Trastuzumab
Cytostatic · Monoclonal antibody
Indications
Metastatic breast cancer. Metastatic gastric cancer.
Dosage
Adults: Metastatic breast cancer: 4 mg/kg by IV infusion over 90 min. Maint: 2 mg/kg IV over 30 min every wk. Metastatic gastric cancer, HER2+: In combination with cisplatin and either capecitabine or fluorouracil for 6 cycles followed by trastuzumab monotherapy: Initially, 8 mg/kg infused by IV route over 90 mins followed by maintenance dose 6 mg/kg infused over 30-90 mins every 3 wks until disease progression. Children: Not recommended.
Administration
Do not give as an IV push or bolus. Administered by IV inf loading doses or infused over 90 min; maintenance doses may be infused over 30 min if tolerated. Reconstitution: Reconstitute each 440 mg vial with 20 mL of bacteriostatic water for injection, containing benzyl alcohol 1.1% as a preservative, to yield a multidose solution containing trastuzumab 21 mg/mL. In patients with hypersensitivity to benzyl alcohol, reconstitute with 20 mL of SWFI without preservative to yield a single-use solution. Using a sterile syringe, slowly inject 20 mL of the diluents into the vial containing the lyophilized cake of trastuzumab. The stream of diluent should be directed into the lyophilized cake. Swirl the vial gently to aid reconstitution. Do not shake. Slight foaming may be present upon reconstitution. Allow the vial to stand undisturbed for approximately 5 min. Stability: Vials are stable at…
Adverse Effects
Headache, neutropenia, sepsis, CNS disorders, skin reactions, pneumonia, renal disorders, hepatitis, oedema, anorexia, weight loss, flu-like syndrome, infections, blood dyscrasias,, anxiety, depression, insomnia, abnormal thinking, tremor, dizziness, paraesthesia, dysgeusia, peripheral neuropathy, hypertonia, somnolence, ataxia, conjunctivitis, dry eye, increased lacrimation, BP changes, arrhythmia, palpitation, reduced LVEF, CHF, cardiomyopathy, hot flush, vasodilatation, respiratory disorders, GI upset, dry mouth, lip and face swelling, mucosal inflammation, pancreatitis, haemorrhoids, hepatitis, hepatocellular injury, liver tenderness, skin and nail disorders, alopecia, pain (abdominal, chest, musculoskeletal, extremity), arthritis, muscle tightness, muscle spasm, renal disorder, mastitis, asthenia, chills, fatigue, inf-related reactions, pyrexia, malaise, contusion. Reports of…
Risk Factor (Pregnancy/Lactation)
Pregnancy: No evidence of risk in humans. Lactation: Contraindicated or not recommended. Contraindications: In early breast cancer: also, history of MI, angina, CHF, LVEF <55%, other cardiomyopathy, arrhythmia, clinically significant cardiac valvular disease, poorly controlled hypertension, haemodynamic effective pericardial effusion. Hypersensitivity to murine proteins, severe dyspnoea. Precautions: Cardiovascular disease, congestive heart failure, left ventricular dysfunction, hypertension, coronary artery disease, uncontrolled arrhythmias, LVEF <55%, older age. Monitor cardiac function before and every 3 months during treatment. Continue monitoring every 6 months for 2 years after stopping treatment and for 5 years in early breast cancer if anthracyclines are used. Pneumonitis. Monitor for inf reactions for 6 hrs after first inf and 2 hrs after subsequent inf. Risk of late-onset inf…
Interactions
Anthracyclines, cyclophosphamide.
Advice to Patient
This medication is administered by infusion. Avoid highly crowded places to prevent infection. Consult prescriber for mild analgesic to relieve headache, joint pain or back pain. Report immediately any adverse effects occurring during infusion such as nausea, vomiting, chills, fever, headache, back pain, difficulty in breathing. Contact prescriber if there is persistent GI upset, runny nose, sore throat, chest pain, palpitations, irregular heartbeat, weakness, numbness or pain in muscle or joint, unusual weight gain, swelling of extremities, itching or pain on urination, skin rash or irritation, unusual bruising or bleeding, unhealed sores, white plaques in mouth or genital area.
Pharmacokinetics
In most patients, trastuzumab concentrations will decrease to approx. 3% (97% washout) by 7 months following discontinuation.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.