What is this medication?
Trastuzumab, Herceptin/Herzuma/Kanjinti/Ogivri/Trazimera (US/CDN)/Ontruzant (US)
Antineoplastic Agent, Monoclonal Antibody
Indicated for treatment of breast cancer, and gastric cancer.
Note: Herzuma (trastuzumab-pkrb), Kanjinti (trastuzumab-anns), Ogivri (trastuzumab-dkst), Ontruzant (trastuzumab-dttb), and Trazimera (trastuzumab-qyyp) are approved as biosimilars to Herceptin (trastuzumab). In Canada, Herzuma, Ogivri, and Trazimera are biosimilars to Herceptin (trastuzumab).
“Alert: Box Warning
Trastuzumab, Herceptin/Herzuma/Kanjinti/Ogivri/Trazimera/Ontruzant has caused heart failure when used with anthracycline-containing chemotherapy regimens.
Trastuzumab, Herceptin/Herzuma/Kanjinti/Ogivri/Trazimera/Ontruzant administration can result in a serious and/or fatal infusion reaction and pulmonary toxicity.
Exposure to trastuzumab products during pregnancy can result in oligohydramnios and oligohydramnios sequence manifesting as pulmonary hypoplasia, skeletal abnormalities, and neonatal death. Advise patients of these risks and the need for effective contraception.”
How does this medication work?
Trastuzumab, Herceptin/Herzuma/Kanjinti/Ogivri/Trazimera/Ontruzant is a monoclonal antibody which binds to the extracellular domain of the human epidermal growth factor receptor 2 protein (HER-2); it mediates antibody-dependent cellular cytotoxicity by inhibiting proliferation of cancer cells which overexpress HER-2 protein.
How should I take this medication?
Usual (IV): Initial loading of 4mg/kg infused over 90 minutes followed by a maintenance dose of 2mg/kg infused over 30 minutes weekly.
Note: The dose, length of therapy is dependent on indication and concurrent drug treatment. Do not substitute conventional trastuzumab products for or with ado-trastuzumab emtansine, fam-trastuzumab deruxtecan, pertuzumab/trastuzumab/hyaluronidase, or trastuzumab/hyaluronidase; products are different and are not interchangeable. Herzuma (trastuzumab-pkrb), Kanjinti (trastuzumab-anns), Ogivri (trastuzumab-dkst), Ontruzant (trastuzumab-dttb), and Trazimera (trastuzumab-qyyp) are approved as biosimilars to Herceptin. In Canada, Herzuma, Ogivri, and Trazimera are biosimilars to Herceptin (trastuzumab)
How to Take: Administer by IV infusion; loading doses are infused over 90 minutes; maintenance doses may be infused over 30 minutes if tolerated. Do not administer with D5W. Do not administer IV push or by rapid bolus. Do not mix with any other medications.
What should I watch for while using this medication?
Before starting Trastuzumab, Herceptin/Herzuma/Kanjinti/Ogivri/Trazimera/Ontruzant make sure your physician is aware of any allergies or medications you currently take, and current medical conditions. Trastuzumb has caused serious adverse reactions such as cardiomyopathy, Hepatitis B virus reactivation, infusion reactions, pulmonary toxicity, and renal toxicity. When Trastuzumab is used in combination with myelosuppressive chemotherapy, trastuzumab may increase the incidence of neutropenia (moderate-to-severe) and febrile neutropenia. The incidence of anemia may be higher when trastuzumab is added to chemotherapy.
What if I miss a dose?
If a dose is missed by 1 week or less, the usual maintenance dose (based on the patient's schedule) should be administered as soon as possible. Do not wait until the next planned cycle. Subsequent Herceptin maintenance doses should be administered 7 days or 21 days later according to the patient's schedule
If a dose is missed by more than 1 week, Herceptin should be reloaded using the appropriate loading dose administered over approximately 90 minutes.
How should I store this medication?
Vials are stable at 2-8°C (36-46°F) prior to reconstitution. Do not use beyond the expiration date stamped on the vial. A vial reconstituted with BWFI, as supplied, is stable for 28 days after reconstitution when stored refrigerated at 2-8°C (36-46°F), and the solution is preserved for multiple use. Discard any remaining multi-dose reconstituted solution after 28 days. If unpreserved SWFI (not supplied) is used, the reconstituted solution should be used immediately and any unused portion must be discarded. Do not freeze reconstituted solution.
The solution for infusion diluted in polyvinylchloride or polyethylene bags containing 0.9% Sodium Chloride Injection, USP, may be stored at 2-8°C (36-46°F) for up to 24 hours prior to use.
What are the possible side effects of using this medication?
Decrease left ventricular ejection fraction, cardiac failure, arrhythmia, pain, chills, headache, insomnia, dizziness, skin rash, nausea, diarrhea, vomiting, abdominal pain, anorexia, infection, weakness, back pain, cough, dyspnea, rhinitis, pharyngitis, fever and infusion related reactions
Note this is not a complete list of side effects, only the most common.
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