Cyramza Ramucirumab

Cyramza Ramucirumab


Cyramza (ramucirumab) is a member of the VEGF/VEGFR inhibitors drug class and is commonly used for Colorectal Cancer, Gastric Cancer, Hepatocellular Carcinoma, and others.

Cyramza is the brand name of the generic drug ramucirumab, a prescription drug used to treat advanced stomach cancer.

Cyramza is also used to treat cancer located where the stomach meets the esophagus (gastroesophageal junction cancer).

Stomach cancer is the fifth most common cancer in the world and is the third-leading cause of cancer death.

Cyramza is a monoclonal antibody. It works by stopping the growth of cancer cells.

The drug is manufactured by Eli Lilly.



Cyramza Ramucirumab Dosage Forms & Strengths
IV solution
10mg/mL (10mL and 50mL vials)
Non-Small Cell Lung Cancer
Combination therapy with docetaxel
Indicated in combination with docetaxel for metastatic non-small cell lung cancer (NSCLC) with disease progression on or after platinum-based chemotherapy
Patients with epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) genomic tumor aberrations should have disease progression before receiving ramucirumab
Ramucirumab 10 mg/kg IV on Day 1, PLUS
Docetaxel 75 mg/m2 IV on Day 1
Repeat cycle every 21 days
Continue until disease progression or unacceptable toxicity
Combination therapy with erlotinib
Indicated in combination with erlotinib, for first-line treatment of metastatic NSCLC in patients whose tumors have EGFR exon 19 deletions or exon 21 (L858R) substitution mutations
Ramucirumab 10 mg/kg IV q2Weeks, PLUS
Erlotinib 150 mg PO qDay
Continue until disease progression or unacceptable toxicity
Refer to prescribing information for erlotinib for dosage information
Gastric Cancer
As a single agent or in combination with paclitaxel for advanced gastric or gastro-esophageal junction adenocarcinoma in patients with disease progression on or after prior fluoropyrimidine-or platinum-containing chemotherapy

Single agent: Ramucirumab 8 mg/kg IV q2wk

Combination with paclitaxel
Days 1 and 15: Ramucirumab 8 mg/kg IV
Days 1, 8, and 15: Paclitaxel 80 mg/m2
Repeat cycle every 28 days
Continue until disease progression or unacceptable toxicity
Colorectal Cancer
Indicated for use in combination with FOLFIRI for patients with metastatic colorectal cancer (mCRC) whose disease has progressed on a first-line bevacizumab-, oxaliplatin- and fluoropyrimidine-containing regimen

Ramucirumab 8 mg/kg IV q2wk in combination with FOLFIRI

Continue until disease progression or unacceptable toxicity

Hepatocellular Carcinoma
Indicated as a single agent for hepatocellular carcinoma (HCC) in patients with alpha fetoprotein (AFP) of ≥400 ng/mL who have been treated with sorafenib

8 mg/kg IV q2wk

Continue until disease progression or unacceptable toxicity

Dosage Modifications
Posterior reversible encephalopathy syndrome (PRES), arterial thromboembolic events, GI perforation, or grade 3 or 4 hemorrhage: Permanently discontinue

Wound healing (all grades)
Withhold for 28 days before elective surgery; resume no sooner than 2 weeks after surgery and until adequate wound healing
Safety of resumption of ramucirumab after resolution of wound healing complications has not been established
Infusion-related reactions
Grade 1 or 2: Reduce infusion rate by 50%
Grade 3 or 4: Permanently discontinue
Severe hypertension: Interrupt therapy until controlled with medical management
Uncontrolled severe hypertension despite antihypertensive therapy: Permanently discontinue
First occurrence of increased urine protein levels ≥2 g/24 hr: Withhold dose until urine protein levels <2 g/24 hr; resume at reduced dose (eg, reduce 8 mg to 6 mg, 10 mg to 8 mg)
Reoccurrence of protein level ≥2 g/24 hr: Withhold dose until urine protein <2 g/24 hr; resume at reduced dose (eg, reduce 6 mg to 5 mg, 8 mg to 6 mg) Urine protein level >3 g/24 hr or nephrotic syndrome: Permanently discontinue
Hepatic impairment
Mild-to-moderate (total bilirubin ≤3x ULN and any AST): No dosage adjustment necessary
Severe (total bilirubin >3x ULN and any AST): Pharmacokinetics unknown
Clinical deterioration was reported in patients with Child-Pugh B or C cirrhosis who received single agent ramucirumab
Renal impairment
Mild-to-severe (CrCl 15-89 mL/min): No clinically meaningful effect on pharmacokinetics
Dosing Considerations
Blood pressure should be controlled before initiating treatment and monitored every 2 weeks or more frequently if indicated

2 reviews for Cyramza Ramucirumab

  1. Florentino Pedretti

    Contact with us will help you

  2. Maryam Speziale

    Terrific article

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