Ado-trastuzumab emtansine (Kadcyla®)
About This Drug
Ado-trastuzumab emtansine is used to treat cancer. It is given in the vein (IV).
Possible Side Effects
- Decrease in the number of platelets. This may raise your risk of bleeding.
- Constipation (not able to move bowels)
- Changes in your liver function
- Joint, muscle and/or bone pain
Note: Each of the side effects above was reported in 25% or greater of patients treated with ado-trastuzumab emtansine. Not all possible side effects are included above.
Warnings and Precautions
- Scarring and/or inflammation (swelling) of the lungs, which can be life-threatening. 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.
- Skin and tissue irritation including redness, pain, warmth, or swelling at the IV site. This happens if the drug leaks out of the vein and into nearby tissue.
- Severe changes in your liver function, which can cause liver failure and be life-threatening.
- Changes in your heart function.
- Abnormal bleeding, which can be life-threatening– symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding.
- Severe decrease in the number of platelets.
- Effects on the nerves are called peripheral neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped but it does not get better in all people.
Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.
- Notify your doctor right away if you get pregnant during treatment or within 7 months of receiving treatment. There is a pregnancy exposure registry and a pregnancy monitoring program. It is recommended that you report your pregnancy to Genentech at 1-888-835-2555 and register with the MotHER pregnancy registry by calling 1-800-690-6720 or by visiting ttp://www.motherpregnancyregistry.com/.
- 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 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
- Ask your doctor or nurse about medicines that are available to help stop or lessen constipation.
- If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories
- Drink plenty of fluids (a minimum of eight glasses per day is recommended).
- 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).
- To help with nausea and vomiting, 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.
- Infusion reactions may happen after your infusion. If this happens, call 911 for emergency care.
- Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
- If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids.
- If you have a nose bleed, sit with your head tipped slightly forward. Apply pressure by lightly pinching the bridge of your nose between your thumb and forefinger. Call your doctor if you feel dizzy or faint or if the bleeding doesn’t stop after 10 to 15 minutes.
Food and Drug Interactions
- There are no known interactions of ado-trastuzumab emtansine with food.
- This drug may interact with other medicines. Tell your doctor and pharmacist about all the prescription and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
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
- Pain in your chest
- Dry cough
- Trouble breathing
- Swelling of legs, ankles, or feet
- Weight gain of 5 pounds in one week (fluid retention)
- Easy bleeding or bruising
- Blood in your urine, vomit (bright red or coffee-ground) and/or stools (bright red, or black/tarry)
- Coughing up blood
- No bowel movement in 3 days or when you feel uncomfortable.
- Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
- Throwing up more than 3 times a day
- Tiredness that interferes with your daily activities
- Signs of infusion reaction: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain
- Pain that does not go away, or is not relieved by prescribed medicines
- Numbness, tingling, or pain in your hands and feet
- Nose bleed that doesn’t stop bleeding after 10 -15 minutes
- Feeling dizzy or lightheaded
- Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
- While you are getting this drug, please tell your nurse right away if you have any pain, redness, or swelling at the site of the IV infusion
- If you think you may be pregnant or may have impregnated your partner
- Pregnancy warning: This drug 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. Men with female partners of child bearing potential should use effective methods of birth control during your cancer treatment and for 4 months after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
- Breastfeeding warning: Women should not breastfeed during treatment and for 7 months after treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
- Fertility warning: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking. Human fertility studies have not been done with this drug.
Revised November 2018
This patient information was developed by Via Oncology, LLC © 2018. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.
CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.