- March 18, 2023
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Brand Name :
Zaltrap
Synonyms :
ziv-aflibercept
Class :
Tyrosine Kinase Inhibitor, Anti-neoplastics
Brand Name :
Zaltrap
Synonyms :
ziv-aflibercept
Class :
Tyrosine Kinase Inhibitor, Anti-neoplastics
Dosage Forms & Strengths
injectable solution
25mg/mL
Indicated for metastatic colorectal cancer that is resistant to or has advanced after receiving oxaliplatin, it is recommended in conjunction with 5-fluorouracil, leucovorin, and irinotecan (FOLFIRI):
4mg/kg intravenous every two weeks
On the day of therapy, give before any FOLFIRI regimen component
Safety and efficacy not established
Refer adult dosing
may increase the neutropenic effect of myelosuppressive agents
may increase the myelosuppressive effect of myelosuppressive agents
may increase the QTc prolonging effect of QT-prolonging agents
may decrease the therapeutic effect of myelosuppressive agents
may increase the myelosuppressive effect of myelosuppressive agents
may increase the toxic effect of myelosuppressive agents
may increase the myelosuppressive effect of myelosuppressive agents
may increase the myelosuppressive effect of myelosuppressive agents
may increase the hypertensive effect of hypertension-associated agents
may increase the hypertensive effect of hypertension-associated agents
may increase the hypertensive effect of hypertension-associated agents
may increase the hypertensive effect of hypertension-associated agents
may increase the hypertensive effect of hypertension-associated agents
may increase the hypertensive effect of hypertension-associated agents
may increase the arrhythmogenic effect of Inhalational Anaesthetics
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
may decrease the levels of serum concentration
Actions and Spectrum:
Frequency defined
>10%
All grades
Diarrhea (69%)
Proteinuria (62%)
ALT increased (50%)
Thrombocytopenia (48%)
Hypertension (41%)
Decreased appetite (32%)
Epistaxis (28%)
Dysphonia (25%)
Asthenia (18%)
Dyspnea (12%)
Upper abdominal pain (11%)
Leukopenia (78%)
Neutropenia (67%)
AST increased (62%)
Stomatitis (50%)
Fatigue (48%)
Decreased weight (32%)
Abdominal pain (27%)
Increased serum creatinine (23%)
Grades 3 to 4
Diarrhea (19%)
Leukopenia (16%)
Fatigue (13%)
Neutropenia (37%)
Hypertension (19%)
Stomatitis (13%)
Palmar-plantar erythrodysesthesia syndrome (11%)
1-10%
All grades
Oropharyngeal pain (8%)
Venous thromboembolic events (9%)
Rectal bleeding (5%)
Pulmonary embolism (5%)
Urinary tract infection (9%)
Skin hyperpigmentation (8%)
Hemorrhoids (6%)
Proctalgia (5%)
Grades 3-4
Asthenia (5%)
Palmar-plantar erythrodysesthesia syndrome (3%)
AST increased (3%)
Decreased weight (3%)
Upper abdominal pain (1%)
Proteinuria (8%)
Abdominal pain (4%)
Thrombocytopenia (3%)
ALT increased (3%)
Decreased appetite (3%)
<1%
Grades 3-4
Rectal bleeding (0.7%)
Proctalgia (0.3%)
Oropharyngeal pain (0.2%)
Dyspnea (0.8%)
Dysphonia (0.5%)
Epistaxis (0.2%)
Post-marketing Reports
Aneurysms
Arterial (including aortic)
Dissections and rupture
Contraindications/caution:
Contraindications:
ziv-aflibercept is contraindicated in patients with a previous severe allergic reaction to ziv-aflibercept or any of its components
Caution:
Pregnancy consideration: ziv-aflibercept may harm an unborn baby and is not recommended during pregnancy.
Lactation:
Pregnancy category:
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: There is no data available for the drug under this category
Pharmacology:
ziv-aflibercept is a medication used to treat certain types of cancer, including colorectal, lung, and ovarian cancer. It works by blocking the growth of blood vessels that supply tumors with nutrients and oxygen, slowing down or stopping the growth of cancer cells.
The pharmacology of ziv-aflibercept involves several vital mechanisms:
Pharmacodynamics:
The pharmacodynamics of ziv-aflibercept are complex and involve multiple mechanisms of action that work together to inhibit angiogenesis and improve the efficacy of chemotherapy. By blocking the formation of new blood vessels, ziv-aflibercept can help to slow down or stop the growth of tumors, and may be effective in treating various types of cancers, including colorectal, lung, and ovarian cancer.
Pharmacokinetics:
Absorption
ziv-aflibercept is administered as an intravenous infusion, and its absorption is irrelevant.
Distribution
ziv-aflibercept has a large volume of distribution, indicating that it distributes widely throughout the body. The protein binds to plasma proteins to a moderate extent.
Metabolism
ziv-aflibercept is not metabolized by the liver. It is broken down into smaller peptides and amino acids by proteolytic enzymes in the reticuloendothelial system.
Elimination and Excretion
The half-life of ziv-aflibercept is approximately 11 days, and it is eliminated from the body through the reticuloendothelial system. The drug is not excreted through the kidneys.
Administration:
Patient information leaflet
Generic Name: ziv-afilbercept
Why do we use ziv-afilbercept?
ziv-aflibercept is a medication used to treat certain types of cancer, including: