forms of birth control at the same time while receiving this drug. Keep using birth control until at least 3 months after the last dose. Discuss with your healthcare team.

  • Do not breastfeed while using this drug
     
  • This medication may affect fertility (ability to get pregnant)
How is this medication given?
  • This drug is given by injection into a vein.

What else do I need to know while on this medication?
  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • For mild aches and pain:

    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding.
    • Talk to your health care team before you start or stop these medications.
    • If you feel unwell, take your temperature before taking any of these medications. They may hide a fever. 
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.

What are the side effects of this medication?

You may not have all of the side effects below. You may have side effects that are not listed.

Side effects and what to do When to contact doctor?
Common Side Effects (25 to 49 out of 100 people)

Pains or cramps in the belly

  • If you have constipation or diarrhea it may be causing the pain in your belly.
  • If the pain is severe, gets worse or doesn’t go away, talk to your health care team about other possible causes.
Contact your health care team if no improvement or if severe

 

 

Side effects and what to do When to contact doctor?
Less Common Side Effects (10 to 24 out of 100 people)

High blood pressure (may be severe)

  • Check your blood pressure regularly. Your doctor may prescribe medication to treat high blood pressure.
  • If you have a severe headache, severe dizziness, or if you faint get emergency help right away as it may be a sign your blood pressure is too high or too low.
Contact your health care team if no improvement or if severe

Diarrhea

May happen days to weeks after you get your treatment.

If you have diarrhea :

  • Take anti-diarrhea medication if your health care team prescribed it.
  • Avoid foods or drinks with artificial sweetener (e.g. chewing gum, “diet” drinks), coffee and alcohol.
  • Eat many small meals and snacks instead of 2 or 3 large meals.
  • Drink at least 6 to 8 cups of liquids each day. Talk to your health care team if you can’t drink 6-8 cups of liquids each day when you have diarrhea. You may need special liquids with salt and sugar, called Oral Rehydration Therapy.

​See the Diarrhea pamphlet for more information.

Contact your health care team if no improvement or if severe

 

Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:

  • Signs of unusual bruising or bleeding such as black stools, blood in your urine, or bleeding that will not stop
  • Signs of an infection, such as fever: oral temperature of 38.3°C (100.9°F) or higher at any time OR 38.0°C (or 100.4°F) or higher for at least one hour
  • Signs of a kidney problem such as swelling, passing very little or no pee, and/or unusual weight gain
  • Signs of a liver problem such as yellowish skin or eyes, unusually dark pee or pain on the right side of your belly
  • Sudden, severe pain in your belly, chest or arm
  • Shortness of breath or coughing up blood
  • Severe pain, swelling or hardening of a vein in your arm or leg
  • Signs of an allergy such as fever, flushing, itchiness, rash, swollen lips, face or tongue, wheezing, chest and throat tightness
  • Severe headache, fainting, seizures, confusion and/or vision loss
  • Wounds that do not heal well
  • Signs of a thyroid problem such as feeling tired, dry skin, nails or hair that breaks easily and sensitivity to cold


For more links on how to manage your symptoms go to https://www.cancercareontario.ca/en/symptom-management.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.