herceptin

Herceptin (trastuzumab) is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Herceptin is used to treat certain types of breast cancer or stomach cancer. Other cancer medicines are sometimes used in combination with Herceptin.

Important information

Do not use Herceptin if you are pregnant. It could harm the unborn baby.

Herceptin can cause heart failure, especially if you have heart disease or if you are also receiving certain other cancer medicines.

Some side effects may occur during the injection. Tell your caregiver right away if you feel dizzy, nauseated, light-headed, weak, short of breath, or if you have a headache, fever, chills, sudden chest pain, wheezing, dry cough, hives, or swelling of your face, lips, tongue, or throat.

You should not use Herceptin if you are allergic to trastuzumab.

To make sure Herceptin is safe for you, tell your doctor if you have:

• heart disease;

• congestive heart failure;

• a history of heart attack; or

• any allergies or breathing problems.

Herceptin can cause heart failure, especially if you have heart disease or if you are also receiving certain other cancer medicines (such as daunorubicin, doxorubicin, epirubicin, or idarubicin)

Do not use Herceptin if you are pregnant. It could harm the unborn baby. Tell your doctor if you become pregnant during treatment. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 7 months after your treatment ends.

If you are pregnant, your name may need to be listed on a Cancer and Childbirth registry when you start using this medication.

It is not known whether trastuzumab passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using Herceptin.

How is Herceptin given?

Herceptin is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Herceptin must be given slowly, and the IV infusion can take up to 90 minutes to complete.

You may need to undergo a biopsy to make sure Herceptin is the right medicine to treat your cancer.

Herceptin is usually given once every week or every 3 weeks. Follow your doctor"s dosing instructions very carefully.

You may need frequent medical tests to be sure this medicine is not causing harmful effects. Your cancer treatments may be delayed based on the results of these tests.

Herceptin Dosing Information

Usual Adult Dose of Herceptin for Breast Cancer:

For use in the treatment of metastatic breast cancer:
Administer trastuzumab, alone or in combination with paclitaxel.
Initial dose: 4 mg/kg IV infusion over 90 minutes
Subsequent therapy: 2 mg/kg IV infusion over 30 minutes once weekly until disease progression

Usual Adult Dose of Herceptin for Breast Cancer -- Adjuvant:

Administer according to one of the following doses and schedules:

1) Initiate trastuzumab during and following paclitaxel, docetaxel, or docetaxel/carboplatin:
Initial dose: 4 mg/kg IV infusion over 90 minutes then 2 mg/kg IV infusion over 30 minutes weekly during chemotherapy for the first 12 weeks (paclitaxel or docetaxel) or 18 weeks (docetaxel/carboplatin).
Subsequent therapy: one week after the last weekly dose of trastuzumab, give trastuzumab as 6 mg/kg IV infusion over 30 to 90 minutes every 3 weeks for a total of 52 weeks of therapy.

or

2) Initiate trastuzumab as a single agent within 3 weeks following completion of all chemotherapy.
Initial dose: 8 mg/kg IV infusion over 90 minutes
Subsequent therapy: 6 mg/kg IV infusion over 30 to 90 minutes every 3 weeks for a total of 17 doses (52 weeks of therapy)

Usual Adult Dose of Herceptin for Esophageal Carcinoma:

For use in the treatment of metastatic gastric or gastroesophageal junction adenocarcinoma:
Administer trastuzumab in combination with cisplatin and capecitabine or 5-fluorouracil.
Initial dose: 8 mg/kg IV infusion over 90 minutes
Subsequent therapy: 6 mg/kg IV infusion over 30 to 90 minutes every 3 weeks until disease progression

Usual Adult Dose of Herceptin for Gastric Cancer:

For use in the treatment of metastatic gastric or gastroesophageal junction adenocarcinoma:
Administer trastuzumab in combination with cisplatin and capecitabine or 5-fluorouracil.
Initial dose: 8 mg/kg IV infusion over 90 minutes
Subsequent therapy: 6 mg/kg IV infusion over 30 to 90 minutes every 3 weeks until disease progression

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your Herceptin injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving Herceptin?

Follow your doctor"s instructions about any restrictions on food, beverages, or activity.

Herceptin side effects

Some side effects may occur during the injection. Tell your caregiver right away if you feel dizzy, nauseated, light-headed, weak, short of breath, or if you have a headache, fever, chills, sudden chest pain, wheezing, dry cough, hives, or swelling of your face, lips, tongue, or throat.

Get emergency medical help if you have any signs of an allergic reaction to Herceptin: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• shortness of breath (even with mild exertion or while lying down);

• rapid or shallow breathing, grunting, gasping for breath, pain when you breathe;

• blue-colored skin or lips;

• sudden chest pain or discomfort, wheezing, new or worsening cough;

• pounding heartbeats or fluttering in your chest;

• swelling, rapid weight gain;

• fever, swollen gums, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms; or

• heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating.

Common Herceptin side effects may include:

• nausea, diarrhea, weight loss;

• fever, chills, mouth sores;

• headache, sleep problems (insomnia);

• cough, trouble breathing;

• skin rash, bruising, pale skin;

• altered sense of taste; or

• cold symptoms such as stuffy nose, sinus pain, sneezing, cough, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Herceptin?

Other drugs may interact with trastuzumab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.