Herceptin Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Herceptin Injection (trastuzumab) is a prescription HER2/neu receptor antagonist given by IV infusion. It is used in adults with certain HER2-positive breast cancers and HER2-positive stomach cancers. It works by targeting the HER2 protein on cancer cells to interfere with their growth signals. It must be given by a healthcare professional and carries important warnings, including serious heart risks.

What is Herceptin Injection

Herceptin is a prescription medicine given by IV infusion that targets cancer cells with high levels of a protein called HER2. It is used in adults with certain HER2-positive breast cancers and HER2-positive stomach cancers. Its generic name is trastuzumab, and it belongs to the HER2/neu receptor antagonist (monoclonal antibody) drug class.

Herceptin Injection uses

• Treatment of HER2-overexpressing breast cancer, including as adjuvant therapy to help prevent cancer from returning after surgery
• Treatment of HER2-overexpressing metastatic (spreading) breast cancer
• Treatment of HER2-overexpressing metastatic gastric (stomach) or gastroesophageal junction adenocarcinoma

Benefits of Herceptin Injection

• HER2-Positive Cancer Treatment: Targets cancers that overexpress the HER2 protein
• Breast Cancer Support: Used for certain HER2-positive breast cancers
• Gastric Cancer Support: Used for certain HER2-positive metastatic gastric or gastroesophageal-junction cancers
• Targeted Therapy: Binds to HER2 and interferes with HER2-driven cancer-cell signaling

How Herceptin Injection works

Herceptin attaches to HER2 receptors found in large amounts on some cancer cells. By binding to these receptors, it blocks the growth signals the cancer cells need to grow and divide, and it also helps the immune system recognize and attack the cancer cells.

Herceptin Injection dosage

Herceptin is given only by a healthcare professional as an intravenous (IV) infusion; it must not be given as a quick IV push or bolus. Herceptin has different dosing instructions than other trastuzumab products, so it should not be substituted for them. It is not mixed with other drugs in the same bag.

If a dose is missed by one week or less, the usual dose is given as soon as possible rather than waiting for the next planned visit; if missed by more than one week, a larger reloading dose is given before returning to the regular schedule. People of childbearing potential should have a pregnancy test before starting treatment.

Use exactly as prescribed by your doctor or pharmacist.

Available forms and strengths

• Lyophilized powder in a single-dose vial for reconstitution (150 mg) for intravenous infusion
• 600 mg/5 mL solution for subcutaneous injection (Herceptin SC)

Side effects of Herceptin Injection

Common

• Headache
• Diarrhea
• Nausea and vomiting
• Chills and fever
• Fatigue
• Cough
• Rash
• Insomnia
• Joint, muscle, back, or abdominal pain
• Infections (such as urinary tract or upper respiratory infections)
• Hot flashes
• Swelling (fluid retention)
• Weight changes
• Change in taste
• Hair loss

Serious

• Heart problems, including weakened heart muscle or congestive heart failure
• Severe infusion or injection reactions, including anaphylaxis and angioedema
• Lung problems such as interstitial pneumonitis or acute respiratory distress syndrome
• Low red blood cell count (anemia)
• Low white blood cell count (neutropenia), which raises infection risk
• Low platelet count (thrombocytopenia), with easy bruising or bleeding
• Blood clots
• Kidney problems
• Tumor lysis syndrome
• Nerve damage (neuropathy)
• Harm to an unborn baby

Warnings and precautions

• This medicine can cause serious and sometimes fatal heart problems, including heart failure and decreased heart pumping function. The risk is highest when combined with certain chemotherapy drugs called anthracyclines. Heart function is checked before and during treatment, and treatment may need to be stopped if heart problems occur.
• Serious and sometimes fatal reactions can occur during or soon after the infusion, including severe allergic reactions and lung problems. Treatment is stopped right away if these occur.
• Taking this medicine during pregnancy can seriously harm or even cause the death of an unborn baby. Effective birth control is needed during and after treatment.
• This medicine can make chemotherapy-related drops in white blood cell counts worse, increasing infection risk.
• Herceptin can seriously harm an unborn baby, including causing low amniotic fluid levels that can lead to lung problems, bone problems, or death of the baby. Pregnancy should be ruled out before starting treatment, and effective birth control should be used during treatment and for 7 months after the last dose.
• It is not known if Herceptin passes into breast milk or if it is safe for a nursing baby. Breastfeeding is generally not recommended during treatment and for 7 months after the last dose.
• Kidney problems, including rare cases of kidney disease, have been reported with this medicine. Tell your doctor about symptoms like swelling, dizziness, dark urine, itching, or reduced urine output.
• There are no known direct interactions between Herceptin and alcohol, but drinking alcohol may worsen certain side effects such as heart problems, swelling, headache, and diarrhea.
• Be careful about driving or operating machinery until you know how this medicine affects you, and avoid these activities if you have symptoms during treatment.

Storage

• Store Herceptin vials in the refrigerator at 2°C to 8°C (36°F to 46°F) until time of reconstitution.
• Do not freeze.
• If not used immediately after mixing, the prepared solution can be stored for up to 24 hours at 2°C to 8°C (36°F to 46°F); discard any unused solution after 24 hours.
• The vial must be stored in the outer carton to protect it from light.

When to see a doctor

• Get medical help right away if you have new or worsening shortness of breath, cough, swelling of the ankles, legs, or face, a fast or irregular heartbeat, rapid weight gain, dizziness, or fainting — these can be signs of heart problems.
• Call your doctor right away or go to the nearest emergency department if you notice swelling of the face, lips, tongue, or throat with difficulty breathing, severe swelling of the hands or feet, severe shortness of breath or wheezing, severe chest pain, an irregular heartbeat, rash, itching, hives, fever, chills, or severe coughing.
• Tell your doctor right away if you think you might be pregnant while being treated with this medicine.

Alternatives

• Pertuzumab
• Trastuzumab deruxtecan
• Ado-trastuzumab emtansine