This medicine is subject to additional monitoring. This will allow quick identification
of new safety information. You can help by reporting any side effects you may get.
You can report side effects to your doctor, or directly at www.tga.gov.au/reporting-problems .
BAVENCIO®
avelumab (rch)
CONSUMER MEDICINE INFORMATION
What is in this leaflet
This leaflet answers some common questions about BAVENCIO.
It does not contain all the available information. It does not take the place of talking
to your doctor or pharmacist.
All medicines have benefits and risks. Your doctor has weighed the risks of treating
you with BAVENCIO against the benefits expected for you.
If you have any concerns about receiving this medicine, talk to your doctor, nurse
or the hospital pharmacist.
Keep this leaflet in a safe place.
You may need to read it again.
What BAVENCIO is used for
BAVENCIO contains the active substance avelumab, a monoclonal antibody, which is a
protein designed to recognise and attach to a specific target in the body to help
the immune system attack and destroy cancer cells.
BAVENCIO is used to treat:
a rare type of skin cancer called metastatic Merkel cell carcinoma (mMCC) where the
disease has spread.
a type of cancer in the bladder or urinary tract called urothelial carcinoma, when
the disease is advanced or metastatic but has not progressed with platinum-based chemotherapy.
a type of kidney cancer called renal cell carcinoma (RCC), when it is advanced, in
combination with another medicine, axitinib. It is important that you also read the
Consumer Medicine Information for axitinib. If you have any questions about axitinib,
ask your doctor.
This medicine is available only with a doctor's prescription.
Ask your doctor if you have any questions about why BAVENCIO has been prescribed for
you.
Your doctor may have prescribed it for another reason.
When you must not be given it
Do not use BAVENCIO:
if you are allergic (hypersensitive) to avelumab or any of the other ingredients of
BAVENCIO. If you are not sure, talk to your doctor.
Some of the symptoms of an allergic reaction may include:
shortness of breath, wheezing or difficulty breathing
swelling of the face, lips, tongue or other parts of the body
rash, itching or hives on the skin.
Do not use BAVENCIO after the expiry date printed on the pack.
The expiry date refers to the last day of that month. If you take it after the expiry
date has passed, it may not work well. Your pharmacist or nurse will check the expiry
date on the packaging.
Do not use BAVENCIO if the packaging is torn or shows signs of tampering.
Your pharmacist or nurse will check the packaging for any signs of damage.
If you are not sure whether you should start using this medicine, talk to your doctor.
Before you are given BAVENCIO
Tell your doctor if you have allergies to any other medicines, foods, preservatives
or dyes.
Tell your doctor if you have, or have had, any of the following medical conditions:
an autoimmune disease (a condition where the body attacks its own cells) like Crohn's,
Guillain- Barré, ulcerative colitis or lupus
a HIV, hepatitis B or hepatitis C infection
taking any medicines that suppress your immune system
have had an organ transplant.
If you have not told your doctor about any of the above, tell them before you are
given BAVENCIO.
Once you are treated with BAVENCIO, your doctor may give you corticosteroids to reduce
any possible side effects that you may have during your treatment.
Talk to your doctor or nurse before receiving BAVENCIO as it may cause:
problems with your lungs such as breathing difficulties, or cough. These may be signs
of inflammation of the lungs (pneumonitis).
problems with your liver (hepatitis). Signs and symptoms of hepatitis may include
yellowing of the whites of the eyes or skin (jaundice), severe nausea or vomiting,
pain on the right side of your stomach area, drowsiness, dark urine (tea colored),
bleeding or bruising more easily than normal, tiredness, abnormal liver function tests.
problems with your intestines (colitis) such as diarrhoea (loose stools), more bowel
movements than usual, blood in your stools or dark, tarry, sticky stools, severe stomach
area (abdomen) pain or tenderness.
problems with your pancreas (pancreatitis). Signs of pancreatitis may include abdominal
pain, nausea and vomiting.
problems with your hormone producing glands (including the thyroid, pituitary, and
adrenal glands) that may affect how these glands work. Signs and symptoms that your
glands are not working properly may include rapid heart beat, increased sweating,
extreme tiredness, weight changes changes in mood or behaviour, such as irritability
or forgetfulness, feeling cold, very low blood pressure(dizziness or fainting, fatigue,
nausea), headache.
problems with your pancreas (Type 1 diabetes), including a serious, sometimes life-threatening
problem due to increased acid in the blood produced from diabetes (diabetic ketoacidosis).
Signs and symptoms include feeling more hungry or thirsty than usual, needing to urinate
more often, weight loss, feeling tired, having difficulty thinking clearly, breath
that smells sweet or fruity, feeling sick or being sick, stomach pain, deep or fast
breathing.
problems with your kidneys such as abnormal kidney function tests, need to urinate
less than usual, blood in your urine, swelling in your ankles.
problems with your muscles (myositis, myasthenia gravis/myasthenic syndrome) such
as muscle pain or weakness.
problems with your heart:
(myocarditis) such as trouble breathing, dizziness or fainting, fever, chest pain,
chest tightness or flu-like symptoms.
(major adverse cardiovascular events) such as trouble breathing, chest discomfort,
or swelling of lower legs or hands.
infusion-related reactions, which may include chills or shaking, hives, shortness
of breath or wheezing, fever, back pain and/or abdominal pain, bumpy rash or skin
wheals, flushing, low blood pressure (dizziness, fatigue, nausea).
In addition, autoimmune haemolytic anaemia (headaches, short of breath, looking pale,
and yellowing of the skin and/or eyes) and systemic inflammatory response syndrome
(redness and swelling in the affected parts of your body, pain, loss of function of
parts of your body, fatigue, fast heart rate, abnormal breathing, fever or low body
temperature, shaking or chills, warm or clammy/sweaty skin, rash, confusion, agitation
or other mental changes, loss of consciousness) have been reported with BAVENCIO or
other products in this class (PD-1/PD-L1 blocking antibodies).
Should any of the above occur, your doctor may:
give you other medicines in order to prevent complications and reduce your symptoms
withhold the next dose of BAVENCIO
or stop your treatment with BAVENCIO altogether.
Pregnancy
Tell your doctor if you are pregnant or plan to become pregnant.
BAVENCIO must not be used during pregnancy as it may cause harm to your unborn baby.
Make sure you maintain adequate contraception during treatment and for at least one
month after your last dose.
Breast-feeding
Tell your doctor if you are breastfeeding or wish to breastfeed.
It is unknown if BAVENCIO is passed into your breast milk. A risk to the breast-fed
infant cannot be excluded.
You should not breastfeed during treatment and for at least one month after your last
dose.
Use in Children
The effectiveness of BAVENCIO in children under the age of 12 years has not been established.
Taking other medicines
Tell your doctor, pharmacist or nurse if you are taking or have recently taken any
other medicines, including medicines obtained without a prescription from your pharmacy,
supermarket or health food shop.
Some medicines and BAVENCIO may interfere with each other. These include:
medicines that make your immune system weak, such as steroids.
These medicines may be affected by BAVENCIO or may affect how well it works. You may
need different amounts of your medicines, or you may need to take different medicines.
Your doctor or nurse will have more information on medicines to be careful with or
to avoid while using BAVENCIO.
How to use BAVENCIO
Follow all directions given to you by your doctor, nurse or pharmacist carefully.
They may differ from the information contained in this leaflet.
A doctor experienced in the use of medicines for cancer will supervise your treatment
with BAVENCIO.
You will receive BAVENCIO as an infusion (a drip) into a vein (intravenously) over
a period of 60 minutes, once every 2 weeks.
Your doctor will decide how many treatments you need.
You will also receive premedication (paracetamol and an antihistamine) prior to the
first four infusions of BAVENCIO, and prior to further infusions of BAVENCIO if your
doctors believes this is necessary. These premedications are given to help minimise
potential reactions to the BAVENCIO infusion.
How much to use
BAVENCIO is a concentrated solution for infusion. The recommended dose is either 10
mg per kg of your body weight or 800 mg of BAVENCIO. Your doctor will calculate the
correct dose and dilution for you.
BAVENCIO has to be diluted with 0.9% or 0.45% saline solution before use. More than
one vial is required to obtain the required dose.
How long to use BAVENCIO for
Your doctor will decide how long you will receive BAVENCIO based on your response
to the medicine and the type of cancer you have.
If you miss a dose
It is very important for you to keep all your appointments to receive BAVENCIO.
If you miss a dose, talk to your doctor or nurse and arrange another visit as soon
as possible.
If you take too much (overdose)
Immediately contact your doctor or the Poisons Information Centre (telephone 13 11
26) for advice, or go to Accident and Emergency at the nearest hospital, if you think
that you or anyone else may have taken too much BAVENCIO.
Do this even if there are no signs of discomfort or poisoning.
You may need urgent medical attention.
Things you must do
Limit your exposure to sunlight by wearing hat, protective clothing and sunscreen
when you go outside.
Keep all appointments with your doctor so that your progress can be checked. Your
doctor may do blood tests or other laboratory tests from time to time to prevent unwanted
side effects during your treatment with BAVENCIO.
Before starting any new medicine, remind your doctor or pharmacist that you are receiving
BAVENCIO.
Tell all the doctors, dentists and pharmacists who are treating you that you are receiving
BAVENCIO.
If you become pregnant while you are treated with BAVENCIO, tell your doctor immediately.
Things to be careful of
Be careful driving or operating machinery until you know how BAVENCIO affects you.
Treatment-related symptoms can affect your concentration and ability to react.
Side effects
Tell your doctor or nurse as soon as possible if you do not feel well while you are
receiving BAVENCIO.
All medicines, including BAVENCIO, can have unwanted side effects. Sometimes they
are serious, most of the time they are not. You may need medical attention if you
get some of the side effects.
Be aware of important symptoms of inflammation. BAVENCIO acts on your immune system
and may cause inflammation in parts of your body. Inflammation may cause serious damage
to your body and some inflammatory conditions may be life-threatening and need treatment
or withdrawal of BAVENCIO.
Do not try to treat your symptoms with other medicines.
Do not be alarmed by this list of possible side effects.
You may not experience any of them.
Ask your doctor to answer any questions you may have.
Tell your doctor or nurse if you notice any of the following, particularly if they
worry you:
feeling tired or weak
muscle or back pain, stomach area pain, joint pain
loose stools, vomiting, nausea, constipation
swelling in the arms, feet or legs
feeling less hungry, weight loss
cough
rash, itching, redness of the skin
fever, chills
shortness of breath
dizziness, headache
high blood pressure
low blood pressure
flushing
difficulty in speaking or breathing, hoarseness
urinary tract infection (UTI) such as burning sensation when urinating, strong or
frequent or urge to urinate
The above list includes the common side effects of BAVENCIO.
If any of the following happen, tell your doctor immediately or go to Accident and
Emergency at your nearest hospital:
signs of problems with your liver: yellowing of the whites of the eyes or skin, severe
nausea or vomiting, pain on the right side of your stomach area, drowsiness, dark
urine (tea coloured), bleeding or bruising more easily than normal, feeling less hungry
than usual, tiredness or abnormal liver function tests
signs of problems with your thyroid, adrenal or pituitary glands (hormone producing
glands): extreme tiredness, rapid heartbeat, increased sweating, weight changes, changes
in mood or behaviour, such as irritability or forgetfulness, feeling cold, very low
blood pressure (fainting, dizziness, fatigue, nausea), headache
signs of problem with your intestines: diarrhoea, more bowel movements than usual,
blood in your stools or dark, tarry, sticky stools, severe stomach pain or tenderness
signs of problems with your lungs: breathing difficulties, coughing
signs of problems with your pancreas (type 1 diabetes including a serious, sometimes
life-threatening problem due to increase acid in the blood produced from diabetes
(diabetic ketoacidosis)) may include feeling more hungry or thirsty than usual, needing
to urinate more often, weight loss, and feeling tired, having difficulty thinking
clearly, breath that smells sweet or fruity, feeling sick or being sick, stomach pain,
deep or fast breathing
signs of inflammation of the kidney may include abnormal kidney function tests, needing
to urinate less than usual, blood in your urine, or swelling in your ankles
signs of problems with your heart: trouble breathing, dizziness or fainting, fever,
chest pain, chest tightness, swelling in lower legs or hands, or flu-like symptoms
signs of problems with your muscles: muscle pain or weakness
signs of problems with your pancreas: abdominal pain, nausea, vomiting
signs of problems with your eyes such as inflammation of the eyes (redness, pain,
vision problems)
Guillain-Barré Syndrome (an immune system disorder that causes nerve inflammation
and can result in pain, numbness, muscle weakness and difficulty walking)
signs of an allergic reaction (anaphylactic reaction and/or hypersensitivity): shortness
of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or
other parts of the body; rash, itching or hives on the skin
The above list includes serious side effects. You may need urgent medical attention
or hospitalisation.
Please note that these signs and symptoms are sometimes delayed, and may develop weeks
or months after your last dose.
Infusion-related side effects
Tell your doctor or nurse if you experience any of the following symptoms, during
or after treatment with BAVENCIO:
fever
back and/or abdominal pain
chills or shaking
shortness of breath or wheezing
bumpy rash or skin wheals
flushing
low blood pressure (dizziness, fatigue, nausea).
Sometimes these symptoms may occur up to several hours later. To recognise early signs
of these side effects, you will be monitored closely while you are receiving each
infusion.
Your doctor may consider reducing the infusion rate, stop the infusion temporarily
or permanently in order to manage these symptoms.
Tell your doctor if you notice anything that is making you feel unwell.
Other side effects not listed above may also occur in some patients.
Storage
Undiluted BAVENCIO must be kept in a refrigerator at 2° to 8°C, but it must not be
frozen. Store in the original package in order to protect from light.
Each vial is intended for single use only. When the needed amount of solution has
been withdrawn from the vial, any remaining concentrated solution must be discarded.
What it looks like
BAVENCIO is a clear, colourless, to slightly yellow solution. It is supplied in 10
mL colourless glass vials with a rubber stopper and aluminium seal. Each pack contains
1 vial.
Ingredients
The active ingredient in BAVENCIO is avelumab. Each 10 mL vial contains 200 mg avelumab.
The solution also contains the following inactive ingredients:
mannitol
glacial acetic acid
polysorbate 20
sodium hydroxide
water for injections.
BAVENCIO solution does not contain any preservative.