Precautions and Warnings With Trastuzumab

By reviewing the precautions and warnings with trastuzumab before taking it, you can help ensure a safe treatment process. Some of these precautions and warnings include the potential risk of the drug causing congestive heart failure, the safety of taking the drug when pregnant or breastfeeding, and the possibility of the drug causing infusion reactions. You should not take trastuzumab if you are allergic to any of the ingredients used to make the drug.

 

Trastuzumab: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking trastuzumab (Herceptin®) if you have:
 
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Precautions and Warnings With Trastuzumab

Some of the warnings and precautions to be aware of prior to taking trastuzumab include the following:
 
  • Trastuzumab can increase your risk of congestive heart failure (CHF). Your healthcare provider should monitor you closely to make sure you are not developing heart problems (see Cardiotoxicity and Herceptin for more information).
     
  • Trastuzumab can cause "infusion reactions," during or just after a dose of trastuzumab. Some symptoms of an infusion reaction include:
o Fever
o Chills
o Nausea or vomiting
o Pain
o Dizziness
o Difficulty breathing
o Rashes
o Low blood pressure (hypotension). 
Most of the time, infusion reactions are uncomfortable but not dangerous. However, severe allergic reactions can occur.
  • Trastuzumab can worsen neutropenia caused by chemotherapy medications. Neutropenia is a low level of certain white blood cells that can increase the risk of infection.
     
  • You must be tested to make sure that your tumor overexpresses HER2 (that your tumor cells have a high concentration of the HER2 receptors). While HER2 testing may be expensive, trastuzumab cannot be prescribed without the test.
     
  • Trastuzumab can interact with other medications (see Drug Interactions With Trastuzumab).
     
  • Trastuzumab is considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy. Talk to your healthcare provider about the risks and benefits of taking the drug during pregnancy (see Herceptin and Pregnancy).
     
  • It is not known if trastuzumab passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Herceptin and Breastfeeding).
     
(Precautions and Warnings With Trastuzumab Continued: Page 2)
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;