Trastuzumab | Side Effects, Dosage, Uses & More
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Generic Name:

trastuzumab, Injectable solution

All Brands

  • Herceptin
SECTION 1 of 5

Highlights for trastuzumab

Injectable solution
1

Trastuzumab is used alone and in combination with other drugs to treat HER2-positive breast, stomach, and stomach-related cancers.

2

Trastuzumab is an injected drug. It’s only administered by a healthcare provider.

3

Common side effects include tiredness, fever, diarrhea, shortness of breath, and increased infections.

4

This drug can harm your heart and lungs. Ask your doctor to clearly explain the risks to you.

5

Trastuzumab can harm your unborn baby if you take it during pregnancy. If you’re a woman of childbearing age, use effective birth control during treatment with this drug. Keep using it for at least 7 months after your last dose of trastuzumab.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Heart failure warning. This drug can cause heart failure. This can be fatal. Your doctor will do tests to check your heart before and during your treatment, and for at least two years after you’ve completed trastuzumab therapy. Tell your doctor if you have any of these heart failure symptoms:

  • shortness of breath
  • cough
  • swelling of your face
  • palpitations
  • weight gain of more than 5 pounds in 24 hours
  • dizziness or loss of consciousness

Infusion reactions warning. This drug can cause serious infusion reactions. These can be fatal. Symptoms usually occur during or within 24 hours of receiving trastuzumab. Tell your doctor if you have any signs of an infusion reaction:

  • fever
  • chills
  • nausea
  • vomiting
  • pain, possibly at the site of your cancer
  • headache
  • dizziness
  • shortness of breath
  • low blood pressure
  • skin rash
  • weakness

Lung problems warning. Trastuzumab can cause serious lung toxicity. This can be fatal. Tell your doctor right away if you have shortness of breath. This may be a sign of lung problems.

Birth defects warning. Trastuzumab can harm your unborn baby if you take it during pregnancy. The risk is highest during the second and third trimesters. Use effective birth control during treatment with this drug and for at least 7 months after your last dose of trastuzumab.

Chemotherapy-induced neutropenia

When used during chemotherapy treatment, this drug can worsen neutropenia. This condition is a low level of a certain type of white blood cell. White blood cells fight infection, so this condition raises your risk of infection.

What is trastuzumab?

Trastuzumab is a prescription drug. It’s available as an intravenous solution (IV). It’s only given by a healthcare provider.

This drug may be used as part of a combination therapy. That means you may need to take it with other drugs.

Why it's used

Trastuzumab is used to treat cancer. It may be used:

  • in combination with other drugs to treat HER2-positive breast cancer
  • with or without other drugs to treat HER2-positive breast cancer that’s spread to other areas of the body
  • with or without other drugs to treat HER2-positive stomach and stomach-related cancer that’s spread to other areas of the body

How it works

Trastuzumab belongs to a class of drugs called HER2 receptor antagonists. A class of drugs refers to medications that work similarly. They are often used to treat similar conditions.

HER2 is a gene that makes HER2 proteins. HER2 proteins are receptors on breast cells. Normally, HER2 receptors help control how your healthy breast cells grow, divide, and repair themselves.

More Details

How it works

Trastuzumab belongs to a class of drugs called HER2 receptor antagonists. A class of drugs refers to medications that work similarly. They are often used to treat similar conditions.

HER2 is a gene that makes HER2 proteins. HER2 proteins are receptors on breast cells. Normally, HER2 receptors help control how your healthy breast cells grow, divide, and repair themselves. If the HER2 gene doesn’t work correctly, it can cause your breast cells to grow and divide in an uncontrolled way. Trastuzumab targets breast cancer cells that are HER2-positive and helps stop them from growing.

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trastuzumab Side Effects

Injectable solution

Most Common Side Effects

Side effects for trastuzumab vary slightly based on what the drug is being used to treat.

  • The more common side effects that can occur when treating breast cancer include:

    • fever
    • nausea
    • vomiting
    • infusion reactions
    • diarrhea
    • infections
    • coughing
    • headache
    • tiredness
    • shortness of breath
    • skin rash
    • low white blood cells
    • anemia
    • muscle aches
    • trouble sleeping
  • The more common side effects that can occur when treating stomach or related cancer include:

    • low white blood cell count
    • infection caused by low white blood cell count. Symptoms can include:
      • fever or chills
      • sore throat
      • sores in your mouth
    • low blood platelet count
    • diarrhea
    • tiredness
    • anemia
    • mouth sores
    • weight loss
    • infections
    • fever
    • runny nose or sneezing
    • abnormal taste in your mouth
    • trouble sleeping

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • heart problems, including heart rhythm problems, high blood pressure, and heart failure. Symptoms include:

    • new or worsening shortness of breath
    • cough
    • swelling in your ankles or legs
    • swelling in your face
    • fast heart rate (palpitations)
    • weight gain of more than 5 pounds in 24 hours
    • dizziness
    • loss of consciousness
  • infusion reactions. Symptoms include:

    • fever
    • chills
    • nausea
    • vomiting
    • pain, possibly at the site of your cancer
    • headache
    • dizziness
    • shortness of breath
    • low blood pressure
    • skin rash
    • weakness
  • lung toxicity. Trastuzumab can cause inflammation of lung tissue, fluid trapped in lung tissue, reduced oxygen level, and damaged or scarred lung tissue. Symptoms include:

    • shortness of breath
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Trastuzumab often causes infusion reactions. Symptoms include:

  • fever
  • chills
  • nausea
  • vomiting
  • pain, possibly at the site of your cancer
  • headache
  • dizziness
  • shortness of breath
  • low blood pressure
  • skin rash
  • weakness
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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trastuzumab May Interact with Other Medications

Injectable solution

Trastuzumab can interact with other medications, herbs, or vitamins you might be taking. Your healthcare provider will look out for interactions with your current medications. Always be sure to tell your doctor about all medications, herbs or vitamins you’re taking.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Trastuzumab warnings
heart disease
People with heart disease

Your doctor may reduce or stop your dose of trastuzumab. This is because trastuzumab can cause heart damage and your risk is increased if you have a history of certain heart problems. These include heart failure, heart attack, constant chest pain, high blood pressure, or irregular heartbeats.

lung disease
People with lung disease

Your doctor may reduce or stop your dose of trastuzumab. This is because trastuzumab can cause lung damage and make it hard to breathe. It can worsen lung disease if you already have it.

Pregnant women
Pregnant women

Trastuzumab is a category D pregnancy drug. That means two things:

  1. Studies show a risk of adverse effects to the fetus when the mother takes the drug.
  2. The benefits of taking the drug during pregnancy may outweigh the potential risks in certain cases.

Trastuzumab can cause harm to your unborn baby if you take it during pregnancy. The risk is highest during the second and third trimesters. Use effective birth control during treatment with this drug and for at least 7 months after your last dose of trastuzumab.

Tell your doctor if you’re pregnant or plan to become pregnant. Trastuzumab should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding
Women who are breast-feeding

Trastuzumab may pass into breast milk and cause serious effects in a child who is breastfed.

You should not breastfeed while taking this drug.

For seniors
For seniors

Seniors may have a greater risk for developing heart problems from trastuzumab.

For children
For children

The safety and effectiveness of trastuzumab haven’t been established in children under the age of 18 years.

When to call the doctor
When to call the doctor

Call your doctor right away if you develop any of the following:

  • new or worsening shortness of breath
  • cough
  • swelling in your ankles or legs
  • swelling in your face
  • fast or irregular heartbeats (palpitations)
  • weight gain of more than 5 pounds in 24 hours
  • dizziness
  • loss of consciousness

These symptoms may be signs of heart problems.

Also call your doctor if you become pregnant while taking this drug.

Allergies
Allergies

Trastuzumab can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

If you have a reaction, call your doctor right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take trastuzumab (Dosage)

Injectable solution

Your doctor will determine a dose that’s right for you based on your individual needs. Your general health may affect your dose. Tell your doctor about all health conditions you have before your doctor or nurse administers the drug to you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Trastuzumab comes with risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your cancer may not be treated or cured, or it may reoccur.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You’re at increased risk of side effects from the drug. If you think you’ve been given too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

What to do if you miss a dose/appointment

Call your doctor right away to find out what to do.

How to tell the drug is working

Your doctor will do tests to tell if this drug is working to kill the cancer cells.

Trastuzumab is a short-term drug treatment.

Important considerations for taking trastuzumab

How long does it take?

It will take 30–90 minutes to receive your dose of trastuzumab. You will likely need to stay for a time after you receive your drug. This allows your healthcare team to monitor your response to the drug.

Can I drive home after?

Side effects, such as nausea, vomiting, infusion reactions, and fatigue, could make it difficult to drive. You may need a ride home from your appointment.

Travel

Trastuzumab should only be given by a healthcare provider who knows your medical history, is experienced giving chemotherapy, and at a location with appropriate support to manage any infusion reactions.

Talk to your doctor when planning your travel. You may need to plan your travel around your trastuzumab injections. 

In certain cases, you may need additional tests

Your doctor will do tests to check your heart before and during your treatment. Your doctor will also do these tests for at least two years after you’ve finished trastuzumab therapy.

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How Much Does trastuzumab Cost?

Injectable solution

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These prices represent the lowest priced national pharmacies for trastuzumab on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on August 23, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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