Cyramza

• Women of reproductive potential should take effective contraceptive measures during ramucirumab treatment and should continue the contraceptives for three months after the last dose of ramucirumab. • Ramucirumab increases the risk of bleeding events such as stomach bleeding mainly in patients who take medications for pain and swelling.​​​‍​​‍​​​​‍​​‍‍ If the bleeding episodes are frequent and high, permanently discontinue the use of ramucirumab and treat the patient accordingly. • Patients should be monitored for their blood pressure level every two weeks or even more frequently if the patients have a history of high blood pressure as ramucirumab can cause severe high blood pressure. • Monitor patients for symptoms and signs of infusion-related reactions such as tremors, breathing difficulty, and chills during the infusion and permanently discontinue the infusion if the side effects are severe. • Ramucirumab can weaken or slow the process of wound healing; therefore do not use ramucirumab before any surgical procedure and re-use only when the wound is completely healed. • Ramucirumab can cause liver damage, neurological disorder such as Reversible Posterior Leukoencephalopathy Syndrome (RPLS), and thyroid dysfunction. Monitor patients for symptoms and signs of these illnesses and consider for medical management if the side effects are severe. • Damage to the kidneys can be expected during ramucirumab treatment. Patients should check their protein levels in urine (proteinuria) by urine dipstick or urinary protein creatinine ratio if worsening of kidney damage occurs. • Blot clots can occur in the blood vessels during ramucirumab treatment that may lead to a heart attack or reduced blood supply to the areas of the brain. Discontinue the use of ramucirumab in such cases and treat the patient in an ICU setting of a hospital.