Care During Chemotherapy and Beyond


Generic name: Ramucirumab uses generic names in all descriptions of drugs. Ramucirumab is the generic name for the trade name CYRAMZA™. In some cases, health care professionals may use the generic name ramucirumab when referring to the trade drug name CYRAMZA™.

Drug type: CYRAMZA™ is a monoclonal antibody, Vascular Endothelial Growth Factor Receptor 2 (VEGFR2) Inhibitor. (For more detail, see "How this drug works" section below).

What This Drug Is Used For:

  • Treatment of advanced gastric cancer or gastro-esophageal junction adenocarcinoma.
  • Non-small cell Lung cancer
  • Metastatic Colorectal cancer

Note: If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.

How This Drug Is Given:

  • As an infusion into a vein (intravenous, IV) every 2 weeks.
  • Medications may be given just before the infusion to reduce the occurrence of infusion-related symptoms.
  • There is no pill form of CYRAMZA™.
  • The amount of this medication you will receive depends on many other factors, including your weight and your general health or other health problems. Your doctor will determine your dosage and schedule.

Side Effects:

Important things to remember about the side effects of CYRAMZA™:

  • Most people do not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset and duration.
  • Side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

The following are possible side effects (occurring in about 10-29%) of patients receiving CYRAMZA™:

A serious but rare side effect of CYRAMZA™ is an increase in the risk of bleeding. Contact your health care provider if any unusual bleeding occurs or if you experience any symptoms of bleeding including lightheadedness, coughing up blood-tinged sputum, nose bleed, or blood in your urine.

Other rare but serious side effects:

  • Arterial Thromboembolic Events (blood clots)
  • Infusion Related Reaction
  • Gastrointestinal perforation
  • Impaired Wound Healing
  • Clinical Deterioration in Patients with Cirrhosis
  • Reversible Posterior Leukoencephalopathy Syndrome

If you have questions about this information ask your health care provider

Not all side effects are listed above. Some that are uncommon are not listed here. You should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4° F (38° C) or chills (possible signs of infection)
  • Shortness of breath, chest pain or discomfort; swelling of your lips or throat
  • Any unusual bleeding occurs or any symptoms of bleeding including lightheadedness, coughing up blood-tinged sputum, nose bleed, or blood in your urine.

The following symptoms require medical attention, but are not emergency situations. Contact your health care provider within 24 hours of noticing any of the following:

  • Rise in blood pressure or symptoms of high blood pressure such as headache, lightheadedness, visual changes, etc.
  • A rash
  • Diarrhea (4-6 episodes in a 24-hour period).
  • Nausea (interferes with ability to eat and unrelieved with prescribed medication).
  • Vomiting (vomiting more than 4-5 times in a 24 hour period).
  • Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness.
  • Decreased appetite
  • Cough with or without mucus
  • Other signs of infection, such as sore throat, pain with urination

Always inform your health care provider if you experience any unusual symptoms.


  • Before starting CYRAMZA™ treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking CYRAMZA™.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category C (CYRAMZA™ may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.)
  • For both men and women: Do not conceive a child (get pregnant) while taking CYRAMZA™. Barrier methods of contraception, such as condoms, are recommended during treatment and for 3 months after stopping the treatment. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking this medication.

Self-Care Tips:

  • CYRAMZA™ may cause temporary low blood pressure. If you are taking medication to reduce your blood pressure, check with your doctor or nurse as to whether you should take it as usual or not before the infusion.
  • You may experience shortness of breath, feel flushed or dizzy during the infusion. You will most likely receive medication before the infusion, and you will be closely monitored during the infusion.
  • For flu-like symptoms, keep warm with blankets and drink plenty of liquids. There are medications that can help reduce the discomfort caused by chills.
  • Drink 2 to 3 quarts of fluid for the first 48 hours after each infusion, unless you were told to restrict your fluid intake.
  • This medication infrequently causes nausea. But if you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals. Sucking on lozenges and chewing gum may also help.
  • You may experience drowsiness or dizziness; avoid driving or engaging in tasks that require alertness until your response to the drug is known.
  • In general, drinking alcoholic beverages should be avoided. You should discuss this with your doctor.
  • Maintain good nutrition.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing

You will be checked regularly by your health care provider while you are taking CYRAMZA™, to monitor side effects and check your response to therapy. Your blood pressure will be monitored routinely as high blood pressure may be a side effect of CYRAMZA™.

How This Drug Works:

CYRAMZA™ is classified as a monoclonal antibody. Monoclonal antibodies are a relatively new type of "targeted" cancer therapy.

Antibodies are an integral part of the body's immune system. Normally, the body creates antibodies in response to an antigen (such as a protein in a germ) that has entered the body. The antibodies attach to the antigen in order to mark it for destruction by the immune system.

To make anti-cancer monoclonal antibodies in the laboratory, scientists analyze specific antigens on the surface of cancer cells (the targets). Then, using animal and human proteins, they create a specific antibody that will attach to the target antigen on the cancer cells. When given to the patient, these monoclonal antibodies will attach to matching antigens like a key fits a lock.

Since monoclonal antibodies target only specific cells, they may cause less toxicity to healthy cells. Monoclonal antibody therapy is usually given only for cancers in which antigens (and the respective antibodies) have been identified already.

CYRAMZA™ is a monoclonal antibody that works by targeting and binding with the vascular endothelial growth factor receptor-2 (VEGFR-2) and blocks the activation of VEGF.

When VEGF is overexpressed, it can contribute to disease. Solid cancers cannot grow beyond a limited size without an adequate blood supply; cancers that can express VEGF are able to grow and metastasize. Drugs such as CYRAMZA™ can inhibit VEGF and control or slow down tumor growth by decreasing the blood supply to the tumor.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice. is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit