Ramucirumab
About Ramucirumab
Ramucirumab is a specialised prescription medication used to treat certain advanced cancers, including cancers of the stomach, gastro-oesophageal junction, lungs, colon, rectum, and liver. It belongs to a class of targeted therapies that work by stopping cancer cells from growing and spreading. This medicine is prescribed when other standard treatments have not worked or have stopped working.
This treatment is given as an intravenous infusion, typically once every two or three weeks depending on your specific treatment plan. It is highly important to receive these infusions consistently on the schedule set by your oncologist to get the best results. While undergoing therapy, eating a balanced diet rich in protein and drinking plenty of fluids can help your body manage treatment stress and maintain your energy levels.
While taking Ramucirumab, you may experience common side effects such as high blood pressure, headaches, or feeling very tired. However, you must contact your healthcare team immediately if you experience serious side effects, such as severe bleeding, persistent stomach pain, or chest tightness during or after an infusion.
Talk to your doctor before starting this medicine if you have a history of high blood pressure, thyroid issues, liver damage, or blood clots. Do not take this if you have unhealed wounds or are scheduled to have a major surgery in the near future, as it can severely interfere with wound healing.
This medicine can interact with blood thinners, increasing your risk of bleeding, so inform your doctor about all drugs you take. Additionally, pregnant or breastfeeding individuals must not receive Ramucirumab due to the risk of serious harm to the baby, and elderly patients should consult their doctor for personalised monitoring.
Uses of Ramucirumab
Medicinal Benefits
Ramucirumab offers significant benefits by directly targeting the physical processes that allow advanced cancers to grow and spread in the body.
- Slowing Cancer Progression: By targeting the blood supply of tumours, this medicine helps delay the growth and spread of advanced cancers, providing more time under disease control.
- An Alternative When Other Treatments Fail: It offers a viable and effective option for patients whose cancers have become resistant to standard first-line chemotherapy regimens.
- Targeted Action: Because it specifically targets the signals that create tumour blood vessels, it focuses directly on the tumour environment rather than damaging all rapidly dividing healthy cells in the body.
Directions for Use
- Follow your doctor’s instructions on the dosage and timing of this medication.
- Ramucirumab is administered by the doctor or nurse.
- Avoid self-administration.
Storage
Side Effects of Ramucirumab
Common Side Effects (Usually mild):
- High blood pressure
- Feeling unusually tired or weak
- Diarrhoea
- Headache or mild nosebleeds
- Dry mouth or mouth sores
Serious Side Effects (Call a doctor right away):
- Severe, unexpected bleeding, such as coughing up blood or heavy nosebleeds
- Sudden, severe pain in your stomach area, which may be accompanied by fever or chills
- Signs of a blood clot, including chest pain, sudden shortness of breath, or swelling and warmth in one leg
- Signs of an allergic reaction during infusion, such as trouble breathing, flushing, extreme dizziness, or sweating
- Slow wound healing or surgical wounds that start to open up
Medicines Containing this Salt
View AllDrug Warnings
- Inspect the infusion solution: Ensure the solution is clear and colourless to slightly yellow before the infusion begins. It should not be used if it contains visible particles.
- Report unhealed wounds: Inform your healthcare provider about any unhealed cuts, ulcers, recent surgeries, or dental wounds before receiving an infusion, as this medicine may delay wound healing.
- Watch for infusion reactions: Tell your nurse immediately if you experience chills, shivering, dizziness, difficulty breathing, or any unusual symptoms during the infusion.
- Avoid certain pain relievers unless approved: Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, unless your oncologist advises it, as they may increase the risk of bleeding.
- Attend routine monitoring tests: Keep all scheduled appointments for urine tests, as your doctor will regularly check for protein in your urine to monitor your kidney health.
Drug Interactions
The following medicines may interact with Ramucirumab and increase the risk of complications:
- Blood Thinners (like warfarin or heparin): May significantly increase the risk of serious, internal bleeding when used together with Ramucirumab.
- NSAIDs (like ibuprofen or naproxen): Can raise the risk of stomach irritation and severe bleeding.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionIt is unknown whether Ramucirumab interacts with alcohol. Consult your doctor for more information.
Pregnancy
unsafeRamucirumab is not recommended for use in pregnancy as it may cause embryo-fetal toxicity and harm your foetus. Hence, if you are pregnant or planning pregnancy, inform your doctor before receiving Ramucirumab. You should not become pregnant while you are receiving Ramucirumab for at least three months from the last dose of Ramucirumab. Using effective birth control methods while on treatment is suggested.
Breast Feeding
unsafeRamucirumab should not be taken if you are breastfeeding as it passes into breast milk and may harm your infant. Avoid nursing your child while on treatment with this medicine and for at least two months from the last dose of medicine.
Driving
cautionRamucirumab will be administered to hospitalized patients. Driving is not recommended.
Liver
safe if prescribedIf you have a pre-existing or a history of liver disease, inform your doctor before receiving Ramucirumab. Based on population PK analysis, no dose adjustment is advised for patients with mild liver impairment. Patients with Child-Pugh B or C cirrhosis who received single-agent Ramucirumab reported clinical deterioration.
Kidney
safe if prescribedHence, if you have a pre-existing or a history of kidney disease, inform your doctor. Based on population PK analysis, no dose adjustment is advised for patients with kidney impairment.
Children
unsafeRamucirumab is not recommended for use in children as the safety and efficacy are not established.
Habit Forming
Diet & Lifestyle Advise
- Monitor your blood pressure: Check your blood pressure daily at home and keep a log. Report any sudden or high readings to your medical team.
- Practice gentle dental hygiene: Use an extra-soft toothbrush and avoid flossing aggressively to prevent gum bleeding, as Ramucirumab can increase bleeding risks.
- Plan around surgeries: Always inform your dentist or surgeon that you are receiving Ramucirumab. You will need to stop using the medicine temporarily before and after any surgical procedures to ensure proper wound healing.
- Stay hydrated: Drink plenty of water and clear broths, especially if you experience diarrhoea, to protect your kidneys and prevent dehydration.
- Eat smaller, frequent meals: If you experience nausea or loss of appetite, consuming small portions of bland foods throughout the day can help maintain your strength.
Special Advise
- Avoid intercourse while on treatment with Ramucirumab.
- Regular, complete blood count monitoring is advised during the treatment.
- Liver function tests (LFT) and kidney function tests (RFT) should be performed before starting the treatment and every 4 to 6 weeks during the treatment.
- Regular ECG, blood pressure, and electrolytes should be monitored while taking the medicine.
Patients Concern
Disease/Condition Glossary
Stomach Cancer (Gastric adenocarcinoma) is a type of cancer that develops from the stomach lining. When the cancer cells spread to other organs of the body, it is called metastatic. This condition can occur mainly due to smoking, a highly processed or salty diet, and severe bacterial infection of H. pylori. Symptoms of stomach cancer include feeling bloated after eating, feeling full after eating small amounts of food, nausea, heartburn or indigestion.
Non-Small Cell Lung Cancer (NSCLC): It is the most common form of lung cancer, which occurs when cells that form the lining of the lung start growing uncontrollably. It is mostly seen in persons who smoke. Symptoms may include chest pain, weight loss, hoarseness, and difficulty breathing.
Hepatocellular carcinoma: It occurs when the cancer/ malignant cells grow out of control in the liver. This infects the liver, destroys the liver cells and affects the ability of the liver to work properly. Symptoms may include abdominal pain, loss of appetite, weight loss, and pale bowel motions.
Colorectal cancer: Also known as colon cancer (growth of cancer cells in the colon) or rectal cancer (cancer cells grow in the rectum area), is a condition in which the cancerous or malignant cells grow out of control in the colon or rectum. Symptoms may include diarrhoea, constipation, bloody stools, change in bowel habits, abdominal discomfort, etc.
FAQs
Ramucirumab is used to treat Colorectal Cancer, Stomach Cancer, Hepatocellular cancer and Non-small cell lung cancer.
Ramucirumab contains Ramucirumab, which works by inhibiting the abnormal growth of cancer cells and, finally, causes the initiation of programmed cell death.
Inform your doctor whether you have received any other cancer treatment. Ramucirumab may cause reversible posterior leukoencephalopathy syndrome, arterial thromboembolic events, hypertension, infusion-related reactions, gastrointestinal perforation, and embryo-fetal toxicity during the treatment. Hence, inform your oncologist if you have any cardiovascular conditions, liver/kidney disease, lung problems, are pregnant, are planning to become pregnant, or are breastfeeding before receiving Ramucirumab.
No, Ramucirumab is not a classic chemotherapy drug. It is a targeted therapy (a monoclonal antibody) that specifically blocks the blood supply to cancer cells, whereas chemotherapy generally targets all rapidly dividing cells. Talk to your doctor to understand how this differs from your other treatments.
The infusion typically takes about 60 minutes. However, it may take longer if you experience any mild side effects or reactions during the administration. Talk to your doctor or nurse about what to expect on your treatment day.
Most people can drive after the infusion, but some may feel fatigued, dizzy, or weak. It is best to have someone drive you to and from your first few appointments until you know how the medicine affects you. Talk to your doctor if you feel unsure.
On its own, Ramucirumab does not typically cause hair loss. However, because it is often given in combination with traditional chemotherapy drugs, you may still experience hair loss from those other medications. Talk to your doctor to clarify the side effects of your specific combination regimen.
You must inform your dentist that you are taking Ramucirumab before scheduling any invasive procedures. Because this medicine interferes with wound healing and increases bleeding risks, you will likely need to temporarily pause the medication before and after the dental work. Talk to your oncologist to coordinate the timing.
No, you should not receive Ramucirumab if you are pregnant, as it can cause severe harm to an unborn baby. You should use highly effective birth control during treatment and for at least 3 months after your last dose. Talk to your doctor if you have concerns about fertility or pregnancy.
Ramucirumab can cause a significant increase in blood pressure by narrowing blood vessels. Your healthcare team will check your blood pressure before every infusion and may prescribe blood pressure medication if it becomes too high. Talk to your doctor if you notice high readings at home.
Mild nosebleeds can happen, but you should notify your healthcare team about any bleeding. If the nosebleed is severe, frequent, or hard to stop, seek emergency medical care immediately. Talk to your doctor or pharmacist about safe ways to manage dry nasal passages.
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