Fam-trastuzumab deruxtecan-nxki (Enhertu)
About This Drug
Fam-trastuzumab deruxtecan-nxki is used to treat cancer. It is given in the vein (IV).
Possible Side Effects
- Bone marrow suppression. 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.
- Nausea and vomiting (throwing up)
- Constipation (not able to move bowels)
- Diarrhea (loose bowel movements)
- Decreased appetite (decreased hunger)
- Hair loss. Hair loss is often temporary, although with certain medicine, hair loss can sometimes be permanent. Hair loss may happen suddenly or gradually. If you lose hair, you may lose it from your head, face, armpits, pubic area, chest, and/or legs. You may also notice your hair getting thin.
Note: Each of the side effects above was reported in 20% or greater of patients treated with famtrastuzumab deruxtecan-nxki. Not all possible side effects are included above.
Warnings and Precautions
- Inflammation (swelling) or scarring of the lungs which may be life-threatening. You may have a dry cough or trouble breathing.
- Severe decrease in white blood cells, including fever in the setting of decreased white blood cells, which is a serious condition.
- Changes in your heart’s ability to pump blood properly Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.
Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.
- 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 the risk of 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 the risk of 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).
- If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack of 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 stop or lessen these symptoms.
- Ask your doctor or nurse about medicines that are available to help stop or lessen constipation or diarrhea.
- 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.
- If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
- To help with decreased appetite, eat small, frequent meals. Eat foods high in calories and protein, such as meat, poultry, fish, dry beans, tofu, eggs, nuts, milk, yogurt, cheese, ice cream, pudding, and nutritional supplements.
- Consider using sauces and spices to increase taste. Daily exercise, with your doctor’s approval, may increase your appetite.
- To help with hair loss, wash with a mild shampoo and avoid washing your hair every day.
- Avoid rubbing your scalp, pat your hair or scalp dry.
- Avoid coloring your hair.
- Limit your use of hair spray, electric curlers, blow dryers, and curling irons.
- If you are interested in getting a wig, talk to your nurse. You can also call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
Food and Drug Interactions
- There are no known interactions of fam-trastuzumab deruxtecan-nxki with food and other medications.
- Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are known drug interactions with fam-trastuzumab deruxtecan-nxki. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement 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 100.4° F (38° C) or higher
- Tiredness that interferes with your daily activities
- Pain in your chest
- Coughing up yellow, green, or bloody mucus
- Wheezing or trouble breathing
- Dry cough
- Feeling dizzy or lightheaded
- Easy bleeding or bruising
- Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
- Throwing up more than 3 times a day
- No bowel movement in 3 days or when you feel uncomfortable
- Diarrhea, 4 times in one day or diarrhea 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 arms, hands, legs and/or feet
- Weight gain of 5 pounds in one week (fluid retention)
- 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 childbearing potential should use effective methods of birth control during your cancer treatment and for at least 7 months after treatment. Men with female partners of childbearing potential should use effective methods of birth control during your cancer treatment and for at least 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 breast feed during treatment and for 7 months after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
- Fertility warning: In men, 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 banking.
New January 2020
This patient information was developed by Via Oncology, LLC © 2020. 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.
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