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Panitumumab parenteral

Updated 2 Feb 2023 | Panitumumab


Concentrate for solution for infusion containing panitumumab.

Drugs List

  • panitumumab 100mg/5ml concentrate for solution for infusion
  • panitumumab 400mg/20ml concentrate for solution for infusion
  • VECTIBIX 100mg/5ml concentrate for solution for infusion
  • VECTIBIX 400mg/20ml concentrate for solution for infusion
  • Therapeutic Indications


    Wild-type RAS metastatic colorectal cancer (monotherapy or in combination)

    For the treatment of patients with wild-type RAS (at exons 2, 3 and 4 of KRAS and NRAS) metastatic colorectal cancer (mCRC) as:

    First line treatment in combination with FOLFOX or FOLFIRI.

    Second line treatment in combination with FOLFIRI for patients who have received first line fluoropyrimidine-based chemotherapy, excluding irinotecan.

    Monotherapy after failure of fluoropyrimidine, oxaliplatin and irinotecan containing chemotherapy regimens.



    The recommended dose is 6 mg/kg of body weight given once every 2 weeks.

    Additional Dosage Information

    Before initiating treatment with panitumumab, detection of wild-type RAS (KRAS and NRAS) expression should be performed by an experienced laboratory using a validated test method.

    Dermatological reactions
    If a patient develops dermatologic reactions that are grade 3 (NCI-CTC/CTCAE) or higher or that are considered intolerable, temporarily suspend panitumumab treatment until the reactions have improved to grade 2 or lower.

    Doses can be modified as follows, or if no recovery is seen, treatment should be discontinued.

    Initial occurrence of grade 3 or higher dermatologic reaction: Withhold treatment for 1 or 2 doses. If the reaction improves to grade 2 or lower, continue infusion at 100% of original dose.

    Second occurrence of grade 3 or higher dermatologic reaction: Withhold treatment for 1 or 2 doses. If the reaction improves to grade 2 or lower, continue infusion at 80% of original dose.

    Third occurrence of grade 3 or higher dermatologic reaction: Withhold treatment for 1 or 2 doses. If the reaction improves to grade 2 or lower, continue infusion at 60% of original dose.

    Fourth occurrence of grade 3 or higher dermatologic reaction, or failure to recover to grade 2 or lower at any time: Discontinue treatment.


    For intravenous infusion after dilution only. The final concentration should not exceed 10 mg/ml.

    The recommended infusion time is approximately 60 minutes. If the first infusion is well tolerated then subsequent infusions may be administered over 30 to 60 minutes.


    Children under 18 years
    History of pulmonary fibrosis
    Interstitial lung disease
    Pulmonary fibrosis

    Precautions and Warnings

    Performance status of ECOG greater than or equal to 2
    Restricted sodium intake
    Wearing of contact lenses
    Hepatic impairment
    Pulmonary disease
    Renal impairment
    Severe dry eyes

    Refer patients with symptoms of keratitis to an ophthalmology specialist
    Sodium content of formulation may be significant
    Advise ability to drive/operate machinery may be affected by side effects
    Before initiating, ensure patient positive for wild type KRAS or NRAS
    Supplemental electrolytes may be required
    Treatment to be prescribed under the supervision of a specialist
    Consider oral antibiotic/topical steroid to treat dermatologic reactions
    Record name and batch number of administered product
    Reduce infusion rate if mild to moderate infusion reaction occurs
    Staff: Not to be handled by pregnant staff
    Monitor renal function in patients with dehydration or severe diarrhoea
    Monitor serum calcium levels during + for 8 weeks after treatment
    Monitor serum magnesium during + for 8 weeks after treatment
    Monitor serum potassium levels during and after administration
    Patients with new pulmonary symptoms should be investigated
    Severe skin reactions should be monitored for inflammation / infection
    Advise patient to inform physician if severe diarrhoea occurs
    Advise patient to report any blurred vision or any other eye symptoms
    Advise patient to report any new or worsening respiratory symptoms
    Contact doctor immediately with any signs of hypersensitivity reactions
    Discontinue / interrupt treatment if ulcerative keratitis develops
    If reactions recur/become intolerable at reduced dose discontinue treatment
    Interrupt therapy/reduce dose if grade 3 or worse skin reaction occurs
    Discontinue if evidence of interstitial lung disease
    Discontinue if severe hypersensitivity reactions occur
    Discontinue if severe skin reaction occurs
    Discontinue permanently if life threatening infusion reactions occur
    May cause impaired fertility
    Female: Contraception required during and for 2 months after treatment
    Breastfeeding: Do not breastfeed during and for 2 months after treatment
    Advise patient on appropriate sun protection methods
    Advise patient that the use of topical moisturisers may be necessary
    Advise patient to report signs / symptoms of infusion related reactions
    Advise patient to seek medical advice if delayed adverse event(s) occurs
    Avoid direct exposure to sunlight

    In the treatment of metastatic colorectal cancer, evidence of wildtype RAS status (at exons 2, 3 and 4 of KRAS and NRAS) is required before initiating treatment with panitumumab alone or in combination with other chemotherapy. Inferior progression-free survival and overall survival have been shown in patients with RAS mutations beyond KRAS exon 2 who have received panitumumab combined with FOLFOX (oxaliplatin-containing) chemotherapy versus FOLFOX alone.

    Panitumumab should be permanently discontinued if a severe (NCI-CTC grade 3 and 4) or life-threatening reaction occurs during an infusion or at any time post-infusion. For mild or moderate (NCI-CTC grade 1 and 2) infusion related reactions, the infusion rate should be reduced for the duration of that infusion and this lower infusion rate be maintained in all subsequent infusions. Patients should be informed of the possibility of a late onset reaction (more than 24 hours after infusion) and instructed to contact their doctor if symptoms of a hypersensitivity reaction occur.

    Pregnancy and Lactation


    Panitumumab is contraindicated during pregnancy.

    The manufacturer recommends that if panitumumab is used during pregnancy or if the patient becomes pregnant while being treated with panitumumab, the patient should be advised of potential risk of loss of the pregnancy or potential hazard to the foetus. At the time of writing, there are no reports of the use of panitumumab in human pregnancy. It is unknown whether panitumumab crosses the placenta (the high molecular weight suggests that it is unlikely), however, human immunoglobulin (IgG) does cross the placenta so it is possible that panitumumab may also cross from the mother to the developing foetus. Panitumumab has the potential to cause harm to the foetus when administered to pregnant women as EGFR has been implicated in the control of prenatal development. Animal studies have shown reproductive toxicity, including abortions and foetal death (Briggs 2015).


    Panitumumab is contraindicated during breastfeeding.

    The manufacturer recommends that the patient does not breastfeed during treatment and for 2 months after the last dose of panitumumab. It is unknown whether panitumumab is excreted in human breast milk, however, because human IgG is secreted into human milk so it is possible panitumumab may also be excreted. The potential for absorption and harm to the infant after ingestion is unknown.

    Side Effects

    Abdominal pain
    Acne-like eruptions
    Acute renal failure
    Aphthous stomatitis
    Back pain
    Blood pressure changes
    Blurred vision
    Chest pain
    Crusting of skin
    Decreased appetite
    Deep vein thrombosis (DVT)
    Dry eyes
    Dry lips
    Dry mouth
    Dry skin
    Exfoliative dermatitis
    Exfoliative rash
    Eye infection
    Eye irritation
    Eye pruritus
    Eyelash growth
    Eyelid reaction
    Gastroesophageal reflux disease
    Hypersensitivity reactions including anaphylaxis
    Infusion-related symptoms
    Interstitial lung disease
    Local infection
    Mucosal inflammation
    Nail disorders
    Nasal dryness
    Necrotising fasciitis
    Ocular hyperaemia
    Painful extremities
    Palmar-Plantar Erythrodysaesthesia syndrome
    Peripheral oedema
    Pruritic rash
    Pulmonary embolism
    Pustular rash
    Rectal haemorrhage
    Skin fissures
    Skin lesions
    Skin necrosis
    Skin ulcer
    Stevens-Johnson syndrome
    Toxic epidermal necrolysis
    Ulcerative keratitis
    Urinary tract infections
    Weight loss


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: July 2021

    Reference Sources

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

    Joint Formulary Committee. British National Formulary(online) London: BMJ Group and Pharmaceutical Press. Accessed on 16 July 2021.

    Summary of Product Characteristics: Vectibix 20 mg/mL concentrate for solution. Amgen Ltd. Revised September 2019.

    MHRA Drug Safety Update September 2013
    Available at:
    Last accessed: July 16, 2021

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