Generic
Trastuzumab
8 brands available in the market
At a glance
Trastuzumab is used in the treatment of breast and stomach cancer. It works by killing cancer cells by inhibiting HER2 (human epidermal growth factor receptor protein).
Description
Trastuzumab is a recombinant IgG1 monoclonal antibody. It works against HER2 receptors which are responsible for over-proliferation of cancer cells in breast cancer and stomach cancer. It destroys cancer cells by inhibiting HER2 and downstream signaling pathways.
Indications
- Breast cancer
- Stomach cancer
Therapeutic class
Targeted Cancer Therapy
Pharmacological class
Monoclonal Antibody
Pharmacology
Trastuzumab binds to domain IV of the HER2 receptor, inhibits HER2 signaling, inhibits shedding of HER2 ECD, and mediates antibody-dependent cellular cytotoxicity (ADCC). It inhibits proliferation of HER2-overexpressing tumor cells.
Mechanism of action
Inhibits HER2 receptor, blocking cancer cell proliferation and mediating ADCC.
Dosage
Adult Dose (IV):
- Adjuvant breast cancer: 4 mg/kg over 90 minutes, then 2 mg/kg over 30 minutes weekly; one week after last weekly dose, 6 mg/kg every 3 weeks
- Metastatic breast cancer: 4 mg/kg over 90 minutes, then 2 mg/kg weekly
- Metastatic gastric cancer: 8 mg/kg over 90 minutes first cycle, then 6 mg/kg every 3 weeks
Administration
- Administered by a healthcare professional as IV infusion; do not self-administer
- Do not administer as IV push or bolus
- Do not mix with other drugs
Missed dose
If you miss a dose, consult your doctor.
Side effects
Common Side Effects:
- Anemia
- Chills
- Common cold
- Cough
- Decreased blood cells
- Diarrhea
- Fatigue
- Fever
- Headache
- Heart failure
- Infection
- Insomnia
- Nausea
- Rash
- Stomatitis
- Taste change
- Weight loss
Precautions & warnings
- Unknown if alters ability to drive; caution advised
- Use effective contraception during treatment and for 7 months after stopping
- Regular heart monitoring required
- Inform doctor if breathlessness, cough, shivering, swelling of legs and arm occur
- Consult doctor if pregnant or breastfeeding
Contraindications
- Lactation (start only 6 months after last dose)
- Do not administer by rapid IV or bolus injection
Drug interactions
- Anthracyclines: increased risk of severe cardiotoxicity
- Paclitaxel: increased risk of leukopenia and anemia; may decrease trastuzumab clearance
- Warfarin: increased risk of bleeding
Food interactions
May cause excessive drowsiness with alcohol.
Use in pregnancy
Use in Pregnancy: Unsafe; definite evidence of risk to the developing baby; consult your doctor.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably unsafe; may pass into breast milk and harm the baby; consult your doctor.
Pediatric use
Safety and effectiveness not established in pediatric patients
Geriatric use
No overall differences in safety or effectiveness
Renal / hepatic impairment
Renal Impairment: Probably safe; dose adjustment may not be needed
Hepatic Impairment: Limited information; consult your doctor
Overdose effects
Symptoms: Cardiomyopathy, infusion reactions, pulmonary toxicity.
Treatment: Supportive care.
Storage conditions
Store vials at 2-8°C in original carton; protect from light; keep out of reach of children. Reconstituted solution stable for 28 days at 2-8°C.