Trastuzumab (patient information)

# IMPORTANT WARNING:
Trastuzumab can cause heart damage. Tell your doctor if you are taking cyclophosphamide (Cytoxan, Neosar), daunorubicin (DaunoXome), doxorubicin (Adriamycin, Rubex), or idarubicin (Idamycin). Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to trastuzumab.
Trastuzumab may cause severe or fatal allergic reactions. Usually this reaction occurs within 24 hours of receiving treatment, but it may occur days after treatment.
You should call for help or go to an emergency room immediately if you experience difficulty breathing; swelling of the lips, throat, or inside of your mouth; dizziness or fainting; hives; or a severe skin rash.

# About your treatment
Your doctor has ordered the drug trastuzumab to help treat your illness. The drug is given by injection into a vein.This medication is used to treat metastatic breast cancer.
Trastuzumab is in a class of drugs known as monoclonal antibodies. Antibodies are substances that the body produces to help fight infection or other foreign particles. Trastuzumab recognizes and attaches to certain cancer cells. The body's immune system can recognize and kill the cancer cells to which trastuzumab is attached. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for information.

# Precautions
Before administering trastuzumab
- tell your doctor and pharmacist if you are allergic to trastuzumab, Chinese hamster ovary cell proteins, benzyl alcohol, or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications you are taking, including the medications listed in the IMPORTANT WARNING section, paclitaxel (Taxol), valrubicin (Valstar), and vitamins and herbal products.
- tell your doctor if you have or have ever had heart disease, asthma, or emphysema and if you have ever had radiation treatment.
- tell your doctor if you are pregnant or breast-feeding. You should not plan to have children while receiving chemotherapy or for a while after treatments. (Talk to your doctor for more details.) Use a reliable method of birth control to prevent pregnancy.
- do not have any vaccinations (e.g., measles or flu shots) without talking to your doctor.

# Side effects

## Minor Side Effects
Side effects from trastuzumab are common and usually occur while the drug is being infused. Your doctor may stop your treatment or may give you medications to treat these symptoms. They include:
- chills or shaking chills
- nausea
- vomiting
- pain at tumor site or in the abdomen or back
- shortness of breath
- muscle weakness or stiffness
- rash
- headache
Tell your doctor if any of these symptoms are severe or last for several hours:
- loss of appetite
- diarrhea
- sleeplessness
- runny nose
- sore throat
- sinus pain
- headache
- fatigue
- abdominal pain

## Severe Side Effects
If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:
- unusual bruising or bleeding
- swelling of the feet or ankles
- rapid heartbeat
- difficulty breathing
- wheezing while sleeping
- fever
- upper respiratory tract infection
- chills or shaking chills
- excessive coughing
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storage conditions
In most cases, your health care provider will bring a dose of trastuzumab to your home right before the dose is scheduled. If your pharmacy gives you doses to store, you should keep the container in the refrigerator. Talk to your pharmacist about the proper disposal of containers that are outdated or no longer needed.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Brand names
- Herceptin