Drug interactions
Bevacizumab + Sunitinib
Severity: Major
Bevacizumab and Sunitinib: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining these two anti-angiogenic agents has led to microangiopathic hemolytic anemia in patients with metastatic renal cell carcinoma. Hypertension and thrombocytopenia have also been seen, which makes the combination poorly tolerated.
What this interaction means in plain words
Bevacizumab and Sunitinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Bevacizumab belongs to Oncology; Sunitinib belongs to Oncology.
Why it happens
Combined inhibition of VEGF signalling at the ligand and receptor tyrosine kinase level causing endothelial injury and microangiopathy; exact mechanism is not fully defined.
What to do
Avoid concurrent use. If microangiopathic hemolytic anemia is suspected, check hemoglobin, platelets, LDH, haptoglobin and a blood smear, and stop the drugs.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Bevacizumab
- Bevacizumab + Daunorubicin Moderate
- Bevacizumab + Dengue vaccine Moderate
- Bevacizumab + Doxorubicin Moderate
- Bevacizumab + Doxorubicin liposomal Moderate
- Bevacizumab + Efgartigimod / hyaluronidase sc Moderate
- Bevacizumab + Efgartigimod alfa Moderate
Other interactions of Sunitinib
- Adagrasib + Sunitinib Major
- Amiodarone + Sunitinib Major
- Amisulpride + Sunitinib Major
- Anagrelide + Sunitinib Major
- Apalutamide + Sunitinib Major
- Arsenic trioxide + Sunitinib Major
Frequently asked questions
Can I take Bevacizumab with Sunitinib?
MediHelp rates the interaction as major. Bevacizumab and Sunitinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Combining these two anti-angiogenic agents has led to microangiopathic hemolytic anemia in patients with metastatic renal cell carcinoma. Hypertension and thrombocytopenia have also been seen, which makes the combination poorly tolerated.
How serious is the interaction between Bevacizumab and Sunitinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use. If microangiopathic hemolytic anemia is suspected, check hemoglobin, platelets, LDH, haptoglobin and a blood smear, and stop the drugs.
What other medicines interact with Bevacizumab?
MediHelp also lists interactions of Bevacizumab with, for example, Daunorubicin, Dengue vaccine, Doxorubicin. The full list is on the Bevacizumab page.
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