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trastuzumab

( trass-TOO-zoo-mab )
Other Name(s): Herceptin®, Kanjinti™; Ogivri™; Trazimera™; Herzuma®; Ontruzant®
Appearance: Clear, colourless solution mixed into larger bags of fluids

Medication Information Sheet
trastuzumab (trass-TOO-zoo-mab)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Herceptin®, Ogivri™, Trazimera™, Herzuma®, Kanjinti™, Ontruzant®

 

Appearance:
Clear, colourless solution

mixed into larger bags of fluids

 

What is this medication for?

For treating certain types of breast, stomach or esophagus cancers, and others

Trastuzumab is available as a biosimilar medication. See our biosimilar pamphlet for more information. 

What should I do before I have this medication?
  • Tell your doctor and pharmacist if you have or had significant medical condition(s), especially if you have or had:

    • heart or lung problems,

    • breathing problems at rest or

    • any allergies.

  • Tell your health care team if you have ever had a bad reaction with benzyl alcohol.
     

  • Tell your health care team if you have already been treated with chemotherapy drugs (especially anthracyclines such as doxorubicin, epirubicin or related drugs such as mitoxantrone) or radiation therapy.

Remember to:

  • Tell your health care team about all of the other medications you are taking.

  • Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.

 

How will this medication affect sex, pregnancy and breastfeeding?

Talk to your health care team about:

  • How this treatment may affect your sexual health.

  • How this treatment may affect your ability to have a baby, if this applies to you.

This treatment may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.

  • If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time until 7 months after your last treatment dose. Talk to your health care team about which birth control options are best for you.
     

  • Do not use hormonal birth control (such as birth control pills), unless your health care team told you that they are safe. Talk to your health care team about the safest birth control for you.
     

  • Do not breastfeed while on this treatment.

How is this medication given?
  • This drug is given through an IV (injected into a vein) . Talk to your health care team about your treatment schedule.

  • This drug will be given over a longer period of time for the first cycle. If this goes well, it will be given over a shorter time for the rest of the cycles.
     
  • If you missed your treatment appointment, talk to your health care team to find out what to do.

     

What else do I need to know while on this medication?
  • Will this medication interact with other medications or natural health products?

    • Although this medication is unlikely to interact with other medications, vitamins, foods and natural health products, tell your health care team about all of your:

      • prescription and over-the-counter (non-prescription) medications and all other drugs, such as cannabis/marijuana (medical or recreational)

      • natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements

    • Check with your health care team before starting or stopping any of them.

  • What should I do if I feel unwell, have pain, a headache or a fever?

    • Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).

      • Fever can be a sign of infection that may need treatment right away.

      • If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.
         

    How to check for fever:

    Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain).

    • You have a fever if your temperature taken in your mouth (oral temperature) is:
       
      • 38.3°C (100.9°F) or higher at any time

        OR
         
      • 38.0°C (100.4°F) or higher for at least one hour.


    If you do have a fever:

    • Try to contact your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
    • Ask your health care team for the Fever pamphlet for more information. 
       

    If you do not have a fever but have mild symptoms such as headache or mild pain:

    • Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.

    • Talk to your health care team before you start taking Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.

    • Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.
       

  • What to DO while on this medication:

  • DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.

  • DO tell your health care team about any serious infections that you have now or have had in the past.

  • DO talk to your health care team about your risk of getting other cancers and heart problems after this treatment.

  • DO consider asking someone to drive you to and from the hospital on your treatment days. You may feel drowsy or dizzy after your treatment.

  • What NOT to DO while on this medication:

  • DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.

What are the side effects of this medication?

The following table lists side effects that you may have when getting trastuzumab. Some of the side effects listed below may be caused by other drugs you have taken or are taking for your cancer. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.

Read over the side effect table so that you know what to look for and when to get help. Keep this paper during your treatment so that you can refer to it if you need to.

Less Common Side Effects (10 to 24 out of 100 people)
Side effects and what to doWhen to contact health care team

Headache; Mild joint, muscle pain or cramps 

What to look for?

  • New pain in your muscles or joints, muscle cramps, or feeling achy.
     

What to do?

  • Take pain medication (acetaminophen or opioids such as codeine, morphine, hydromorphone, oxycodone) as prescribed.
  • Read the above section: "What should I do if I feel unwell, have pain, a headache or a fever?" on page 3 before taking acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or Aspirin. These medications may hide an infection that needs treatment or they may increase your risk of bleeding.
  • Rest often and try light exercise (such as walking) as it may help.

Ask your health care team for the Pain pamphlet for more information.

Talk to your health care team if it does not improve or if it is severe

Fatigue 

What to look for?

  • Feeling of tiredness or low energy that lasts a long time and does not go away with rest or sleep.
     

What to do?

  • Be active. Aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days.
  • Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Ask family or friends to help you with things like housework, shopping, and child or pet care.
  • Eat well and drink at least 6 to 8 glasses of water or other liquids every day (unless your health care team has told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired.

Ask your health care team for the Fatigue pamphlet for more information. 

Talk to your health care team if it does not improve or if it is severe

Flu-like symptoms (most likely with first infusion)

What to look for?

  • You may have chills (shivers) or a fever during or shortly after your trastuzumab infusion.

What to do?

  • Tell your nurse right away if you have chills or feel like you may have a fever during or just after your trastuzumab treatment.
  • For how to check your temperature to see if you have a fever, after you have left the hospital, read the above section "What should I do if I feel unwell, have pain, a headache or a fever?" on page 3.
Talk to your health care team right away.

 

 

Other rare, but serious side effects are possible.

If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:

  • Irregular heartbeat, shortness of breath, chest pain, fainting (passing out)

  • New swelling in your legs, ankles and/or belly

  • Symptoms of an allergic reaction (during or soon after the medication is given): flushing, itchiness, rash, swollen lips, face or tongue, wheezing, throat and/or chest tightness

  • Difficulty breathing, painful cough, coughing up blood

  • Pain, hardening, and swelling of a vein in your arms or legs

  • Difficulty moving arms or legs

  • Muscle weakness that gets worse

  • Confusion, sudden vision changes, difficulty speaking

  • Black stools, blood in your urine, bleeding that won’t stop, easy bruising

  • New belly pain that may extend to your back

  • Fever, chills, signs of infection

  • Redness or rash in areas where you previously received radiation

  • Lower back pain, pee less than usual, body swelling

 

Who do I contact if I have questions or need help?          

My cancer health care provider is: ______________________________________________

During the day I should contact:________________________________________________

Evenings, weekends and holidays:______________________________________________

 

Other Notes:

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September 2022 Updated "Other Name" section

For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.