WARNING

Trastuzumab injection is a medication used to treat certain types of cancer, particularly breast cancer that is HER2-positive. While generally effective, there are risks associated with its use:

• Cardiotoxicity: Trastuzumab can affect the heart, leading to heart failure or weakening of the heart muscle. Monitoring heart function during treatment is essential.
• Infusion Reactions: Some individuals may experience infusion reactions, such as fever, chills, nausea, vomiting, headache, or shortness of breath, during or after receiving the injection.
• Decreased Blood Cell Counts: Trastuzumab can lower the levels of certain blood cells, increasing the risk of infection, anemia, or bleeding.
• Lung Problems: Rarely, trastuzumab may cause lung problems such as pneumonitis or pulmonary toxicity, leading to difficulty breathing.
• Risk During Pregnancy: Trastuzumab can harm an unborn baby, so it’s important to avoid its use during pregnancy unless the potential benefits outweigh the risks.
• Allergic Reactions: Some individuals may experience allergic reactions to trastuzumab, which can range from mild to severe.
• Liver Problems: Trastuzumab may cause liver damage in some cases, leading to elevated liver enzymes or liver dysfunction.
• Increased Risk of Infections: Trastuzumab can weaken the immune system, making individuals more susceptible to infections.

It’s crucial for patients to discuss these risks with their healthcare provider and weigh them against the potential benefits of treatment. Close monitoring and communication with healthcare professionals can help manage these risks effectively.

Why is this medication prescribed?

Trastuzumab injection is prescribed primarily for the treatment of certain types of cancer, particularly HER2-positive breast cancer. It may also be used in combination with other medications to treat HER2-positive metastatic gastric or gastroesophageal junction adenocarcinoma.

How should this medicine be used?

As for how it should be used:

• Dosage: The dosage of trastuzumab injection can vary based on factors such as the specific cancer being treated, the patient’s weight, overall health, and other medications being used in combination.
• Administration: Trastuzumab injection is typically administered intravenously (IV) by a healthcare professional in a clinic or hospital setting.
• Frequency: The frequency of administration and duration of treatment depend on the individual’s condition and response to the medication. It is often given once a week or once every three weeks.
• Preparation: The injection should be prepared and administered according to the instructions provided by the healthcare provider or pharmacist. It’s essential to follow proper aseptic technique during preparation and administration to reduce the risk of contamination.
• Monitoring: Patients receiving trastuzumab injection should undergo regular monitoring, including cardiac function tests, to detect any potential side effects or complications early on.
• Patient Education: Patients should be educated about the potential side effects of trastuzumab injection and instructed on when to seek medical attention if they experience any adverse reactions.

It’s crucial for patients to adhere to the prescribed dosage and administration schedule and to communicate regularly with their healthcare provider throughout the course of treatment. Any questions or concerns about the use of trastuzumab injection should be discussed with a healthcare professional.

Other uses for this medicine

In addition to its primary use in treating HER2-positive breast cancer and HER2-positive metastatic gastric or gastroesophageal junction adenocarcinoma, trastuzumab injection may be used off-label or in clinical trials for other types of cancer where HER2 overexpression is a factor. These could include cancers of the lung, colon, and ovaries, among others. However, the efficacy and safety of trastuzumab in these contexts may vary and should be carefully evaluated.

What special precautions should I follow?

Regarding special precautions for trastuzumab injection, it’s important to consider the following:

• Cardiac Monitoring: Trastuzumab can cause heart problems, including heart failure. Before starting treatment, patients should undergo baseline cardiac assessments, including echocardiograms or MUGA scans, and regular monitoring during treatment to assess cardiac function.
• Pregnancy and Breastfeeding: Trastuzumab may harm a developing fetus, so it’s crucial to avoid its use during pregnancy unless the potential benefits outweigh the risks. Breastfeeding while receiving trastuzumab is not recommended due to the potential for harm to the nursing infant.
• Allergic Reactions: Patients should be monitored for signs of allergic reactions during and after trastuzumab infusion. If severe reactions occur, appropriate medical interventions should be initiated.
• Infusion Reactions: Infusion-related reactions, including fever, chills, nausea, vomiting, and headache, may occur during or after trastuzumab administration. Pre-medication with antihistamines or corticosteroids may be considered to minimize these reactions.
• Immune System Effects: Trastuzumab can weaken the immune system, increasing the risk of infections. Patients should be monitored for signs of infection and appropriate measures taken if an infection occurs.
• Liver Function: Trastuzumab may cause liver problems, so liver function tests should be monitored periodically during treatment.
• Concomitant Medications: Patients should inform their healthcare provider about all medications, including prescription, over-the-counter, and herbal supplements, they are taking, as some medications may interact with trastuzumab.
• Special Populations: Caution should be exercised when administering trastuzumab to elderly patients or those with pre-existing cardiac conditions, as they may be at increased risk of cardiac toxicity.

Patients should discuss any concerns or questions about trastuzumab treatment with their healthcare provider to ensure safe and effective use.

What special dietary instructions should I follow?

There are no specific dietary instructions associated with Trastuzumab Injection. However, maintaining a balanced and nutritious diet can support overall health and well-being during cancer treatment. Patients should consult with healthcare providers or nutritionists for personalized dietary recommendations.

What should I do if I forget a dose?

It’s essential to contact a healthcare provider promptly if a dose is missed. The healthcare provider will provide guidance on the appropriate course of action, which may involve rescheduling the missed dose or adjusting the treatment plan as needed. It’s crucial not to attempt to “catch up” by doubling the dose, as this can increase the risk of adverse effects. Consistent adherence to the prescribed dosing schedule is essential for optimal treatment outcomes.

What side effects can this medication cause?

Trastuzumab Injection, like any medication, can cause side effects, although not everyone will experience them. Common side effects include:

• Cardiac Effects: Trastuzumab can weaken the heart muscle, leading to symptoms like shortness of breath, fatigue, and swelling of the ankles or legs. It may also cause heart failure in severe cases.
• Infusion Reactions: During or shortly after the infusion, some individuals may experience fever, chills, nausea, vomiting, headache, or difficulty breathing.
• Decreased Blood Cell Counts: Trastuzumab can lower the levels of certain blood cells, increasing the risk of infection (due to low white blood cell counts), anemia (due to low red blood cell counts), or bleeding (due to low platelet counts).
• Lung Problems: Rarely, trastuzumab may cause lung problems such as pneumonitis or pulmonary toxicity, leading to symptoms like cough, difficulty breathing, or chest pain.
• Allergic Reactions: Some individuals may experience allergic reactions to trastuzumab, which can range from mild symptoms like itching or rash to severe reactions like anaphylaxis.
• Liver Problems: Trastuzumab may cause liver damage in some cases, leading to elevated liver enzymes or liver dysfunction.
• Skin Reactions: Skin rashes or itching may occur in some patients.
• Gastrointestinal Symptoms: Nausea, vomiting, diarrhea, or abdominal pain may occur.
• Musculoskeletal Symptoms: Muscle or joint pain may be experienced by some individuals.
• Fatigue: Feeling tired or weak is a common side effect of trastuzumab treatment.

It’s important to report any side effects experienced during trastuzumab treatment to healthcare providers promptly. They can provide guidance on managing side effects and may adjust the treatment plan if necessary to minimize discomfort and ensure the best possible outcomes.

What should I know about storage and disposal of this medication?

Regarding storage and disposal of Trastuzumab Injection:

• Storage: Trastuzumab injection should be stored according to the manufacturer’s instructions, typically in a refrigerator at a temperature between 36°F to 46°F (2°C to 8°C). It should be protected from light. Do not freeze the medication.
• Handling: Trastuzumab should be handled with care and prepared for administration by a healthcare professional trained in sterile techniques.
• Disposal: Unused or expired trastuzumab injection should be disposed of properly according to local regulations or guidelines. This often involves returning unused medication to a healthcare facility or pharmacy for proper disposal.

In case of emergency/overdose

In case of emergency or overdose of Trastuzumab Injection:

• Seek Medical Attention: If you suspect an overdose or experience severe adverse reactions after receiving Trastuzumab Injection, seek immediate medical attention or contact your healthcare provider or local emergency services.
• Treatment: Emergency treatment for Trastuzumab overdose would be supportive and symptomatic, as there is no specific antidote. The healthcare provider will assess the situation and provide appropriate care based on the individual’s symptoms and condition.

What other information should I know?

• Follow-up Care: Regular follow-up appointments with healthcare providers are essential during Trastuzumab treatment to monitor for any adverse effects, assess treatment response, and adjust the treatment plan as needed.
• Pregnancy and Breastfeeding: Trastuzumab may harm an unborn baby, so it’s crucial to use effective contraception during treatment and avoid becoming pregnant. Breastfeeding is not recommended during Trastuzumab treatment due to potential harm to the nursing infant.
• Inform Healthcare Providers: Keep healthcare providers informed about any other medications, supplements, or herbal products you are taking, as they may interact with Trastuzumab.
• Patient Support: Seek support from healthcare providers, support groups, or counselors if needed to cope with the emotional and physical challenges of cancer treatment.
• Patient Education: Educate yourself about Trastuzumab treatment, including its purpose, potential side effects, and what to expect during the course of treatment. Ask questions and communicate openly with healthcare providers about any concerns or questions you may have.