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Trastuzumab is used in the treatment of breast and stomach cancer. It works by killing the cancer cells by inhibiting HER2 (human epidermal growth factor receptor protein). Trastuzumab is given as an injection by a qualified medical professional. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to. The most common side effects of this medicine include nausea, headache, rash, insomnia, and infection. This medicine may reduce the number of blood cells (decrease red blood and white blood cells) in your blood, thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells along with heart, liver, and blood uric acid levels. You must have to inform your doctor if you experience breathlessness, cough, shivering, swelling of legs and arm. Many other medicines can affect, or be affected by, this medicine so let your healthcare team know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. The use of effective contraception by both males and females during treatment is important to avoid pregnancy. Trastuzumab is a recombinant IgG1 monoclonal antibody. It works against the HER2 (human epidermal growth factor receptor protein) receptors which are responsible for the over-proliferation of cancer cells in breast cancer and stomach cancer cells. It destroys the cancer cells by inhibiting HER2. It also inhibits various cancer-causing downstream signaling pathways.

• Breast cancer • Stomach cancer

Trastuzumab, a monoclonal antibody, has action directed against a cell surface protein produced by human epidermal growth factor receptor 2 (HER2). It inhibits proliferation of tumour cells that overexpress HER2 e.g. in 1/3 of breast cancer.

Adult Dose: Intravenous Breast Cancer Adjuvant treatment Indicated for adjuvant treatment of HER-2 overexpressing breast cancer Administer during and following paclitaxel, docetaxel, or docetaxel/carboplatin 4 mg/kg IV over 90 minutes, THEN 2 mg/kg IV over 30 minutes qWeek during chemotherapy for the first 12 weeks (paclitaxel or docetaxel) or 18 weeks (docetaxel/carboplatin) One week following the last weekly dose administer at 6 mg/kg as an IV infusion over 30?90 min every three weeks As single agent within three wk following completion of multi-modality, anthracycline based chemotherapy regimens: Initial dose at 8 mg/kg as an IV infusion over 90 min; subsequent doses at 6 mg/kg as an IV infusion over 30?90 min every three wks Extending adjuvant treatment beyond one year not recommended Metastatic breast cancer Treat as a single agent or in combination with paclitaxel 4 mg/kg IV over 90 minutes, THEN 2 mg/kg IV over 30 minutes qWeek Gastric Cancer Indicated for treatment of HER2-overexpressing metastatic gastric or gastroesophageal junction adenocarcinoma Administered in combination with cisplatin and capecitabine or 5-fluorouracil who have not received prior treatment for metastatic disease First cycle: 8 mg/kg IV; infuse IV over 90 min Subsequent cycles: 6 mg/kg IV q3wk; infuse IV over 30-90 min Continue q3week cycles until disease progression Child Dose: Safety and efficacy not established

Your doctor or nurse will give you this medicine. Kindly do not self administer.

If you miss a dose of Trastuzumab, please consult your doctor.

Common: • Anemia (low number of red blood cells) • Chills • Common cold • Cough • Decreased blood cells (red cells, white cells, and platelets) • Diarrhea • Fatigue • Fever • Headache • Heart failure • Infection • Insomnia (difficulty in sleeping) • Mucosal inflammation • Nausea • Rash • Stomatitis (Inflammation of the mouth) • Taste change • Upper respiratory tract infection • Weight loss

[CONSULT YOUR DOCTOR] It is not known whether Trastuzumab alters the ability to drive. Do not drive if you experience any symptoms that affect your ability to concentrate and react. It is given as an injection into your vein or under the skin, usually over 1 hour. Use effective contraception method to prevent pregnancy while taking this medicine and for 7 months after you stop the treatment. Your doctor will monitor your heart regularly while taking this medicine. Inform your doctor if you notice symptoms such as breathlessness, cough, shivering, swelling of legs and arm. Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.

Lactation (start only 6 mth after last dose of drug). Do not admin by rapid IV or bolus inj.

Increased risk of severe cardiotoxicity with anthracyclines. Increased risk of leukopenia and anaemia in combination chemotherapy (e.g. paclitaxel). Paclitaxel may decrease the clearance of trastuzumab. Increased risk of bleeding with warfarin.

[UNSAFE] Trastuzumab may cause excessive drowsiness with alcohol.

[CONSULT YOUR DOCTOR] Trastuzumab is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.

[CONSULT YOUR DOCTOR] Trastuzumab is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.

[SAFE IF PRESCRIBED] Trastuzumab is probably safe to use in patients with kidney disease. Limited data available suggests that dose adjustment of Trastuzumab may not be needed in these patients. Please consult your doctor. [CONSULT YOUR DOCTOR] There is limited information available on the use of Trastuzumab in patients with liver disease. Please consult your doctor.

If any symtom of brest cancer if have whats the cure First is confirmation of breast cancerChance of cure depends on stage of cancer BREAST CANCER , PET REPORT SAYS INFECTION IN SKELETON. Metastatic breast cancer, send me previous treatment details I am PATIENT have pain in my breastes and feel very weight before one week of my menstrual perieds date Is it any symptoms of breast cancer ? Need your advice And also having back pain during menstrual dates please give your valubel advice No it's not a symptom of breast cancer. She has breast cancer at 4 sta Dear PATIENT 4 Breast Cancer means that the cancer has spread to other parts of the body. The management of such cancers depends on the site where the cancer has spread and on the receptor status of the breast cancer. If you can share the details with me, I will be happy to let you know the potential management How to diagonise breast cancer? It should be diagnosed by mammogram and biopsy I am herewith forwarding you biopsy report, please suggest further course of treatment. U have a high risk of breast cancerSend me ur Mammography reports also left breast cancer had amplated Please write complete information I want to know the symptoms of cancer as I am a smoker Symptoms for cancer depends upon which organ involved. For smokers , definitely chronic , they have possibility to develop lung cancer, head and neck cancers, oesophagus cancer, pancreatic cancer, stomach cancer and so more on. General symptoms would be like loss of appetite, weight loss, low grade fever in some cases, chronic cough for long time.