Skip To Main Content
Lilly
Menu closed
Lilly
  • Account Login / Register
  • Medical Home
    • Medical Information
  • Medical Education
  • Science
Ask Lilly

We're here to help.

Chat
Chat with us Chat with us
Question Contact Us
Expand contact lilly
Lilly

You are now leaving the LillyMedical.com website

The link you clicked on will take you to a site maintained by a third party, which is solely responsible for its content. Lilly USA, LLC does not control, influence, or endorse this site, and the opinions, claims, or comments expressed on this site should not be attributed to Lilly USA, LLC. Lilly USA, LLC is not responsible for the privacy policy of any third-party websites. We encourage you to read the privacy policy of every website you visit.
Click "Continue" to proceed or "Return" to return to LillyMedical.com.

  1. Medical Information Right
  2. Oncology Right
  3. Cyramza (ramucirumab) injection Right
  4. What are the recommended dosing regimens for Cyramza® (ramucirumab)?
Search Cyramza (type in keywords)
Search Medical Information

If you wish to report an adverse event or product complaint, please call 1-800-LILLYRX (1-800-545-5979)

Loading icon

Cyramza ® (ramucirumab) injection

10 mg/mL solution

Full Prescribing Information

This information is provided in response to your request. Resources may contain information about doses, uses, formulations and populations different from product labeling. See Prescribing Information above, if applicable.

What are the recommended dosing regimens for Cyramza® (ramucirumab)?

Cyramza (ramucirumab) is dosed based on indication.

US_cFAQ_RAM016_DOSING
US_cFAQ_RAM016_DOSING
en-US

Approved Dosing Regimens

It is recommended that treatment with ramucirumab be continued until progression of the underlying disease or until unacceptable toxicity.1

Gastric Cancer

Single Agent

The recommended dose of ramucirumab as a single agent is 8 mg/kg every 2 weeks administered as an intravenous (IV) infusion over 60 minutes.1

In Combination With Paclitaxel

The recommended dose of ramucirumab is 8 mg/kg every 2 weeks administered as an IV infusion over 60 minutes prior to administration of paclitaxel.1

Non-Small Cell Lung Cancer

In Combination with Docetaxel

The recommended dose of ramucirumab is 10 mg/kg administered by IV infusion over 60 minutes on day 1 of a 21-day cycle prior to docetaxel infusion.1

In Combination with Erlotinib

The recommended dose of ramucirumab is 10 mg/kg every two weeks administered by IV infusion over 60 minutes.1

Colorectal Cancer

The recommended dose of ramucirumab is 8 mg/kg every 2 weeks administered by IV infusion over 60 minutes prior to irinotecan, folinic acid and 5-fluorouracil (FOLFIRI) administration.1

Hepatocellular Carcinoma

The recommended dose of ramucirumab is 8 mg/kg every 2 weeks administered by IV infusion over 60 minutes.1

Shorter Duration of Infusion

The ramucirumab prescribing information recommends that if the first 60-minute infusion of ramucirumab is tolerated, then all subsequent infusions may be administered over 30 minutes. This applies to all recommended doses of ramucirumab and all approved indications.1

Premedication

Prior to each ramucirumab infusion, all patients should be premedicated with an IV histamine-1 receptor antagonist (eg, diphenhydramine hydrochloride).1

Patients who have experienced a grade 1 or 2 infusion-related reaction, should be premedicated prior to each ramucirumab infusion with the following 

  • a histamine-1 receptor antagonist
  • dexamethasone (or equivalent), and
  • acetaminophen.1 

Dose Modifications

The recommended dose adjustments for ramucirumab are summarized in Recommended Ramucirumab Dose Adjustments. For toxicities related to paclitaxel, docetaxel, erlotinib, or the components of FOLFIRI, please refer to the current prescribing information for these products.

Recommended Ramucirumab Dose Adjustments1

Adverse Reaction

Severitya 

Recommended Dose Modification

IRRs

Grade 1 or 2

Reduce the infusion rate of ramucirumab by 50%.

Grade 3 or 4

Permanently discontinue ramucirumab.

Hypertension

Severe hypertension

Withhold ramucirumab until controlled with medical management.

Severe hypertension that cannot be controlled with antihypertensive therapy 

Permanently discontinue ramucirumab.

Proteinuria


First occurrence of increased urine protein levels ≥2 g/24 hours

Withhold ramucirumab until urine protein level is <2 g/24 hours. When resuming treatment, reduce the dose to

  • 6 mg/kg if original dose was 8 mg/kg, or
  • 8 mg/kg if original dose was 10 mg/kg.

Reoccurrence of urine protein level >2 g/24 hours following initial dose reduction

Withhold ramucirumab until urine protein level is <2 g/24 hours. When resuming treatment, further reduce the dose to

  • 5 mg/kg if initial reduced dose was 6 mg/kg, or
  • 6 mg/kg if initial reduced dose was 8 mg/kg.

Urine protein level >3 g/24 hours or in the setting of nephrotic syndrome

Permanently discontinue ramucirumab.

Wound-healing complications

All grades

Withhold ramucirumab for 28 days prior to elective surgery. Do not administer ramucirumab for at least 2 weeks following surgery and until adequate wound healing. The safety of resumption of ramucirumab after resolution of wound healing complications has not been established.

ATE, GI perforation, PRES

All grades

Permanently discontinue ramucirumab.

Hemorrhage

Grade 3 or 4

Abbreviations: ATE = arterial thromboembolic event; GI = gastrointestinal; IRR = infusion-related reaction; PRES = posterior reversible encephalopathy syndrome.

aNational Cancer Institute Common Toxicity Criteria for Adverse Events (NCI CTCAE) Criteria Version 4.0 used to identify adverse reactions.

Enclosed Prescribing Information

CYRAMZA® (ramucirumab) injection, for intravenous use, Lilly

Reference

1Cyramza [package insert]. Indianapolis, IN: Eli Lilly and Company; 2022.

Date of Last Review: May 17, 2022

Are you satisfied with this content?

Can't find what you're looking for? Contact us for answers to your medical questions.

  • Copyright
  • Terms of Use
  • Privacy Statement
  • Accessibility Statement
  • Sitemap

    This site is intended for US Healthcare Professionals only.

    4.0.17 02/2023 | GLOOTH00001 04/2015 | © Lilly USA, LLC 2023. All rights reserved.

    Product names listed above are trademarks or registered trademarks owned by or licensed to Eli Lilly and Company, its subsidiaries, or affiliates

    facebook twitter linkedin
    visit www.phactmi.org
    Lilly