ziv-aflibercept 200 mg/8 mL (25 mg/mL) intravenous solution

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Medication name

Generic name:
Ziv-aflibercept - injection

Pronunciation
(a-FLIB-er-sept)

Brand name(s)
Zaltrap

Uses

Ziv-aflibercept is used to treat cancer of the colon and rectum.

How to use

This medication is given by injection into a vein by a health care professional. It is given as directed by your doctor, usually every 2 weeks. The medication is injected slowly into a vein over 1 hour.

The dosage is based on your medical condition, weight, and response to treatment.

Use this medication regularly to get the most benefit from it. To help you remember, mark your calendar with a reminder.

Side effects

Diarrhea, headache, mouth pain/sores, runny nose, voice changes, weight loss, weakness, tiredness, or darkening of the skin may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

  • diarrhea that is severe or doesn't stop
  • signs of kidney problems (such as change in the amount of urine)
  • swelling hands/ankles/feet
  • signs of dehydration (such as muscle cramps, extreme thirst, dizziness)
  • pain/redness/swelling/tingling/burning of the hands/feet
  • slow wound healing

Get medical help right away if you have any very serious side effects, including:

  • chest/jaw/left arm pain
  • weakness on one side of the body
  • trouble speaking
  • confusion
  • sudden vision changes
  • seizure
  • sudden/severe back pain or headache

This medication may cause serious (possibly fatal) bleeding. It may also rarely cause a hole to open in the stomach or intestines (gastrointestinal perforation). Tell your doctor right away if you have symptoms such as stomach/abdominal pain that doesn't go away, easy or unusual bleeding/bruising (such as from cuts, gums, nosebleeds), pink/dark urine, bloody or black/tarry stools, vomit that looks like coffee grounds, coughing up blood, lightheadedness, unusual tiredness/weakness.

This medication may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse. Tell your doctor right away if you have any signs of infection (such as sore throat that doesn't go away, fever, chills, cough).

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high. Your doctor may control your blood pressure with medication.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • rash
  • itching/swelling (especially of the face/tongue/throat)
  • severe dizziness
  • trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before receiving ziv-aflibercept, tell your doctor or pharmacist if you are allergic to it; or to aflibercept; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

  • high blood pressure
  • kidney disease
  • recent surgery
  • recent injuries/wounds
  • recent/current infection
  • blood/bone marrow disorders (such as low platelet/neutrophil/red blood cell levels)
  • bleeding problems (such as bleeding of the stomach/intestines)
  • blood vessel problems (such as an aneurysm or a tear/break in the aorta or other blood vessels)

Before having surgery or any medical procedure, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This medication may cause wounds to heal slowly or poorly. You should not receive this medication for at least 4 weeks before and at least 4 weeks after major surgery, until wounds from the surgery are fully healed. Ask your doctor for specific instructions about when to stop and when to restart treatment with this medication.

Ziv-aflibercept can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.

Tell your health care professional that you are using ziv-aflibercept before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

Older adults may be more sensitive to the side effects of this drug, especially diarrhea, dehydration, weight loss, and weakness.

Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using ziv-aflibercept. Ziv-aflibercept may harm an unborn baby. Your doctor should order a pregnancy test before you start this medication. Ask about reliable forms of birth control while using this medication and for 3 months after the last dose. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.

It is unknown if this medication passes into breast milk. Because of the possible risk to the infant, breastfeeding is not recommended while using this medication and for 1 month after the last dose. Consult your doctor before breastfeeding.

Drug interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Ziv-aflibercept is very similar to aflibercept. Do not use ziv-aflibercept while using the form of aflibercept that is also given by injection into a vein.

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669.

Notes

Lab and/or medical tests (such as blood pressure, urine protein, complete blood count, liver function) should be done while you are using this medication. Keep all medical and lab appointments.

Missed dose

It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.

Storage

Not applicable. This medication is given in a hospital or clinic and will not be stored at home.

Medical alert

Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

Important note

HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Information last revised October 2024.

Selected from NATIONAL DRUG DATA FILE (NDDF) data included with permission and copyrighted by First Databank, Inc., 2019. This copyrighted material has been downloaded from a licensed data provider.

The above information is intended to supplement, not substitute for, the expertise and judgment of your health care professional. You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment.