Ramucirumab Injection
Ramucirumab is a targeted cancer medicine used intravenously to treat certain advanced or metastatic gastric, lung, colorectal, and liver cancers.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
📖 Ramucirumab Injection: Patient Information Guide
A plain-language walkthrough of Ramucirumab Injection — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Ramucirumab (given as Cyramza injection) is approved to treat several types of advanced cancer in adults. All uses are specific to Cyramza administered by intravenous infusion.
- Cyramza is used alone or combined with paclitaxel for advanced or metastatic gastric (stomach) cancer or gastro-esophageal junction (GEJ) adenocarcinoma that has progressed during or after fluoropyrimidine- or platinum-based chemotherapy.
- Cyramza combined with erlotinib is a first-line option for metastatic non-small cell lung cancer (NSCLC) in patients whose tumors carry EGFR exon 19 deletions or exon 21 (L858R) mutations.
- Cyramza combined with docetaxel treats metastatic NSCLC that has progressed on or after platinum-based chemotherapy. Patients with EGFR or ALK tumor mutations must have already tried an FDA-approved targeted therapy for those mutations first.
- Cyramza combined with FOLFIRI (irinotecan, folinic acid, and fluorouracil) treats metastatic colorectal cancer that has progressed after prior treatment with bevacizumab, oxaliplatin, and a fluoropyrimidine.
- Cyramza alone treats hepatocellular carcinoma (a type of liver cancer) in patients with an alpha-fetoprotein (AFP) level of 400 ng/mL or higher who have previously received sorafenib.
⚙️How it works▾
Ramucirumab targets and blocks a protein on blood vessel cells called VEGFR2 (vascular endothelial growth factor receptor 2). Tumors send out chemical signals — including VEGF-A, VEGF-C, and VEGF-D — that activate VEGFR2 to trigger the growth of new blood vessels, a process called angiogenesis. Ramucirumab binds directly to VEGFR2 and blocks those signals from getting through, which prevents new blood vessel formation. Without a growing blood supply, tumors have less ability to expand and spread.
💊How it's taken▾
Cyramza is given as an intravenous (IV) infusion at an infusion clinic or cancer center — it is not a pill or a shot you give at home. The infusion schedule depends on the cancer being treated and what other medicines are given alongside it; most regimens involve infusions every 2 weeks or on a set cycle. The first infusion is typically given over 60 minutes; if that is well tolerated, later infusions may be shorter.
- Patients receive premedication before every infusion to lower the risk of an infusion reaction.
- Cyramza is continued until the cancer progresses or side effects become unacceptable.
- Your oncology team will manage any dose adjustments needed based on side effects — do not adjust on your own.
🤒Side effects — in detail▾
Side effects vary depending on whether Cyramza is given alone or with another chemotherapy agent. Common ones reported across studies include:
- High blood pressure (hypertension)
- Fatigue or weakness
- Diarrhea
- Nosebleeds (epistaxis)
- Mouth sores (stomatitis or mucosal inflammation)
- Nausea
- Decreased appetite
- Swelling in the legs or feet (peripheral edema)
- Low white blood cell counts (neutropenia) — especially when combined with chemotherapy
- Infections
More serious reactions — including severe bleeding, gastrointestinal perforation, arterial blood clots, infusion reactions, and signs of a rare brain condition (PRES) — require immediate medical attention. Contact your care team right away if you experience anything sudden or severe.
⚠️Warnings & precautions▾
- Bleeding: Cyramza significantly raises the risk of serious or fatal bleeding, including in the stomach and intestines. Severe bleeding means treatment must be stopped permanently.
- Gastrointestinal perforation: A hole can form in the stomach or intestinal wall — a potentially fatal emergency requiring permanent discontinuation.
- Arterial blood clots: Serious and sometimes fatal clotting events (such as heart attack or stroke) can occur. Cyramza must be stopped permanently if this happens.
- High blood pressure: Blood pressure is monitored throughout treatment. Severe or uncontrollable high blood pressure requires pausing or stopping Cyramza.
- Wound healing problems: Cyramza can interfere with healing. It should be stopped at least 28 days before elective surgery and not restarted for at least 2 weeks after surgery.
- Infusion reactions: Reactions during the IV drip can range from mild (managed by slowing the infusion) to severe (requiring permanent discontinuation).
- Liver worsening: Patients with Child-Pugh B or C cirrhosis may experience worsening liver function, including new or worsening encephalopathy (confusion from liver disease), fluid buildup (ascites), or kidney failure related to liver disease.
- PRES (posterior reversible encephalopathy syndrome): A rare but serious brain condition — symptoms include sudden confusion, vision changes, or seizures. Requires permanent discontinuation.
- Proteinuria and kidney effects: Protein in the urine is monitored regularly. Very high levels or nephrotic syndrome (a serious kidney condition) require stopping Cyramza.
- Fetal harm: Cyramza can cause serious harm to an unborn baby. Effective contraception is required during treatment and for 3 months after the last dose.
🔀What it interacts with▾
Based on the label, there are a few important drug interactions and cautions to be aware of with Cyramza:
- NSAIDs (ibuprofen, naproxen, etc.): May increase the risk of stomach or intestinal bleeding, particularly in patients with gastric cancer. These patients were excluded from some Cyramza trials.
- Therapeutic anticoagulants (blood thinners): Patients on anticoagulation were excluded from certain Cyramza lung cancer studies, so the combined bleeding risk is not fully known — discuss with your doctor.
- Anti-platelet medicines: Drugs beyond low-dose daily aspirin were excluded from several studies; talk with your prescriber before using them.
- Combination chemotherapy partners (paclitaxel, docetaxel, irinotecan, erlotinib): Clinical studies showed no meaningful changes in how Cyramza or these drugs are processed when used together, but these combinations still require close monitoring for overlapping side effects.
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Pregnancy: Cyramza can cause serious harm to a fetus — tell your doctor immediately if you are pregnant or become pregnant during treatment.
- Breastfeeding: Do not breastfeed during treatment or for 2 months after the last dose due to potential risk to the infant.
- Women of childbearing potential: Use reliable contraception during treatment and for 3 months after the last Cyramza dose. Cyramza may also impair fertility based on animal data.
- Liver disease: Patients with moderate or severe liver impairment (especially Child-Pugh B or C cirrhosis) are at higher risk of serious complications — tell your doctor about any liver conditions.
- Upcoming surgery: Tell your surgeon and oncologist — Cyramza must be stopped well before elective surgery to reduce wound healing risks.
- High blood pressure: Pre-existing high blood pressure should be controlled before starting Cyramza, and blood pressure must be monitored throughout treatment.
- Children: Safety and effectiveness have not been established in pediatric patients.
- Kidney problems: Mild to moderate kidney impairment did not meaningfully affect how the body handles Cyramza, but urine protein levels are monitored during treatment.
🔬Pharmacokinetics — how your body processes it▾
Ramucirumab is given intravenously and distributes into a relatively small volume of the body (about 5.4 liters on average), consistent with it staying mostly in the bloodstream rather than spreading widely into tissues. It has a long elimination half-life of about 14 days, meaning it takes roughly two weeks for half of the drug to leave the body. Steady-state levels — where the amount entering and leaving the body is balanced — are reached after about 12 weeks of regular dosing. Age, sex, race, mild-to-moderate kidney impairment, and mild-to-moderate liver impairment do not meaningfully change how ramucirumab behaves in the body; the effect of severe liver impairment is not yet known.
📦How to store it▾
Store vials in a refrigerator at 2°C to 8°C (36°F to 46°F) in the original carton to protect from light until time of use. Do not freeze or shake the vial.
📄 Written from Ramucirumab Injection’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Ramucirumab Injection — the kind of thing our pharmacy team would talk through with you at the counter.
What exactly does Cyramza do, and why was it prescribed for me? ▾
How will I actually receive this medicine — do I take it at home? ▾
What side effects should I expect, and which ones mean I should call someone right away? ▾
I'm having surgery soon — does Cyramza affect that? ▾
Can I get pregnant or breastfeed while on Cyramza? ▾
Are there any medicines or supplements I should avoid while on Cyramza? ▾
Is Ramucirumab Injection available over the counter? ▾
When was Ramucirumab Injection first available? ▾
💬 Answers drafted from Ramucirumab Injection’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
💊 How Ramucirumab Injection comes
Ramucirumab Injection is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Injection
How this form is used
- Cyramza is used alone or with paclitaxel for advanced or metastatic gastric or gastro-esophageal junction cancer after prior chemotherapy
- Cyramza is used with erlotinib as first-line treatment for metastatic non-small cell lung cancer with specific EGFR mutations
- Cyramza is used with docetaxel for metastatic non-small cell lung cancer after platinum-based chemotherapy
- Cyramza is used with FOLFIRI for metastatic colorectal cancer after certain prior treatments, and alone for hepatocellular carcinoma in eligible patients
- Cyramza is given only as an intravenous infusion — never as a rapid IV push or bolus
- Cyramza infusions are administered through a separate infusion line using an infusion pump, typically over 60 minutes for the first dose
- Patients must receive premedication before every Cyramza infusion to reduce infusion reaction risk
- Cyramza must be diluted only with 0.9% Sodium Chloride — do not use dextrose-containing solutions, and do not shake the bag
📊 Ramucirumab Injection across the U.S. market
How Ramucirumab Injection appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
📈 How widely Ramucirumab Injection is used
A general measure of how commonly Ramucirumab Injection is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Ramucirumab Injection is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Ramucirumab Injection prescribed? Of the 1,596 medications we measure, Ramucirumab Injection ranks #1,180 by Medicaid prescriptions — more than 26% of them.
Utilization by Ramucirumab Injection product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
10 ML ramucirumab 10 MG/ML Injection Most dispensed
Summed across the 1 of 1 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1657775
50 ML ramucirumab 10 MG/ML Injection
Summed across the 1 of 1 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1657780
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Ramucirumab Injection, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 2 of 2 listed Ramucirumab Injection NDCs with Medicaid activity.
🔍 Compare Ramucirumab Injection products
A representative set of FDA-listed product records for Ramucirumab Injection — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Injection | ||||
| 10 mg/mL | Intravenous | Eli Lilly and Company × 6 listings | BLA | View NDC → |
Showing 6 of 6 products — FDA National Drug Code Directory. See every product, package size and price: browse all 6 Ramucirumab Injection NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Ramucirumab Injection — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Ramucirumab Injection in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Ramucirumab Injection went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 1535922 1 dose form · 2 strengths
-
Dose form (SCDF) Injection RxCUI 1657774In current FDA listingsClinical drug / strength (SCD) 10 ML ramucirumab 10 MG/MLRxCUI 165777550 ML ramucirumab 10 MG/MLRxCUI 1657780
Look up RxCUI 1535922 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Supply & shortage status
Whether Ramucirumab Injection is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
RxNorm drug class
Ramucirumab Injection belongs to the Vascular Endothelial Growth Factor Receptor 2 Antagonist class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Eli Lilly and Company is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.