Versavo Drug Interactions

Effects of other antineoplastic agents on bevacizumab pharmacokinetics: No clinically relevant interaction of co-administered chemotherapy on bevacizumab pharmacokinetics was observed based on the results of a population pharmacokinetics analyses. There was neither statistical significance nor clinically relevant differences in bevacizumab clearance in patients receiving bevacizumab monotherapy compared to patients receiving bevacizumab in combination with interferon alpha 2a, erlotinib or chemotherapies (IFL 5-FU/LV, carboplatin/paclitaxel, capecitabine, doxorubicin or cisplatin/gemcitabine)
Effect of bevacizumab on pharmacokinetics of other antineoplastic agents: No clinically relevant interaction of bevacizumab was observed on the pharmacokinetics of co-administered interferon alpha 2a, erlotinib (and its active metabolite OSI-420) or the chemotherapies irinotecan (and its active metabolite SN38), capecitabine, oxaliplatin (as determined by measurement of free and total platinum), and cisplatin. Conclusions on the impact of bevacizumab on gemcitabine pharmacokinetics cannot be drawn.
Combination of bevacizumab and sunitinib malate: In two clinical trials of metastatic renal carcinoma, microangiopathic hemolytic anemia (MAHA) was reported in 7 of 19 patients treated with bevacizumab (10 mg/kg every two weeks) and sunitinib malate (50 mg daily) combination.
MAHA is a hemolysis disorder which can present with red cell fragmentation, anemia, and thrombocytopenia. In addition, hypertension (including hypertension crisis), elevated creatinine, and neurological symptoms were observed in some of these patients. All of these findings were reversible upon discontinuation of bevacizumab and sunitinib malate (see Hypertension, Proteinuria, Posterior Reversible Encephalopathy Syndrome (PRES) under Precautions).
Radiotherapy: The safety and efficacy of concomitant administration of chemotherapy (temozolomide), radiotherapy and bevacizumab was evaluated in study BO21990, a Phase III, randomized, double blind, placebo controlled study of 921 patients with newly diagnosed glioblastoma. No new adverse events associated with bevacizumab were reported in this study.
The safety and efficacy of concomitant administration of radiotherapy and bevacizumab has not been established in other indications.