Trodelvy (sacituzumab govitecan-hziy) is a prescription drug that’s used to treat certain breast and urothelial cancers. Trodelvy can cause side effects that range from mild to serious. Examples include severe diarrhea, low levels of certain blood cells, and hair loss.
Trodelvy is used in adults to treat the following types of cancer in certain situations:
- breast cancer that is either triple-negative or HR-positive and HER2-negative
- urothelial cancer (including certain bladder cancers and other cancers of the urinary tract)*
For doctors to prescribe this drug, the cancers must be locally advanced or metastatic.†
The active ingredient in Trodelvy is sacituzumab govitecan-hziy. (An active ingredient is what makes a drug work.) Trodelvy is a biologic, which means that it’s
Keep reading to learn about the common, mild, and serious side effects that Trodelvy can cause. For a general overview of the drug, including details about its uses, see this article.
* Trodelvy received
† With locally advanced cancer, the cancer has spread near the location where it started. And with metastatic cancer, the cancer has spread to areas farther away.
Some people may experience mild or serious side effects during Trodelvy treatment. Examples of Trodelvy’s commonly reported side effects include:
- mild nausea and vomiting
- mild diarrhea
- feeling weak or tired
- severe neutropenia (low level of neutrophils, a kind of white blood cell)*†
- hair loss†
* Trodelvy has a
† To learn more about this side effect, see the “Side effects explained” section below.
Treatment with Trodelvy can cause mild side effects. Examples of mild side effects that have been reported with Trodelvy include:
- abdominal pain
- decreased appetite
- feeling weak or tired
- joint pain
- mouth sores
- skin rash
- insomnia (trouble sleeping)
- hair loss*
* To learn more about this side effect, see the “Side effects explained” section below.
In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And do not stop treatment with Trodelvy unless your doctor recommends it.
Trodelvy may cause mild side effects other than the ones listed above. See the Trodelvy prescribing information for details.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Trodelvy, visit MedWatch.
Serious side effects are possible with Trodelvy treatment. Serious side effects that have been reported with Trodelvy include:
- intestinal blockage
- blood clots
- kidney damage
- low red blood cell levels
- serious infection, such as pneumonia
- sepsis (a severe response to an infection, which can be life threatening)
- severe diarrhea*
- severe or life threatening neutropenia (low level of neutrophils, a kind of white blood cell)*
- allergic reaction†
- infusion‡ reaction (symptoms that occur after an infusion of Trodelvy)†
- severe nausea and vomiting†
If you develop serious side effects while receiving Trodelvy, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.
* Trodelvy has a
† For more information, see the “Side effects explained” section below.
‡ Trodelvy is given as an intravenous (IV) infusion (an injection into your vein given over time).
Learn more about some of the side effects Trodelvy may cause.
What might help
Talk with your doctor if you have hair loss while receiving Trodelvy. They may recommend ways to manage this side effect.
Diarrhea was one of Trodelvy’s more common side effects in studies. In most cases, this side effect was mild or moderate. Severe diarrhea was reported, but this was much less common.
What might help
If you have diarrhea during Trodelvy treatment, contact your doctor. Due to the risk of severe diarrhea, they’ll likely check to determine whether you have an infection that could be causing it.
If your diarrhea isn’t caused by an infection, your doctor will likely recommend a medication to treat it, such as Imodium A-D (loperamide). They may also recommend replacing fluids and electrolytes (minerals) that you’ve lost due to diarrhea.
Until your diarrhea goes away or becomes less severe, your doctor will also likely have you temporarily stop treatment with Trodelvy. Once you can safely resume treatment, your doctor may lower your Trodelvy dose.
Severe or life threatening neutropenia
With neutropenia, you have a low level of neutrophils, a kind of white blood cell. Neutrophils help your body fight infection. When your neutrophil level gets too low, your body can’t respond to infections like usual.
Severe neutropenia was among the more common side effects in studies of Trodelvy. Neutropenia itself doesn’t cause noticeable symptoms in most cases. But your doctor will monitor you for this condition. And you should watch for any signs of infection, such as:
In rare cases, people receiving Trodelvy in studies developed febrile neutropenia. This is a life threatening kind of neutropenia that causes a fever above 101°F (38.3°C) or a fever that’s higher than 100.4°F (38°C) for 1 hour or more.
What might help
During Trodelvy treatment, you’ll have blood tests to monitor your neutrophil level. If your level decreases below a certain amount, your doctor will likely have you temporarily pause treatment with Trodelvy.
If you develop febrile neutropenia, your doctor will pause your treatment. You might also need antibiotics and treatment in the hospital.
In most cases, neutrophil levels return to usual 2 to 3 weeks after stopping Trodelvy. Depending on how severe the neutropenia is, your doctor may also recommend medication to help your body make neutrophils.
Once your neutrophil level returns to normal, you and your doctor will decide whether you’ll resume Trodelvy treatment. If you do continue treatment, your doctor will likely lower your Trodelvy dose.
If you develop neutropenia more than twice, it’s likely that your doctor will have you stop Trodelvy treatment.
Severe nausea and vomiting
What might help
Your doctor will prescribe medications for you to take before each Trodelvy infusion* to help prevent nausea and vomiting. You’ll likely also take medications to help prevent or treat these side effects at home during Trodelvy treatment. Examples of medications your doctor may prescribe include:
- a corticosteroid such as dexamethasone
- a nausea medication such as Zofran (ondansetron) or Emend (aprepitant)
Your doctor can provide more information about these medications.
If you have severe or bothersome nausea or vomiting, be sure to talk with your doctor. They might be able to recommend other ways to help manage these side effects.
* Trodelvy is given as an intravenous (IV) infusion (an injection into your vein given over time).
Trodelvy can cause infusion reactions. These are symptoms that occur soon after an IV infusion of Trodelvy.
Symptoms usually develop within 24 hours of receiving a Trodelvy infusion. They can also develop days or weeks after an infusion. Symptoms may include:
- fever or chills
- trouble breathing
- feeling dizzy or lightheaded
- hives (a rash that causes itchy, raised patches of skin)
- low blood pressure
- flushing (temporary warmth, redness, or deepening of skin color)
- skin rash
- swelling in your face, lips, throat, or tongue
Infusion reactions can be life threatening in some cases.
Note: Some of these symptoms can also be a sign of an allergic reaction to Trodelvy. This side effect is described below in “Allergic reaction.”
What might help
Be sure to contact your doctor if you have symptoms of an infusion reaction at any time. This is important to do, even if it’s been a while since your most recent infusion.
To help prevent infusion reactions, your doctor will prescribe medications for you to take before each Trodelvy infusion. These medications may include:
- Tylenol (acetaminophen) to help prevent fever
- a histamine blocker such as Benadryl (diphenhydramine) or Pepcid (famotidine)
A healthcare professional will monitor you during your Trodelvy infusions. You’ll also be monitored for at least 30 minutes after each infusion to watch for symptoms of a reaction.
If you develop symptoms of a reaction, the person giving your infusion may slow down how quickly the drug is being infused. Or they might stop your Trodelvy infusion. You might also be given medications to treat the reaction. If you have life threatening symptoms, your doctor will have you permanently stop Trodelvy treatment.
Like most drugs, Trodelvy can cause an allergic reaction in some people. Serious allergic reactions weren’t common in the drug’s studies.
Symptoms can be mild or serious and can include:
- skin rash
- swelling under your skin, usually in your eyelids, lips, hands, or feet
- swelling of your mouth, tongue, or throat, which can make it hard to breathe
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter antihistamine you take by mouth, such as Benadryl, to manage your symptoms. Or they may recommend a product you apply to your skin, such as hydrocortisone cream.
If your doctor confirms you had a mild allergic reaction to Trodelvy, they’ll decide whether you should continue receiving it.
If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you had a serious allergic reaction to Trodelvy, they may have you switch to a different treatment.
Keeping track of side effects
During Trodelvy treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.
Your side effect notes can include things such as:
- when the side effect started
- what your symptoms were and how they affected your daily activities
- what other medications you were also taking, and what dose
- any other information you feel is important
Keeping notes and sharing them with your doctor will help your doctor learn more about how Trodelvy affects you. And your doctor can use this information to adjust your treatment plan if needed.
There are certain precautions to consider before beginning treatment with Trodelvy. This includes two boxed warnings.
Trodelvy has two
- Risk of severe diarrhea. Treatment with Trodelvy can cause severe diarrhea. If this occurs, your doctor might recommend pausing Trodelvy to treat the diarrhea.
- Risk of severe or life threatening neutropenia. Trodelvy can cause severe or life threatening neutropenia. With this condition, you have a low level of neutrophils (a kind of white blood cell). This can raise your risk of infection.
To learn more, see the “Side effects explained” section above.
Trodelvy may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you start receiving Trodelvy. The list below includes factors to consider.
Liver problems. Your doctor may not prescribe Trodelvy if you have moderate or severe liver problems, such as hepatitis (a liver infection). Your doctor will determine whether Trodelvy is safe for you, depending on your liver function.
Reduced activity of the UGT1A1 gene. You may be at higher risk of some side effects of Trodelvy if you have reduced activity of a gene called UGT1A1. Specifically, this may increase your risk of anemia, neutropenia, and a severe kind of neutropenia called febrile neutropenia. (For more information, see “Side effects explained” above.) Your doctor can determine whether Trodelvy treatment is safe for you.
Allergic reaction. If you’ve had an allergic reaction to Trodelvy or any of its ingredients, your doctor will likely not prescribe Trodelvy. Ask your doctor what other medications are better options for you.
Alcohol and Trodelvy
There are no known interactions between alcohol and Trodelvy. But drinking alcohol could make you more likely to have some side effects or could worsen certain side effects. These include:
If you drink alcohol, ask your doctor about how much is safe for you to drink while you’re receiving Trodelvy.
Pregnancy and breastfeeding with Trodelvy
Trodelvy is not safe to receive during pregnancy. And you should not breastfeed while receiving Trodelvy or for at least 1 month after your last dose.
If you can become pregnant, your doctor will have you take a pregnancy test to check that you’re not pregnant before prescribing Trodelvy. They’ll also recommend using birth control during treatment and for at least 6 months after your last dose.
If you’re male* and have a partner who can become pregnant, your doctor will recommend that you use birth control while receiving Trodelvy. You’ll also need to keep using birth control for 3 months after you stop treatment.
If you’re pregnant, breastfeeding, or planning either, talk with your doctor about your cancer treatment options.
* In this article, we use the term “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
Like most medications, Trodelvy can cause side effects. These might be mild or serious.
Before starting treatment with Trodelvy, talk with your doctor. Ask questions to help you become familiar with this medication and its side effects. Below are a few examples to help get you started:
- Are there ways I can lower my risk of side effects from receiving Trodelvy?
- Does my medical history put me at higher risk of any side effects?
- If I have side effects, can I try a lower dose of Trodelvy?
- How do Trodelvy’s side effects compare with those caused by other treatment options?
To learn more about Trodelvy, see these articles:
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Are there medications that raise my risk of side effects if I take them with Trodelvy?Anonymous
Yes. Certain medications can increase the level of Trodelvy in your body. This can raise your risk of side effects. Due to this risk, doctors usually won’t prescribe these drugs with Trodelvy.
Examples of these drugs include:
- the diabetes drugs Invokana (canagliflozin) and Farxiga (dapagliflozin)
- certain cancer drugs, such as Nexavar (sorafenib) and Tasigna (nilotinib)
- Synthroid (levothyroxine), a thyroid hormone replacement drug
For more examples of drugs that can increase your risk of side effects with Trodelvy, see this article.
Before you begin treatment with Trodelvy, be sure to tell your doctor and pharmacist about all medications you take. They can make sure that your medications are safe to take with Trodelvy. They can also suggest medications that may be safer to take with Trodelvy, if needed.The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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 another 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.