Medical Oncologist
While you are on Bevacizumab
Tests and Monitoring — While You Are on Bevacizumab
Bevacizumab requires blood pressure and urine protein checks before every cycle, alongside standard blood tests. These are not routine formalities — they watch for the two most common ways this drug can affect your body, and a raised result may change whether your next infusion goes ahead.
Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed August 2026
- Before every cycle — Blood pressure, urine protein, and blood tests are checked before each infusion.
- Blood pressure is watched closely — Bevacizumab commonly raises blood pressure, and this needs to be controlled before treatment continues.
- Kidney filtering is monitored — A urine dipstick checks whether protein is leaking through the kidney's filtering layer.
- Surgery needs advance notice — Bevacizumab must be paused before and after any surgery, including minor procedures.
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Before each bevacizumab cycle, your team checks your blood pressure, tests a urine sample for protein, and takes blood for kidney function and a full blood count. These three checks watch for the side effects most associated with this drug. A raised result on any of them may delay your infusion while your team decides the safest next step.
Which tests are checked before every bevacizumab cycle?
| Test | How often | What it watches for | What a change means |
|---|---|---|---|
| When monitoring begins | From your first cycle | A baseline reading is taken so your team has a normal reference for you | All later results are compared against your personal baseline, not a population average |
| Blood pressure | Before every cycle — and at home if your team advises it | Raised blood pressure is a common effect of bevacizumab on blood vessel walls | A new or worsening elevation is reviewed before your infusion proceeds. A blood pressure medicine may be started or adjusted. |
| Urine protein (dipstick) | Before every cycle | Whether protein is leaking through the kidney's filtering layer | A raised dipstick result triggers a more precise 24-hour urine collection to measure how much is leaking per day |
| 24-hour urine protein | When the dipstick is raised | How much protein the kidney is losing each day | A large daily loss signals that treatment may need to be paused or stopped while the kidneys recover |
| Full blood count | Before every cycle | Red cells, white cells and platelets | Low counts may delay your infusion until they recover to a safe level |
| Kidney function (creatinine) | Before every cycle | How well the kidneys are filtering waste from the blood | A rising result is assessed alongside the urine protein to decide whether the dose continues |
What happens at your appointment before each infusion?
Blood pressure check on arrival
A nurse checks your blood pressure as you arrive, before anything else. If it is raised, your team addresses it before your infusion is prepared.
Urine dipstick test
You provide a small urine sample. The dipstick result is usually available within a few minutes and tells your team whether a further urine collection is needed.
Blood draw for pre-cycle tests
A blood sample is taken for your full blood count and kidney function. This is usually done early in your visit so results are ready before your infusion slot.
Results reviewed by your team
A nurse or doctor checks all results before your infusion is authorised. If any result needs attention, you are told before treatment goes ahead.
Infusion proceeds or is held
If all results are within the acceptable range, your bevacizumab is prepared and given. If a result needs review first, your team will explain what happens next and give you a revised timeline.
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What symptoms should you report between cycles?
Headache, changes in your vision, or confusion between cycles can be signs of blood pressure that has risen since your last check. Call your team the same day — do not wait for your next scheduled appointment.
Any bleeding beyond the very minor — nosebleeds that do not stop within a few minutes, blood you cough up, or blood in your urine or stool — needs a same-day call.
Pain, redness, or swelling in one leg, or sudden shortness of breath, are possible signs of a blood clot and need urgent assessment rather than a wait-and-see approach.
If you have a wound from recent surgery that seems to be healing poorly or has reopened, tell your team before your next cycle — not after it.
Why does bevacizumab need to be paused before and after surgery?
Bevacizumab works by blocking the protein that signals new blood vessel growth. That same mechanism slows the tissue formation that a wound needs to close and heal.
For this reason, NCCN and ASCO guidance recommends pausing bevacizumab before planned surgery and waiting until the wound has healed before restarting. Your surgeon and oncologist agree the timing between them.
Tell both teams if any procedure is planned — including a dental extraction, a biopsy, or an endoscopy — so the pause can be built into your schedule rather than discovered afterwards.
Did you know?
Bevacizumab blocks VEGF, a protein that tumours use to grow a blood supply. VEGF also helps regulate blood pressure and kidney filtration in healthy tissue — which is why those two functions are checked at every single cycle, not just at the start of treatment.
ESMO and NCCN list blood pressure and proteinuria monitoring among the most consistent requirements for any anti-VEGF agent in active use.
Source: ESMO Clinical Practice Guidelines; NCCN Guidelines for Bevacizumab-Containing Regimens
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Common questions
Frequently asked questions
Can my bevacizumab be delayed because of a blood pressure or urine result?
Yes, and this is a safety check, not a complication. A raised blood pressure or protein in the urine means your team needs to decide whether your body is ready for the next dose. In many cases treatment resumes once the result has been managed — blood pressure medication adjusted, or a repeat urine test reviewed. The check exists to protect your kidneys and cardiovascular system, and a brief pause is safer than continuing without that review.
Does my team want me to check my blood pressure at home between cycles?
Your team may ask for home readings, particularly if you have had a raised result before or if a blood pressure medicine has recently been started or adjusted. If home monitoring was discussed at your last appointment, bring those readings to your next one — even a photograph of the machine's memory log is useful. If no one has mentioned it yet, ask at your next visit whether it is recommended for you specifically.
What happens if I have too much protein in my urine?
A raised dipstick result is followed by a 24-hour urine collection, where you collect all your urine over one day into a container the clinic provides. That measurement tells your team how much protein is leaking each day. Most patients with a mildly raised dipstick have a small amount that is watched rather than acted on immediately. A large daily loss may mean pausing or stopping bevacizumab until the kidneys recover.
Is it safe to have a dental procedure while on bevacizumab?
Tell your oncologist and your dentist before any dental work is planned. Bevacizumab slows wound healing and affects how blood vessels respond to injury, and even a routine extraction is a wound. In most cases, minor dental work can be done safely with appropriate timing and communication between both teams. The risk is manageable when it is anticipated — and easily overlooked when it is not.
How long does monitoring continue after I finish bevacizumab?
Bevacizumab remains in the body for some weeks after the last dose, and blood pressure changes can persist beyond the end of treatment. Your team will advise how long monitoring continues in your case — it is not typically stopped on the day of your last infusion. If you are transferring to a different hospital or treating team, make sure they know you have been on bevacizumab and when the last dose was given.