<p><strong>Hemorrhage</strong>: Ramucirumab increases the risk of hemorrhage and gastrointestinal hemorrhage, including severe and fatal events. Permanently discontinue Ramucirumab in patients who experience severe bleeding.<br />
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<strong>Gastrointestinal Perforations</strong>: Ramucirumab increases the risk of gastrointestinal perforation, which can be fatal. Permanently discontinue Ramucirumab in patients who experience a gastrointestinal perforation.<br />
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<strong>Impaired Wound Healing</strong>: Withhold Ramucirumab for 28 days prior to elective surgery. Do not administer Ramucirumab for at least 2 weeks following a major surgical procedure and until adequate wound healing. The safety of resumption of Ramucirumab after resolution of wound healing complications has not been established.<br />
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<strong>Arterial Thromboembolic Events (ATEs)</strong>: Serious and sometimes fatal ATEs can occur with Ramucirumab. Permanently discontinue Ramucirumab in patients who experience an ATE.<br />
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<strong>Hypertension</strong>: Monitor blood pressure and treat hypertension. Withhold Ramucirumab for severe hypertension. Permanently discontinue Ramucirumab for hypertension that cannot be controlled with antihypertensive therapy and for hypertensive crisis or hypertensive encephalopathy.<br />
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<strong>Infusion-Related Reactions (IRR)</strong>: Monitor for signs and symptoms during infusion. Reduce the infusion rate for Grade 1 or 2 IRR and permanently discontinue for Grade 3 or 4 IRR.<br />
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<strong>Worsening of Pre-existing Hepatic Impairment</strong>: New onset or worsening encephalopathy, ascites or hepatorenal syndrome can occur in patients with Child-Pugh B or C cirrhosis.<br />
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<strong>Posterior Reversible Encephalopathy Syndrome</strong>: Permanently discontinue Ramucirumab.<br />
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<strong>Proteinuria Including Nephrotic Syndrome</strong>: Monitor for proteinuria. Withhold Ramucirumab for urine protein levels greater than or equal to 2 g per 24 hours. Permanently discontinue Ramucirumab for urine protein levels greater than 3 g per 24 hours or nephrotic syndrome.<br />
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<strong>Thyroid Dysfunction</strong>: Monitor thyroid function during treatment.<br />
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<strong>Embryo-Fetal Toxicity</strong>: Can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception.</p>