Herceptin 150mg

What is this drug and what is it used for?

Your doctor may prescribe Herceptin for the treatment of breast and gastric cancer when:

• You have early breast cancer, with high levels of a protein called HER2.
• You have metastatic breast cancer (breast cancer that has spread beyond the original tumour) with high levels of HER2.
• You have metastatic gastric cancer with high levels of HER2, when it is in combination with the other cancer medicines capecitabine or 5-flououracil and cisplatin.

How is this drug given?

The dose of Herceptin depends on your body weight.

Two different types (formulations) of Herceptin exist:

• One is given as an infusion into a vein (intravenous infusion)
• The other is given as an injection under the skin (subcutaneous injection).

It is important to check the product labels to ensure that the correct formulation is being given as prescribed. Herceptin intravenous formulation is not for subcutaneous use and should be given as an intravenous infusion only.
Your doctor may consider switching your Herceptin intravenous treatment to Herceptin subcutaneous treatment (and vice versa) if considered appropriate for you.
Herceptin intravenous formulation is given as an intravenous infusion (“drip”) directly into your veins. The first dose of your treatment is given over 90 minutes and you will be observed by a health professional while it is being given in case you have any side effects. If the first dose is well tolerated the next doses may be given over 30 minutes (see section 2 under “warnings and precautions”). The number of infusions you receive will depend on how you respond to the treatment. Your doctor will discuss this with you.

In order to prevent medication errors it is important to check the vial labels to ensure that the medicine being prepared and given is Herceptin (trastuzumab) and not trastuzumab emtansine.
For early breast cancer, metastatic breast cancer and metastatic gastric cancer, Herceptin is given every 3 weeks. Herceptin may also be given once a week for metastatic breast cancer.

Possible side effects:

During a Herceptin infusion, chills, fever and other flu like symptoms may occur. These are very common (may affect more than 1 in 10 people). Other infusion-related symptoms are: feeling sick (nausea), vomiting, pain, increased muscle tension and shaking, headache, dizziness, breathing difficulties, wheezing, high or low blood pressure, heart rhythm disturbances (palpitations, heart fluttering or irregular heart beat), swelling of the face and lips, rash and feeling tired. Some of these symptoms can be serious and some patients have died (see section 2 under “warnings and precautions”).
These effects mainly occur with the first intravenous infusion (“drip” into your vein) and during the first few hours after the start of the infusion. They are usually temporary. You will be observed by a health care professional during the infusion and for at least six hours after the start of the first infusion and for two hours after the start of other infusions. If you develop a reaction, they will slow down or stop the infusion and may give you treatment to counteract the side effects. The infusion may be continued after the symptoms improve.
Occasionally, symptoms start later than six hours after the infusion begins. If this happens to you, contact your doctor immediately. Sometimes, symptoms may improve and then get worse later.
Other side effects can occur at any time during treatment with Herceptin, not just related to an infusion. Heart problems can sometimes occur during treatment and occasionally after treatment has stopped and can be serious. They include weakening of the heart muscle possibly leading to heart failure, inflammation (swollen, red, hot, and in pain) of the lining around the heart and heart rhythm disturbances. This can lead to symptoms such as:

• Breathlessness (including breathlessness at night)
• Cough
• Fluid retention (swelling) in the legs or arms
• Palpitations (heart fluttering or irregular heart beat)

Your doctor will monitor your heart regularly during and after treatment but you should tell your doctor immediately if you notice any of the above symptoms.
If you experience any of the above symptoms when your treatment with Herceptin has finished, you should see your doctor and tell them that you have previously been treated with Herceptin.

Very common side effects of Herceptin: may affect more than 1 in 10 people

• Infections
• Diarrhea
• Constipation
• Heartburn (dyspepsia)
• Weakness
• Skin rashes
• Chest pain
• Abdominal pain
• Joint pain
• Low counts of red blood cells and white blood cells (which help fight infection) sometimes with fever
• Muscle pain
• Conjunctivitis
• Watery eyes
• Nose bleeds
• Runny nose
• Hair loss
• Tremor
• Hot flush
• Dizziness
• Nail disorders
• Weight loss
• Loss of appetite
• Inability to sleep (insomnia)
• Altered taste
• Low platelet count
• Bruising
• Numbness or tingling of the fingers and toes
• Redness, swelling or sores in your mouth and/or throat
• Pain, swelling, redness or tingling of hands and/or feet
• Breathlessness
• Headache
• Cough
• Vomiting
• Nausea

Common side effects of Herceptin: may affect up to 1 in 10 people

• Allergic reactions
• Dry mouth and skin
• Throat infections
• Dry eyes
• Bladder and skin infections
• Sweating
• Shingles
• Feeling weak and unwell
• Inflammation of the breast
• Anxiety
• Inflammation of the liver
• Depression
• Kidney disorders
• Abnormal thinking
• Increased muscle tone or tension (hypertonia)
• Asthma
• Infection of lungs
• Pain in the arms and/or legs
• Lung disorders
• Itchy rash
• Back pain
• Sleepiness (somnolence)
• Neck pain
• Haemorrhoids
• Bone pain
• Itchiness
• Acne
• Leg cramps