Avastin Injection Complications

Complications when AvastinTM is given to patients with cancer

When Avastin is given to patients with metastatic colorectal cancer, some patients experienced serious and sometimes life-threatening complications, such as gastrointestinal perforations or wound healing complications, hemorrhage, arterial thromboembolic events (such as stroke or heart attack), hypertension, proteinuria, and congestive heart failure.

Patients who experienced these complications not only had metastatic colon cancer, but were also given 400 times the dose you will be given, at more frequent intervals, and in a way (through an intravenous infusion) that spread the drug throughout their bodies.

Risk when Avastin is given to treat patients with eye conditions

Ophthalmologists believe that the risk of these complications for patients with eye conditions is low.  Patients receiving AvastinTM for eye conditions are healthier than the cancer patients, and receive a significantly smaller dose, delivered only to the cavity of their eye.  While there are no FDA-approved studies about the use of AvastinTM in the eye that prove it is safe and effective, there are ongoing clinical trials of a similar drug as well as studies of patients receiving AvastinTM “off-label.”  One study of patients who received Avastin through an intravenous infusion reported only a mild elevation in blood pressure.  Another study of patients treated like you will be with intravitreal AvastinTM (that is, Avastin injected into the eye) did not have these elevations or the other serious problems seen in the patients with cancer.

However, the benefits and risks of intravitreal AvastinTM for eye conditions are not yet fully known.  In addition, whenever a medication is used in a large number of patients, a small number of coincidental life-threatening problems may occur that have no relationship to the treatment.  For example, patients with diabetes are already at increased risk for heart attacks and strokes.  If one of these patients being treated with AvastinTM suffers a heart attack or stroke, it may be caused by the diabetes and not the AvastinTM treatment.  This possible relationship is the subject of ongoing clinical investigations.

Known risks of intravitreal eye injections

Your condition may not get better or may become worse.  Any or all of these complications may cause decreased vision and/or have a possibility of causing legal blindness.  Additional procedures may be needed to treat these complications.  During the follow up visits or phone calls, you will be checked for possible side effects and the results will be discussed with you.

Any medication has the potential to cause allergic reactions in a small number of people.  Symptoms of an allergic reaction can include a rash, hives, itching, shortness of breath, and rarely death.  In general, allergic reactions to medicines are more likely to occur in people who have allergies to other drugs, foods, or things in the environment, such as dust or grass.  If you have allergies to other medicines, foods, or other things in the environment, or if you have asthma, you should let Dr. Deupree or his staff know.

Possible complications and side effects of the procedure and administration of AvastinTM include but are not limited to retinal detachment, cataract formation (clouding of the lens of the eye), glaucoma (increased pressure in the eye), hypotony (reduced pressure in the eye), damage to the retina or cornea (structures of the eye), and bleeding.  There is also the possibility of an eye infection (endophthalmitis).  You may receive eye drops with instructions on when to use them to reduce the possibility of this occurring.  Any of these rare complications may lead to severe, permanent loss of vision.

Patients receiving an injection of AvastinTM may experience less severe side effects related to the pre-injection preparation procedure (eyelid speculum, anesthetic drops, dilating drops, antibiotic drops, povidone-iodine drops and the injection of the anesthetic).  These side effects may include eye pain, subconjunctival hemorrhage (bloodshot eye), vitreous floaters, irregularity or swelling of the cornea, inflammation of the eye, and visual disturbances.

###
Much of this page’s information provided by: Ophthalmic Mutual Insurance Company