Generic Name and Formulations:
Ziv-aflibercept 25mg/mL; soln for IV infusion after dilution; preservative-free.
Sanofi US and Regeneron
Indications for ZALTRAP:
In combination with 5-fluorouracil, leucovorin, irinotecan (FOLFIRI) for patients with metastatic colorectal cancer (mCRC) that is resistant to or has progressed following an oxaliplatin-containing regimen.
Start ziv-aflibercept prior to any component of the FOLFIRI regimen on treatment day. Give 4mg/kg as an IV infusion over 1hr every 2 weeks; continue until disease progression or unacceptable toxicity. For recurrent or severe hypertension, suspend until controlled. Upon resumption, permanently reduce to 2mg/kg. For recurrent proteinuria, suspend until proteinuria <2g per 24hrs, then permanently reduce to 2mg/kg.
Hemorrhage. GI perforation. Compromised wound healing.
Increased risk of hemorrhage; monitor for signs/symptoms. Do not start in patients with severe hemorrhage; discontinue if develops. Monitor for GI perforation, fistula formation, compromised wound healing; discontinue if occurs. Suspend therapy at least 4 weeks prior to elective surgery; do not resume for at least 4 weeks following major surgery and until wound is fully healed. Monitor BP every 2 weeks and treat appropriately if hypertension occurs; temporarily suspend until controlled; discontinue if hypertensive crisis/encephalopathy occurs. Discontinue if arterial thromboembolic events (eg, transient ischemic attack, cerebrovascular accident, angina pectoris) occur. Monitor for proteinuria; suspend if proteinuria ≥2g per 24hrs; discontinue if nephrotic syndrome or thrombotic microangiopathy occurs. Monitor CBC with differential at baseline and prior to start of each cycle; delay until neutrophils ≥1.5x109/L. Risk of severe diarrhea and dehydration esp. in elderly (monitor). Discontinue if reversible posterior leukoencephalopathy syndrome occurs. Pregnancy (Cat. C). Use effective contraception during and up to 3 months after the last dose. Nursing mothers: not recommended.
Leukopenia, diarrhea, neutropenia, proteinuria, AST/ALT increased, stomatitis, fatigue, thrombocytopenia, hypertension, weight decreased, decreased appetite, epistaxis, abdominal pain, dysphonia, serum creatinine increased, headache.
Single-use vials (100mg/4mL)—1, 3; (200mg/8mL)—1
Neurology Advisor Articles
- Excess Abdominal Obesity Linked to Severe Disability in Multiple Sclerosis
- Change in Dietary Patterns Over 5 Years in Early Multiple Sclerosis
- High-Dose Biotin May Be an Effective Treatment for Progressive MS
- Biobank Data Suggest Vitamin D Reduces Risk for Multiple Sclerosis
- Serious Adverse Events Profile for Cladribine Confirmed With Extended Data
- Unintended Pregnancy Common in Women With Epilepsy
- Aggressive Blood Pressure Lowering in Intracerebral Hemorrhage May Be Harmful
- Risk of Opioid-Benzodiazepine Overlap Up for Dual Prescribing
- Minority Residents Experience Burdens Linked to Race/Ethnicity
- Tips Provided for Budgeting in Medical Residency