Trastuzumab (Herceptin®)

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About This Drug

Trastuzumab is used to treat cancer. It is given in the vein (IV)

Possible Side Effects

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Fever
  • Chills
  • Tiredness
  • Headache
  • Infection
  • Congestive heart failure. You may be short of breath.Your arms, hands, legs and feet may swell.
  • Cough
  • Upper respiratory infection
  • Inflammation of nasal passages and throat
  • Changes in the way food and drinks taste
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt
  • Nausea
  • Loose bowel movements (diarrhea)
  • Weight loss
  • Rash
  • Trouble sleeping

Note: Each of the side effects above was reported in 10% or greater of patients treated with trastuzumab. Not all possible side effects are included above.

Warnings and Precautions

  • Changes in the tissue of the heart and heart function. Some changes may happen that can cause your heart to have less ability to pump blood. This drug may increase your risk of heart attack
  • Inflammation (swelling) of the lungs. You may have a dry cough or trouble breathing.
  • While you are getting this drug in your vein (IV), you may have a reaction to the drug. Sometimes you may be given medication to stop or lessen these side effects. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. These reactions may happen after your infusion.If this happens, call 911 for emergency care.
  • Severe decrease in the number of white blood cells. This may raise your risk of infection which may very rarely be life-threatening

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

Important Information

  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • To help with nausea, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat.
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • If you have diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with weight loss, drink fluids that contribute calories (whole milk, juice, soft drinks, sweetened beverages, milkshakes, and nutritional supplements) instead of water.
  • Include a source of protein at every meal and snack, such as meat, poultry, fish, dry beans, tofu, eggs, nuts, milk, yogurt, cheese, ice cream, pudding, and nutritional supplements.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • If you are having trouble sleeping, talk to your nurse or doctor on tips to help you sleep better
  • Infusion reactions may occur after your infusion. If this happens, call 911 for emergency care.

Food and Drug Interactions

  • There are no known interactions of trastuzumab with food and other medications.
  • Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Fatigue that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • A headache that does not go away
  • Easy bleeding or bruising
  • Wheezing or trouble breathing
  • Coughing up yellow, green, or bloody mucus
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Pain in your chest
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • A new rash or a rash that is not relieved by prescribed medicines
  • Signs of infusion reaction: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain.
  • If you think you may be pregnant

Reproduction Warnings

  • Pregnancy warning: This drug may/can have harmful effects on the unborn baby. Women of child-bearing potential should use effective methods of birth control during your cancer treatment and for 7 months after treatment. Let your doctor know right away if you think you may be pregnant during treatment or within 7 months of receiving treatment. There is a pregnancy exposure registry and pharmacovigilance program which monitors the effect of this drug on your pregnancy. It is recommended that you enroll in the MotHER pregnancy registry and report your pregnancy to Genentech at http://www.motherpregnancyregistry.com.
  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug and for 7 months after treatment because this drug may enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children.Ask for information on sperm or egg banking.

Revised January 2018

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services. The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication. The dose, method of administration and contraindications for any administered medication should be confirmed before use. UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.