Avastin (Bevacizumab) Side Effects

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By Dr Ananya Mandal, MD

Most anti-cancer drugs are associated with moderate to severe side effects and Avastin (bevacizumab) is no exception. The side effects of Avastin occur either as reactions to infusion of the drug or in response to the drug itself.

Infusion-related side effects

Side effects associated with the intravenous infusion of Avastin may be seen for up to 24 hours after infusion and examples include:

Flu-like symptoms such as fever, chills, dizziness and weakness
Skin rash that may appear red, warm and itchy
Angioedema or allergic reactions leading to swelling in the lips, tongue or back of the throat making it difficult to swallow or breathe
Wheezing or coughing
Pain in the back or abdomen
Tightness and pain in the chest

Other side effects

Examples of side effects that may occur for up to days or weeks after the infusion include:

Nausea and vomiting – Usually anti-emetics or drugs that prevent nausea are prescribed to control these symptoms
Loss of appetite – A dietician or a nutritional advisor may help plan a healthy diet that helps prevent malnutrition due to loss of appetite.
High blood pressure – Blood pressure is routinely monitored among patients receiving Avastin to check for abnormal changes. Headaches, nose bleeds or dizziness may indicate a change in blood pressure.
Mouth ulcers and sores – These may be prevented by drinking plenty of fluids, maintaining good oral hygiene and supplementing nutrients in diet.
Increased risk of developing blood clots – This increase in risk is more common among individuals who are already at risk of such clots. Possible signs of blood clotting include chest pain, breathlessness, changes in vision, difficulty speaking, paralysis of the limbs and swelling, pain, or redness in one of the arms or legs. This condition may be life threatening if not treated promptly.
Increased vulnerability to infections – Avastin can reduce the number of white blood cells in the body and increase susceptibility to infection. Common symptoms include high fever and chills.
Risk to unborn baby – Avastin may be harmful to the fetus or a nursing infant.

Reviewed by Sally Robertson, BSc