Like all medicines, Avastin can cause side effects, although not everybody gets them.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
The side effects listed below were seen when Avastin was given together with chemotherapy. This does not necessarily mean that these side effects were strictly caused by Avastin.
These side effects may occur with certain frequencies, which are defined as follows:
- very common: affects more than 1 user in 10
- common: affects 1 to 10 users in 100
- uncommon: affects 1 to 10 users in 1,000
- rare: affects 1 to 10 users in 10,000
- very rare: affects less than 1 user in 10,000
- not known: frequency cannot be estimated from the available data.
Allergic reactions
If you have an allergic reaction, tell your doctor or a member of the medical staff straight away. The signs may include: difficulty in breathing or chest pain. You could also experience redness or flushing of the skin or a rash, increased muscle tension, feeling sick (nausea) or being sick (vomiting).
You should seek help immediately if you suffer from any of the below mentioned side effects.
The common side effects are:
- perforation of the gut,
- bleeding, including bleeding in the lungs in patients with non-small cell lung cancer,
- blocking of the arteries by a blood clot,
- blocking of the veins in the lungs by a blood clot.
The severe side effects, which may be very common, include:
- high blood pressure,
- problems with wound healing after surgery,
- feeling of numbness or tingling in hands or feet,
- decreased number of cells in the blood, including white cells that help to fight against infections (this may be accompanied by fever), and cells that help the blood to clot,
- lack of energy or tiredness,
- diarrhoea, nausea and vomiting.
The severe side effects, which may be common, include:
- allergic reactions,
- decreased number of red cells in the blood,
- bleeding associated with the tumour,
- lack of energy,
- abdominal pain,
- muscle pain,
- dry mouth in combination with thirst and/or reduced or darkened urine,
- inflammation of the lining of the mouth,
- pain, including headache,
- blood clots in the veins of the legs or difficulties in getting the blood to clot,
- localised pus collection,
- infection, and in particular infection in the blood or bladder,
- reduced blood supply to the brain or stroke,
- blood clots in the arteries, which can lead to a stroke and a heart attack,
- falling asleep or fainting,
- problems with the heart with breathing difficulties,
- nose bleed,
- increase in heart rate (pulse),
- blockage in the gut or bowel,
- abnormal urine test (protein in the urine),
- shortness of breath or low levels of oxygen in the blood.
The severe side effects, which may be rare, include:
- seizures (fits),
- headache,
- confusion,
- changes in vision,
- an abnormal tube-like connection between the windpipe and the passage to the stomach (gullet).
You should seek help as soon as possible if you suffer from any of the below mentioned side effects
The very common side effects, which were not severe, include:
- high blood pressure,
- pain, including joint pain,
- lack of energy,
- constipation, bleeding from the lower part of the large bowel, inflammation of the mouth,
- loss of appetite,
- protein in the urine,
- nose bleed,
- fever,
- headache,
- problems with the eyes (including increased production of tears).
The common side effects, which were not severe, include:
- shortness of breath,
- nose bleed,
- runny nose,
- dry skin, flaking and inflammation of the skin, change in skin colour,
- change in the sense of taste,
- voice changes, hoarseness.
Other less common side effects of any severity which have been reported are heart failure, bleeding from the lining of the mouth or vagina, abnormal tube-like connection between internal organs and skin or other tissues that are not normally connected and ulcers in the digestive system (the signs may include abdominal pain, feeling bloated, black tarry stools or blood in your stools (faeces) or blood in your vomit).
There have been very rare reports of patients developing a hole in the septum of the nose ? the structure, which separates the nostrils.
Some side effects are more common in elderly patients. These side effects include blood clot in the arteries which can lead to a stroke or a heart attack. In addition, elderly patients have a higher risk of a reduction in the number of white cells in the blood, and cells that help the blood clot. Other side effects reported with a higher frequency in elderly patients were diarrhoea, sickness, headache and fatigue.
Avastin may also cause changes in laboratory tests carried out by your doctor. These include a decreased number of white cells in the blood, in particular neutrophils (one type of white blood cell which helps protect against infections) in the blood; presence of protein in the urine; decreased blood potassium, sodium or phosphorous (a mineral); increased blood sugar; increased blood alkaline phosphatase (an enzyme); decreased haemoglobin (found in red blood cells, which carry oxygen), which may be severe.
Pain in the mouth, teeth and/or jaw, swelling or sores inside the mouth, numbness or a feeling of heaviness in the jaw, or loosening of a tooth. These could be signs and symptoms of bone damage in the jaw (osteonecrosis). Tell your doctor and dentist immediately if you experience any of them.
Outside of the approved use of Avastin for cancer treatment, the following side effects may occur when Avastin is injected directly into the eye (unapproved use):
- Infection or inflammation of the eye globe,
- Redness of the eye, small particles or spots in your vision (floaters), eye pain,
- Seeing flashes of light with floaters, progressing to a loss of some of your vision,
- Increased eye pressure,
- Bleeding in the eye.
