- April 27, 2022
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Brand Name :
Trazimera, Ontruzant, Herceptin, Kanjinti, Herzuma, Ogivri,
Synonyms :
trastuzumab
Class :
HER2 inhibitors
Dosage forms & Strengths
Powder for injection
150 mg/vial
420 mg/multidose vial
Advanced cancer:
:
Initial dose for cycle 1: 8 mg/kg IV over 90 mins
Maintenance dose: 6 mg/kg IV infused over 30 to 90 minutes every 3 Weeks in combination with carboplatin and paclitaxel for 6 cycles
Gastric metastatic cancer:
Initial dose for cycle 1: 8 mg/kg IV over 90 mins
Maintenance dose: 6 mg/kg IV infused over 30 to 90 minutes every 3 Weeks in combination with cisplatin and capecitabine/fluorouracil for 6 cycles
Initial dose: 4 mg/kg IV over 90 mins
Maintenance dose: 2 mg/kg IV over 30 min every 3 Weeks during the first 12 weeks of chemotherapy, 6 mg/kg IV infused over 30 to 90 minutes every 3 Weeks for 52 weeks 1 week after chemotherapy completed
Adjuvant treatment with concurrent docetaxel/carboplatin:
Initial dose: 4 mg/kg IV over 90 mins
Maintenance dose: 2 mg/kg IV over 30 min every Week during the first 18 weeks of chemotherapy, 6 mg/kg IV infused over 30 to 90 minutes q3Weeks for 52 weeks 1 week after chemotherapy completed
Adjuvant treatment with anthracycline-based chemotherapy:
Initial dose: 8 mg/kg IV over 90 mins
Maintenance dose: 6 mg/kg IV infused over 30 to 90 minutes every 3 Weeks for 52 weeks 1 week after chemotherapy completed
safety and efficacy not established
Refer adult dosing
Risk of infection enhanced due to increased immunosuppressive effects of trastuzumab
in combination with ofatumumab, trastuzumab increases the risk of adverse events
may increase the risk or severity of adverse effects when combined
It may enhance the toxicity effects when combined with triamcinolone by immunosuppressive effects
it may enhance the adverse effects when combined with aducanumab
when trastuzumab and melphalan combine the immunosuppressive effects of both the drugs are enhanced and lead to increased risk of infection
when both the drugs combine the effect of both drugs increases by immunosuppressive effects and increase the risk of infection.
Pharmacodynamic synergism may lead to toxicity of immunosuppressant and myelosupressant effects
when both drugs are combined, there may be a decreased level of serum concentration of paclitaxel
when thiotepa and trastuzumab combine, the immunosuppressive effects of both the drugs are enhanced and lead to an increased risk of infection
may enhance the risk of infection due to neutropenia
either of the drugs, if taken simultaneously, increases the toxicity levels by immunosuppression.
when both drugs are combined, there may be an increased immunosuppressive effect of both drugs and a risk of infection
increase bone marrow suppression
risk of severe infection due to immunosuppressive effects
may enhance the risk of neutropenia due to immunosuppression
when used in combination, both the drugs increase immunosuppression/risk of infection
may enhance the risk of neutropenia due to immunosuppression
trastuzumab: may enhance the risk of neutropenia due to immunosuppression
either of the drug in combination increases the effect of the other due to immunosuppression/risk of infection
may raise the risk of neutropenia and serious infection by increasing immunosuppressant
increase bone marrow suppression
may enhance the immunosuppressive effects of each other
Frequency defined
>10%
Rhinorrhea
nasopharyngitis (13%)
pulmonary toxicity (14%)
rhinitis (22%)
Cough (43%)
epistaxis
Pregnancy consideration:
Pregnancy category:
AU TGA pregnancy category: D
US FDA pregnancy category: N/A
Breastfeeding warnings: Excreted into the milk is unknown
Pregnancy category:
Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester.
Category B: No evidence of risk to the fetus is found in animal reproduction studies, and there are not enough studies on pregnant women.
Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for a human product; Pregnant women must take care of the potential risks.
Category D: There is adequate data with sufficient evidence of human fetal risk from various platforms. However, despite potential dangers may be used only in emergencies for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. The drug is not for pregnant women.
Patient information leaflet
Generic Name: trastuzumab
Why do we use trastuzumab?
trastuzumab is a medication that is used to treat certain types of breast cancer and stomach cancer that overexpress a protein called human epidermal growth factor receptor 2 (HER2).
HER2 is a protein that is involved in the growth and division of cells, including cancer cells. In some types of cancer, including about 20% of breast cancers and a smaller proportion of stomach cancers, the cancer cells produce an excess amount of HER2, leading to more aggressive growth and spread of the cancer.
trastuzumab works by binding to the HER2 protein and blocking its activity, which can slow or stop the growth and spread of cancer cells. It can be given as a standalone treatment or in combination with other chemotherapy medications.
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