Why is this medication prescribed?

Cyramza, also known by its generic name Ramucirumab, is prescribed for several medical conditions, primarily in the treatment of cancer. Here are some specific reasons why Cyramza may be prescribed:

• Advanced Gastric Cancer: Cyramza is used in combination with other chemotherapy medications for the treatment of advanced gastric (stomach) cancer or gastroesophageal junction (GEJ) adenocarcinoma that cannot be treated with surgery.
• Non-Small Cell Lung Cancer (NSCLC): It is also used in combination with docetaxel chemotherapy for metastatic non-small cell lung cancer that has progressed after previous treatment.
• Colorectal Cancer: Cyramza can be prescribed for metastatic colorectal cancer in patients who have previously received chemotherapy.
• Hepatocellular Carcinoma (Liver Cancer): It is used as a second-line treatment in combination with another medication called lenvatinib for patients with advanced hepatocellular carcinoma.
• Esophageal Cancer: In some cases, Cyramza is prescribed for advanced esophageal cancer, typically in combination with other chemotherapy agents.

Cyramza works by targeting and inhibiting a specific protein involved in the formation of blood vessels that supply tumors (angiogenesis), thereby reducing blood flow to the cancerous growths and potentially slowing their growth or shrinking them. As with any medication, its use should be discussed thoroughly with a healthcare provider to ensure it is appropriate for the specific condition and situation of the patient.

How should this medicine be used?

Cyramza (Ramucirumab) is typically administered intravenously (IV) by a healthcare professional in a clinical setting such as a hospital or infusion center. Here are the general guidelines for its use:

• Dosage: The dosage of Cyramza can vary depending on the specific type of cancer being treated and the overall health of the patient. It is determined by the healthcare provider based on individual factors.
• Administration: It is given as an intravenous infusion over a period of time, usually once every two or three weeks. The infusion process allows the medication to be delivered directly into the bloodstream.
• Pre-medication: Before administering Cyramza, healthcare providers may administer medications to reduce the risk of infusion reactions or other side effects. This can include antihistamines, corticosteroids, and acetaminophen.
• Monitoring: During and after the infusion, patients are typically monitored closely for any signs of allergic reactions, infusion-related reactions, or other side effects. This monitoring helps ensure the patient’s safety and well-being.
• Duration of Treatment: Treatment with Cyramza is usually continued as long as it is providing benefit and as long as the patient tolerates it well. This can vary widely depending on the individual’s response to the medication and the progression of the disease.
• Follow-up: Patients receiving Cyramza will have regular follow-up appointments with their healthcare team to assess the effectiveness of the treatment, monitor for side effects, and make any necessary adjustments to the treatment plan.

It’s important for patients to follow the healthcare provider’s instructions carefully regarding the timing and frequency of Cyramza infusions. Any concerns or questions about the administration or side effects should be discussed with the healthcare team promptly.

Other uses for this medicine

• Gastric (stomach) cancer: Specifically, Cyramza is used in combination with other chemotherapy medications or as a single agent in patients who have advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma.
• Colorectal cancer: It is also used in combination with chemotherapy for patients with metastatic colorectal cancer that has progressed after prior treatment.
• Non-small cell lung cancer: Cyramza is used as a single agent in patients with advanced non-small cell lung cancer whose cancer has progressed after other treatments.

What special precautions should I follow?

Special precautions should be taken when using Cyramza to ensure safe and effective treatment. Here are some important considerations:

• Monitoring: Your healthcare provider will monitor you closely during treatment with Cyramza to watch for any signs of side effects or complications. This may involve regular blood tests and other medical evaluations.
• Bleeding Risk: Cyramza can increase the risk of bleeding, especially if you have a history of bleeding disorders or are taking other medications that affect blood clotting. Inform your doctor about any history of bleeding disorders or current use of blood-thinning medications.
• Hypertension: Treatment with Cyramza may lead to high blood pressure (hypertension). Your blood pressure should be monitored regularly during treatment, and medications may be prescribed to manage hypertension if needed.
• Perforation or Fistula Formation: Cyramza may increase the risk of gastrointestinal perforation (a hole in the stomach or intestines) or fistula formation (abnormal connections between organs). Notify your healthcare provider immediately if you experience severe abdominal pain, fever, or other symptoms of these conditions.
• Pregnancy and Breastfeeding: Cyramza may harm an unborn baby. It is important to discuss birth control methods with your doctor if you are of childbearing potential and receiving Cyramza. It is not known whether Cyramza passes into breast milk, so breastfeeding should be avoided during treatment and for some time after the last dose.
• Liver Function: Cyramza can affect liver function, so your doctor may perform regular liver function tests during treatment.

Always inform your healthcare provider about all medications you are taking, including prescription, over-the-counter, vitamins, and herbal supplements, as some may interact with Cyramza. Follow your doctor’s instructions carefully to ensure safe and effective treatment with Cyramza.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Cyramza. However, maintaining a healthy and balanced diet is generally recommended during cancer treatment to support overall health and well-being. If you have specific dietary concerns or restrictions, discuss them with your healthcare team.

What should I do if I forget a dose?

If you miss an appointment for your Cyramza infusion, contact your healthcare provider as soon as possible to reschedule. It’s important to maintain the treatment schedule recommended by your doctor for the best chance of effectiveness against cancer.

What side effects can this medication cause?

Cyramza (ramucirumab) can cause several potential side effects, some of which can be serious. It’s important to note that not all people will experience these side effects, and their severity can vary. Here are some common and serious side effects associated with Cyramza:

Common Side Effects:

• High Blood Pressure (Hypertension): This is a common side effect of Cyramza. Your doctor will monitor your blood pressure regularly during treatment.
• Fatigue: Feeling tired or weak is a common side effect reported by patients receiving Cyramza.
• Decreased Appetite: Some people may experience a loss of appetite while taking Cyramza.
• Nausea and Vomiting: These gastrointestinal symptoms can occur but are usually manageable with medications.
• Diarrhea: Diarrhea can also occur as a side effect of Cyramza.
• Stomach Pain or Discomfort: Abdominal pain or discomfort may occur during treatment.
• Headache: Some patients may experience headaches while receiving Cyramza.
• Protein in Urine: Cyramza can sometimes lead to an increase in protein levels in the urine, which your doctor will monitor.

Serious Side Effects:

• Bleeding: Cyramza can increase the risk of bleeding, which can be serious. This may include bleeding from the stomach, intestines, or other parts of the body.
• Gastrointestinal Perforation: A rare but serious side effect where a hole forms in the stomach or intestines.
• Hypertensive Crisis: This is a severe increase in blood pressure that may require immediate medical attention.
• Blood Clots: Cyramza may increase the risk of blood clots, which can lead to serious conditions such as stroke or heart attack.
• Impaired Wound Healing: Cyramza may delay wound healing after surgery or other procedures.
• Liver Problems: Cyramza can affect liver function, leading to liver enzyme abnormalities or liver failure in rare cases.
• Reversible Posterior Leukoencephalopathy Syndrome (RPLS): A rare condition involving changes in brain function and symptoms like headaches, confusion, seizures, and vision loss.
• Infusion Reactions: Some patients may experience infusion-related reactions, such as fever, chills, or allergic reactions during or shortly after receiving Cyramza.

It’s essential to report any new or worsening symptoms to your healthcare provider promptly while receiving Cyramza. Your doctor will monitor you closely for these side effects and take appropriate measures to manage them.

What should I know about storage and disposal of this medication?

Storage and Disposal of Cyramza:

• Storage: Cyramza is typically stored by healthcare professionals or at a healthcare facility where it will be administered. It is usually supplied as a sterile, preservative-free solution in vials or infusion bags. The storage conditions may vary depending on the specific formulation and manufacturer’s instructions. It should be stored according to the temperature and handling guidelines provided by the healthcare provider or pharmacy.
• Disposal: Since Cyramza is administered in a healthcare setting, any unused portions or materials used during preparation should be disposed of according to medical waste disposal regulations. It’s important not to keep or reuse any leftover Cyramza without proper guidance from healthcare professionals.

In case of emergency/overdose

In case of an emergency or overdose situation with Cyramza, it is crucial to seek immediate medical assistance. The specific management will depend on the nature and severity of the overdose. Healthcare providers are trained to handle emergencies and can provide supportive care as needed.

What other information should I know?

• Regular Monitoring: Your doctor will monitor your condition closely throughout the course of Cyramza treatment. This includes regular assessments of blood pressure, blood counts, liver function, and other parameters to watch for any potential side effects or complications.
• Follow-Up Care: Attend all scheduled appointments with your healthcare provider for follow-up evaluations and monitoring of your response to Cyramza treatment.
• Medication Interactions: Inform your healthcare provider about all medications you are taking, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Some medications may interact with Cyramza, affecting its effectiveness or increasing the risk of side effects.
• Pregnancy and Breastfeeding: Cyramza can harm an unborn baby and is not recommended during pregnancy. Use effective contraception during treatment and discuss family planning with your healthcare provider. It is not known whether Cyramza passes into breast milk, so breastfeeding is not recommended during treatment and for some time after the last dose.
• Patient Support: Consider joining support groups for individuals with cancer or discussing your concerns with healthcare professionals who can provide guidance and support throughout your treatment journey.

Always follow your healthcare provider’s instructions carefully regarding the use of Cyramza and any additional advice they provide related to your specific medical condition and needs.