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
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.
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.
Contraindications
- Lactation (start only 6 months after last dose)
- Do not administer by rapid IV or bolus injection
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
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.
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
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.
Therapeutic class
Targeted Cancer Therapy
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.