Kadcyla trastuzumab emtansine
Other Name: T-DM1
- For treating certain types of breast cancer
- Tell your health care team if you have or had significant medical condition(s), especially if you have / had:
- heart, liver or lung problems
- breathing problems when you are at rest
- problems with bleeding
- nerve problems, such as numbness and tingling in your hands and feet, or
- any allergies.
- Tell your health care team if you ever had serious reactions when being treated with trastuzumab products (such as Herceptin®, Herzuma®, Trazimera ®, Kanjinti®; Ogivri®).
- Your health care team may do tests to examine your heart function before starting treatment. This is done to make sure it is safe for you to receive Kadcyla® trastuzumab emtansine.
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.
Talk to your health care team about:
How this medication may affect your sexual health.
How this medication may affect your ability to have a baby, if this applies to you.
This medication 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.
- 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 taking this medication and for 7 weeks after your last dose.
- This drug is given through an IV (injected into a vein) .
- It is usually given every 21 days. Talk to your health care team about your treatment schedule.
- This drug will be given (infused) 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.
Will this medication interact with other medications or natural health products?
This medication can interact with other medications, vitamins, foods and natural health products. Interactions can make the treatment not work as well or cause severe side effects.
Tell your health care team about all of your:
prescription and over-the-counter (non-prescription) medications and all other drugs, such as 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.
- 38.3°C (100.9°F) or higher at any time
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 talk to your health care team about your risk of getting heart problems during and after completing this treatment.
- DO tell your health care team if you have any new pain, numbness or tingling of your hands or feet. This is especially important if you are having trouble doing tasks (like doing up buttons, writing, walking) or if you have severe pain or numbness.
- DO consider asking someone to drive you to and from the hospital on your treatment days. You may feel tired 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.
The following table lists side effects that you may have when getting trastuzumab emtansine. 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. Refer to this table if you experience any side effects while on trastuzumab emtansine.
Very Common Side Effects (50 or more out of 100 people) | |
Side effects and what to do | When to contact health care team |
Fatigue What to look for?
What to do?
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 |
Common Side Effects (25 to 49 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Nausea and vomiting (Generally mild) What to look for?
What to do? To help prevent nausea:
| Talk to your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if it is severe |
Liver problems Your health care team may check your liver function with a blood test. The liver changes do not usually cause any symptoms.
If you have any symptoms of liver problems, get emergency medical help right away. | Get emergency medical help right away |
Mild joint, muscle pain or cramps; What to look for?
What to do?
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 |
Low neutrophils (white blood cells) in the blood (neutropenia) (May be severe) When neutrophils are low, you are at risk of getting an infection more easily. Ask your health care team for the Neutropenia (Low white blood cell count) pamphlet for more information.
What to look for?
You have a fever if your temperature taken in your mouth (oral temperature) is:
What to do? If your health care team has told you that you have low neutrophils:
If you have a fever: If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away. | If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you MUST get emergency medical help right away. |
Low platelets in the blood (May be severe) When your platelets are low, you are at risk for bleeding and bruising. Ask your health care team for the Low Platelet Count pamphlet for more information. What to look for?
If your health care team has told you that you have low platelets:
If you have signs of bleeding:
If you have bleeding that does not stop or is severe (very heavy), you must get emergency medical help right away. | Talk to your health care team if you have any signs of bleeding. If you have bleeding that doesn’t stop or is severe (very heavy), you MUST get emergency help right away. |
Neuropathy (Tingling, numb toes or fingers) (May be severe) What to look for?
What to do?
In rare cases, it may continue long after treatment ends. If you continue to have bothersome symptoms, talk to your health care team for advice. | Talk to your health care team, especially if you have trouble doing tasks like doing up buttons, writing, moving, or if you have severe pain or numbness |
Less Common Side Effects (10 to 24 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Constipation What to look for?
What to do? To help prevent constipation:
To help treat constipation:
Ask your health care team for the Constipation Pamphlet for more information. | Talk to your health care team if it does not improve or if it is severe |
Mouth sores What to look for?
To help prevent mouth sores:
Ask your health care team for the Oral Care (Mouth Care) pamphlet for more information. | Talk to your health care team as soon as you notice mouth or lip sores or if it hurts to eat, drink or swallow |
Cough and feeling short of breath What to look for?
What to do?
| Talk to your health care team. If you are not able to talk to your health care team for advice, and you have a fever or severe symptoms, you MUST get emergency medical help right away |
Dry mouth What to look for?
What to do?
See our Mouth Care pamphlet for more information. Talk to your health care team if your dry mouth does not improve or if it is severe. | Talk to your health care team if it does not improve or if it is severe |
Trouble Sleeping Your medications may cause trouble sleeping. It may get better once your body gets used to the medication or when your treatment ends. What to look for?
What to do? Talk to your health care team if it does not improve or if it is severe | Talk to your health care team if it does not improve or if it is severe |
Diarrhea What to look for?
What to do? If you have diarrhea:
| Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day) |
Dizziness What to look for?
| Talk to your health care team if it does not improve or if it is severe |
Reactions at the injection site What to look for?
What to do?
| Talk to your health care team if it does not improve or if it is severe |
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:
- Chest pain, fainting (passing out) or unexpected swelling in your legs, ankles and belly
- Symptoms of an allergic reaction (during or soon after the medication is given): flushing, fever, itchiness, rash, swollen lips, face or tongue, wheezing, throat and/or chest tightness
- Difficulty thinking or speaking, confusion, personality changes, forgetfulness, seizures
- Eye pain, sensitivity to light, blurred vision, or any changes to your vision
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:______________________________________________
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Other Notes:
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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.