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Patient Brochure

YOUR INTRODUCTION TO ZIRABEV® (bevacizumab)

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Getting started on my ZIRABEV treatment

Learning about a new treatment can be a challenge. This site has been designed to answer some of the questions you may have and help you better understand what ZIRABEV is and how it works.​​​​​

What is ZIRABEV used for?

ZIRABEV is a treatment option for patients with 1 of the following:

Colon cancer:
ZIRABEV is used in combination with a specific type of chemotherapy (intravenous
5-fluorouracil [5-FU]-based chemotherapy) for treatment of people diagnosed with metastatic colorectal cancer for the first time. Metastatic colorectal cancer is cancer of the colon or rectum that has spread to other organs in the body.

Lung cancer:
ZIRABEV is used in combination with a specific type of chemotherapy (carboplatin and paclitaxel) for the treatment of people diagnosed with metastatic non-small cell lung cancer. Metastatic non-small cell lung cancer is cancer of the lungs that has spread to other organs in the body.

Platinum-sensitive ovarian cancer:
ZIRABEV is used in combination with a specific type of chemotherapy (carboplatin and gemcitabine) for the treatment of people diagnosed with recurrent, platinum-sensitive, epithelial ovarian, fallopian tube or primary peritoneal cancer that comes back at least 6 months after the last time the patient responded to a chemotherapy regimen containing a platinum agent. Epithelial ovarian cancer is cancer that develops on the surface of the ovary. Fallopian tube cancer is cancer that forms in the fallopian tubes, the small ducts that link the ovaries to the uterus. Primary peritoneal cancer is cancer of the tissue that lines the abdominal wall and covers organs in the abdomen.

Platinum-resistant ovarian cancer:
ZIRABEV is used in combination with a specific type of chemotherapy (paclitaxel, topotecan or pegylated liposomal doxorubicin) for the treatment of people diagnosed with recurrent, platinum-resistant, epithelial ovarian, fallopian tube or primary peritoneal cancer who received no more than two prior chemotherapy regimens. Recurrent platinum-resistant ovarian cancer is the type of cancer that progresses within 6 months after the last time the patient responded to a chemotherapy regimen containing a platinum agent.

Glioblastoma:
ZIRABEV is used in combination with lomustine (a specific type of chemotherapy) for the treatment of patients with a particular type of brain cancer called glioblastoma in which the cancer reoccurred after a previous treatment.

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How does ZIRABEV work?

ZIRABEV is not chemotherapy but is given in combination with a specific type of chemotherapy. ZIRABEV is a monoclonal antibody. While chemotherapy attacks the tumour directly, ZIRABEV attacks the blood vessels that surround the tumour.

In order to grow and spread, tumours need a constant supply of oxygen and other nutrients. Tumours get this supply by creating their own network of blood vessels. This process is called angiogenesis (an’-gee-o-jen’-i-sis). ZIRABEV works by blocking angiogenesis. By preventing the growth of new blood vessels, ZIRABEV helps starve the tumour of oxygen and other nutrients. This makes it hard for the tumour to grow.

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What formats are available for ZIRABEV?

ZIRABEV is available as solution for infusion in single-use vials in the presentations listed below: 

  • • 100 mg/4 mL (25 mg/mL)
  • • 400 mg/16 mL (25 mg/mL) ​​​​​

​​​​​​​The vial stopper is not manufactured with natural rubber latex.​​​​​​​​​​

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How will I receive ZIRABEV?

ZIRABEV is given intravenously (through a needle placed in a vein in the arm, hand, or through a central line).

ZIRABEV will be given to you by a healthcare professional in a healthcare setting. Do not use this medication if it looks cloudy or is leaking.

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How often will I receive ZIRABEV?

Depending on your specific type of cancer, you may receive ZIRABEV every 2 to 3 weeks with or without additional treatment. 

Colon cancer: the usual dose is based on your weight in kg (5 mg/kg) and is given once every 14 days for as long as your physician recommends therapy.

Lung cancer: the usual dose is based on your weight in kg (15 mg/kg) and on the specific type of chemotherapy given along with ZIRABEV. ZIRABEV is given once every 3 weeks for as long as your physician recommends therapy.

Platinum-sensitive ovarian cancer: The usual dose of ZIRABEV is based on your weight in kg (15 mg/kg). ZIRABEV is given once every 3 weeks for as long as your physician recommends therapy. 

Ovarian cancer (platinum-resistant recurrent disease): the usual dose is based on your weight in kg (10 mg/kg or 15 mg/kg) and is given once every 2 or 3 weeks for as long as your physician recommends therapy. Your doctor will prescribe a dose and schedule of ZIRABEV that is right for you, based on if and what type of chemotherapy you are receiving. 

Glioblastoma: The usual dose of ZIRABEV is based on your weight in kg (10 mg/kg). ZIRABEV is given once every 2 weeks, in combination with lomustine every 6 weeks for as long as your physician recommends therapy. The dose of lomustine in the first treatment is 90 mg per square metre of your body surface area (mg/m2 ), up to a maximum dose of 160 mg. It can be increased to 110 mg/m2 , up to a maximum of 200 mg, from the second treatment onwards. The increased dose of lomustine after the first treatment will be determined by your doctor based on your blood work. 

The first time ZIRABEV is given, it will take about 90 minutes. 

Once your doctor has made sure that you have no problems with the ZIRABEV infusions, (i.e., after the first or second infusion), subsequent infusions may require less time, usually about 30 or 60 minutes.

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Preparing for my next appointment 

It’s important to ask questions and let your healthcare team know if you have any concerns about your treatment. 

​​​​​​​It’s always good to keep a notebook handy so you can write down any questions or concerns that you would like to talk to your healthcare team about.

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Support may help

Support may help you navigate your treatment experience. If you’d like to join a support group, ask your healthcare team if there’s one in your area.

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Pfizer Liaison Patient Support Program 

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Additional resources

Canadian Cancer Society
The Canadian Cancer Society (CCS) is a national, community-based organization that provides information and support services to patients and families affected by cancer.

The CCS online community – Cancerconnection.ca – is a place where patients and families affected by cancer can share their experiences and build supportive relationships. No matter where you are, you can connect with others online and know that you are not alone.

Visit www.cancerconnection.ca or www.cancer.ca, or call 1-888-939-3333.

Colorectal Cancer Association of Canada
The Colorectal Cancer Association of Canada is a national non-profit organization with a threefold mandate: awareness, support, and advocacy.

Visit www.colorectalcancercanada.com or call 1-877-502-6566.

Lung Cancer Canada
Lung Cancer Canada is a national charitable organization and leader in resources for lung cancer education, patient support, research, and advocacy.

Visit www.lungcancercanada.ca or call 1-888-445-4403.

Ovarian Cancer Canada
Ovarian Cancer Canada is a Canadian organization providing leadership in research, advocacy, and support for women with ovarian cancer.

Visit www.ovariancanada.org or call 1-877-413-7970.

Brain Tumours Foundation of Canada
The Brain Tumours Foundation of Canada is a dedicated team of volunteers, patients, survivors, family members, healthcare professionals and staff, determined to help brain cancer patients along their journey.

Visit www.braintumour.ca or call 1-800-265-5106.

The suggested resources on this page do not imply an endorsement of or an association with third-party organizations and are provided for information purposes only. Pfizer is not responsible for content of non-Pfizer sites.

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Safety Information  +

Privacy Policy

Terms of Use

This website is intended for patients who are taking ZIRABEV®.

ZIRABEV® is a registered trademark of Pfizer Inc. Used under license.

© 2026 Pfizer Canada ULC, Kirkland, Québec H9J 2M5

PP-ZIR-CAN-0026-EN 

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Important Safety Information

What should I know before I take ZIRABEV?

Do not use ZIRABEV if you:

  • are allergic to it or any of its ingredients
  • have a cancer that has spread to your central nervous system (to your brain or spine)
  • had surgery within the past 28 days

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take ZIRABEV.

Talk about any health conditions or problems you may have, including if you:

  • have high blood pressure or heart problems;
  • are pregnant or planning to become pregnant ;
  • are breast feeding;
  • have any allergies to this drug or its ingredients;
  • plan to have surgery or have had surgery in the last 28 days;
  • have any allergies to this drug or its ingredients 
  • have any illnesses or diseases affecting your kidneys;
  • have heart failure or weakened heart muscles;
  • have ever coughed up blood or observed abnormal vaginal bleeding;
  • are diabetic.

What are possible side effects of ZIRABEV?

These are not all the possible side effects that you may feel when taking ZIRABEV. If you experience any side effects not listed here, contact your healthcare professional.

Like all medications, ZIRABEV can cause some unwanted side effects. The following side effects were seen in clinical trials when ZIRABEV in combination with chemotherapy or ZIRABEV alone was given to patients:

Very Common (more than 1 in 10 patients):

  • Lack of energy or strength
  • Loss of appetite
  • Sores in the mouth
  • Runny nose
  • Dry, scaling skin or changes in skin colour
  • Changes in the sense of taste
  • Difficulty sleeping
  • Chills, or excessive sweating
  • Abnormal urine test (protein in the urine)
  • Tingling sensation or numbness in toes and fingers
  • Bruising
  • Change in moods
  • Weight loss
  • Tiredness

Common (fewer than 1 in 10 patients but more than 1 in 100 patients):

  • Altered voice, such as hoarseness
  • Swelling and numbness of the hands and feet

Frequency unknown:

  • Ulcers in the stomach and bowel

    If your blood pressure increases while you are taking ZIRABEV, it is important to contact your doctor.

    Changes in your blood and urine tests done by your doctor may occur while you are receiving ZIRABEV. These changes may include a lower white cell count and protein in the urine. Your doctor will discuss these results with you.

    Elderly patients (65 years or older) have a greater risk of developing the following side effects: blood clots (that may lead to stroke or heart attack), a decrease in certain white blood cells and platelets, protein in the urine, diarrhea, and fatigue.

    Stop taking ZIRABEV right away and get medical help if you experience any of the following serious side effects.

    Serious side effects and what to do about them

    Symptom / effect

    Talk to your healthcare
    professional

    Stop taking
    drug and get
    immediate help

    Only if severe

    In all cases

    VERY COMMON

    High blood pressure: You may not experience any symptoms, but possible symptoms associated with high blood pressure are: headache, blurred vision, fatigue, irregular fast, hard heartbeats

    Bleeding from the nose that lasts for more than 10-15 minutes and cannot be stopped

    Diarrhea

    Vomiting

    Constipation

    Bleeding from the rectum or stomach: Symptoms include fresh blood in stools and/or dark stools

    Decreased number of white blood cells: Symptoms could include fever, sore throat, infection

    Decreased number of red blood cells in the blood that carry oxygen: Symptoms could include feeling of weakness or fatigue in general or during exercise, poor concentration

    Pain: chest pain, back pain, abdominal pain, muscle pain, joint pain

    Low blood pressure: You may not experience any symptoms, but possible symptoms associated with low blood pressure are: lightheadedness, dizziness, fainting

    Dilation (widening of the blood vessels): Symptoms may include low blood pressure, dizziness, flushing

    Weakened heart muscle/loss of the heart’s pumping ability: shortness of breath, fatigue, persistent coughing or wheezing, increased heart rate, swelling in the feet or ankles

    Eye problems: for example: excessive tearing, blurred vision, an experience of discomfort or pain to the eyes

    Bronchitis: an inflammation of the main air passages to the lungs

    Infections: mouth, throat, sinus, lungs or urine infections

    Excess of sugar in the blood: symptoms may include frequent hunger, frequent thirst, frequent urination

    Coughing

    COMMON

    Perforation of the gut (leakage of the bowel): sudden onset of abdominal pain, abdominal tenderness with vomiting, high fever, constipation, vomiting  

    Allergic reactions: difficulty in breathing, chest pain, redness or flushing of the skin, rash, shivering, nausea, vomiting

    Urinary (bladder or kidney) infection

    Infections of the skin or deeper layers under the skin

    Fistula: abnormal tube-like connection between internal parts of the body that are not normally connected such as between the stomach and the intestines (gastrointestinal fistula), in patients with metastatic colorectal cancer and recurrent ovarian cancer, and the vagina and the gut in patients with cervical cancer (unauthorized use)

    Blood clots: In the deep veins of the leg, symptoms include: pain, swelling, warm to the touch, and tenderness of the leg. In the lung, symptoms include: shortness of breath, chest pain, light headedness

    Stroke or heart attack: Symptoms of stroke include: sudden loss of speech or numbness of part or all of the body, loss of vision or blurred vision, unexplained dizziness and/or sudden falls. Symptoms of a heart attack include: chest pain with spreading to the left arm, jaw and/or back, shortness of breath

    Hemorrhage: gastrointestinal bleeding, significant blood in vomit, bleeding from rectum or stomach (fresh blood in stools or dark stool), bleeding from the nose that lasts more than 10-15 minutes and cannot be stopped, spitting of blood

    Wounds opening and not healing: the skin near a surgical area can appear fully or partially open

    Nephrotic syndrome: swelling in the face, arms, legs, belly area, foamy appearance of urine and poor appetite

    Pain: in the pelvis and anal regions

    UNCOMMON

    Non-gastrointestinal perforations and fistulae: Depending on the organs involved, the symptoms could be: leakage of urine, abnormal and bad odor in the genital area, abdominal pain, vomiting, fever, gradually increasing/worsening of shortness of breath (dyspnoea), cough, chest pain, yellowish discoloration of the skin, etc.

    Posterior Reversible Encephalopathy Syndrome (PRES): headache, confusion, seizures and visual loss

    RARE

    Tracheoesophageal fistula: abnormal tube like connection between internal parts of the body that are not normally connected) such as between the trachea (or windpipe) and esophagus (tube connecting the mouth to the stomach)

    Severe bacterial infection of the skin and soft tissue: necrotizing fasciitis

    Bleeding: in the brain

    FREQUENCY UNKNOWN

    Jaw bone damage resulting from poor blood supply to the jaw bone

    Perforation in the gallbladder: hole in the digestive organ that stores bile


    If you have a troublesome symptom or side effect that is not listed here or if it becomes bad enough to interfere with your daily activities, talk to your healthcare professional


        Serious warnings and precautions

        Be sure to contact your healthcare team if there are any signs of these side effects:

        EYE DISORDERS

        EYE DISORDERS
        ZIRABEV was not developed to be injected in the eye and should be used as authorized. Side effects affecting the eye and the body as a whole were seen in some patients who had bevacizumab injected in one or both of their eyes.

        GASTROINTESTINAL PERFORATIONS

        GASTROINTESTINAL PERFORATIONS
        ZIRABEV treatment can cause gastrointestinal perforation (a hole in the stomach or bowel), which can be fatal. ZIRABEV treatment should be stopped if this happens. Gastrointestinal perforation can happen at any time during treatment. Symptoms include abdominal pain, constipation, and vomiting.

        WOUND HEALING COMPLICATIONS

        WOUND HEALING COMPLICATIONS
        ZIRABEV treatment can cause wound dehiscence (wounds opening and not healing), which can be fatal. ZIRABEV treatment should be stopped if this happens and for one month after having surgery or until the wound is fully healed. ZIRABEV should be stopped at least 28 days before elective surgery.

        HEMORRHAGE (BLEEDING)

        HEMORRHAGE (BLEEDING)
        Treatment with ZIRABEV can result in serious or fatal bleeding, including coughing up blood, bleeding in the stomach, vomiting of blood, bleeding in the brain, nosebleeds, and vaginal bleeding. These events occurred up to 5 times more often in people who received bevacizumab compared to patients who received only chemotherapy. People who have recently coughed up blood (greater than or equal to a half teaspoon of red blood) or have serious bleeding should not receive ZIRABEV. Treatment with ZIRABEV should be permanently stopped if serious bleeding occurs (i.e., requiring medical attention).