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| == '''What is Herceptin?''' ==
| | #REDIRECT [[Trastuzumab]] |
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| * '''Herceptin''' ([[trastuzumab]]) is '''a HER2/neu receptor antagonist''' used in combination with other [[antineoplastic agents]] in the therapy of breast and gastric cancer.
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| [[File:Trastuzumab-HER2 complex 1N8Z.png|thumb|Trastuzumab-HER2 complex 1N8Z]] | | [[Category:Drugs developed by Genentech]] |
| | | [[Category:Drugs developed by Hoffmann-La Roche]] |
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| <youtube>
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| title='''{{PAGENAME}}'''
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| movie_url=http://www.youtube.com/v//v=jwPfq0xYqCk
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| == '''What are the uses of this medicine?''' ==
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| '''Herceptin''' (trastuzumab) is used for:
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| * The treatment of HER2-overexpressing [[breast cancer]].
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| * The treatment of HER2 overexpressing metastatic gastric or [[gastroesophageal junction adenocarcinoma]].
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| == '''How does this medicine work?''' ==
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| <youtube>
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| title='''{{PAGENAME}}'''
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| movie_url=http://www.youtube.com/v=ZNnUuolEe4Y
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| </youtube>
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| * Trastuzumab (tras tooz’ ue mab) is '''humanized monoclonal antibody to [[HER2]]''' which is a human growth factor receptor that is overexpressed in 20% to 25% of breast cancers.
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| * The interaction of [[epidermal growth factor]] (EGF) with HER2 results in rapid cell growth and proliferation via intracellular pathways that include MAP and PI3 kinase.
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| * '''Binding of trastuzumab to the HER2 receptor blocks this cell signaling pathway and causes growth arrest'''.
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| * Trastuzumab was shown to decrease recurrences and prolong survival in women with breast cancer that were HER2 positive.
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| == '''Who Should Not Use this medicine ?''' ==
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| * This medicine have no usage limitations.
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| == '''What drug interactions can this medicine cause?''' ==
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| * Patients who receive [[anthracycline]] after stopping Herceptin may be at increased risk of [[cardiac dysfunction]].
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| * If anthracyclines are used, the patient's cardiac function should be monitored carefully.
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| == '''Is this medicine FDA approved?''' ==
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| * Trastuzumab was approved for use in the United States in 1998 and current indications include breast and gastric cancers that express HER2.
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| == '''How should this medicine be used?''' ==
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| * Select patients based on HER2 protein overexpression or HER2 gene amplification in tumor specimens.
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| '''Recommended dosage:'''
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| '''Adjuvant Treatment of HER2-Overexpressing Breast Cancer:'''
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| * Initial dose of 4 mg/kg over 90 minute IV infusion, then 2 mg/kg over 30 minute IV infusion weekly for 12 weeks (with paclitaxel or docetaxel) or 18 weeks (with docetaxel/carboplatin).
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| * One week after the last weekly dose of Herceptin, administer 6 mg/kg as an IV infusion over 30–90 minutes every three weeks to complete a total of 52 weeks of therapy, or
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| * Initial dose of 8 mg/kg over 90 minutes IV infusion, then 6 mg/kg over 30–90 minutes IV infusion every three weeks for 52 weeks.
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| '''Metastatic HER2-Overexpressing Breast Cancer:'''
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| * Initial dose of 4 mg/kg as a 90 minute IV infusion followed by subsequent weekly doses of 2 mg/kg as 30 minute IV infusions.
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| '''Metastatic HER2-Overexpressing Gastric Cancer:'''
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| * Initial dose of 8 mg/kg over 90 minutes IV infusion, followed by 6 mg/kg over 30 to 90 minutes IV infusion every 3 weeks.
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| '''Administration:'''
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| * For [[intravenous]] (IV) infusion only.
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| * Do not administer as an IV push or bolus.
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| * Do not substitute Herceptin (trastuzumab) for or with ado-trastuzumab emtansine.
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| == '''What are the dosage forms and brand names of this medicine?''' ==
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| This medicine is available in fallowing doasage form:
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| * '''As Injection:''' 150 mg [[lyophilized]] powder in a single-dose vial for [[reconstitution]].
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| This medicine is available in fallowing brand namesː
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| * '''Herceptin'''
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| =='''What side effects can this medication cause?'''==
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| The most common side effects of this medicine include:
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| '''In Adjuvant Breast Cancer:'''
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| * headache, [[diarrhea]], nausea, and [[chills]]
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| '''In Metastatic Breast Cancer:'''
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| * fever, [[chills]], headache, infection, [[congestive heart failure]], [[insomnia]], cough, and rash
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| '''In Metastatic Gastric Cancer:'''
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| * [[neutropenia]], diarrhea, fatigue, anemia, [[stomatitis]], weight loss, [[upper respiratory tract infections]], fever, [[thrombocytopenia]], mucosal inflammation, [[nasopharyngitis]], and [[dysgeusia]]
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| ==''' What special precautions should I follow?''' ==
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| * Herceptin can cause [[left ventricular cardiac dysfunction]], [[arrhythmias]], [[hypertension]], disabling cardiac failure, [[cardiomyopathy]], and cardiac death. Conduct thorough cardiac assessment, including history, physical examination, and determination of LVEF by [[echocardiogram]] or MUGA scan.
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| * Infusion reactions consist of a symptom complex characterized by fever and chills, and on occasion included nausea, vomiting, pain (in some cases at tumor sites), headache, [[dizziness]], [[dyspnea]], hypotension, rash, and [[asthenia]]. Patients should be evaluated and carefully monitored until complete resolution of signs and symptoms. Permanent discontinuation should be strongly considered in all patients with severe infusion reactions.
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| * Herceptin can cause fetal harm when administered to a pregnant woman. Advise pregnant women and females of reproductive potential that exposure to Herceptin during pregnancy or within 7 months prior to conception can result in fetal harm. Advise females of reproductive potential to use effective [[contraception]] during treatment and for 7 months following the last dose of Herceptin.
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| * Herceptin use can result in serious and fatal [[pulmonary toxicity]].
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| == '''What to do in case of emergency/overdose?''' ==
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| Symptoms of overdosage may include:
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| * There is no experience with overdosage in human clinical trials.
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| Management of overdosage:
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| * {{overdose}}
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| == '''Can this medicine be used in pregnancy?''' ==
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| * Herceptin can cause fetal harm when administered to a pregnant woman.
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| =='''Can this medicine be used in children?'''==
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| * The safety and effectiveness of Herceptin in pediatric patients have not been established.
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| == '''What are the active and inactive ingredients in this medicine?''' ==
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| '''Active ingredient:'''
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| * TRASTUZUMAB
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| '''Inactive ingredients:'''
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| * HISTIDINE MONOHYDROCHLORIDE MONOHYDRATE
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| * HISTIDINE
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| * TREHALOSE DIHYDRATE
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| * POLYSORBATE 20
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| == '''Who manufactures and distributes this medicine?''' ==
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| '''Manufactured by:'''
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| * [[Genentech, Inc.|Genentech, Inc]].
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| * A Member of the Roche Group
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| * 1 DNA Way
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| * South San Francisco, CA
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| * Herceptin® is a registered trademark of Genentech, Inc.
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| == '''What should I know about storage and disposal of this medication?''' ==
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| * Store Herceptin vials in the refrigerator at 2°C to 8°C (36°F to 46°F) until time of reconstitution.
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| {{coststubd}}
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| {{Extracellular chemotherapeutic agents}}
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| {{Monoclonals for tumors}}
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| {{Growth factor receptor modulators}}
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| {{Portal bar|Medicine}}
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| [[Category:Genentech brands]]
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| [[Category:Hoffmann-La Roche brands]] | |
| [[Category:Immunology]]
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| [[Category:Merck & Co. brands]]
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| [[Category:Monoclonal antibodies for tumors]]
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| [[Category:Specialty drugs]]
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