Hertraz 440 (Trastuzumab Vials) 440 mg

Trastuzumab is used to treat cancers that overexpress the HER2 protein, confirmed by laboratory testing before treatment.

• Early HER2-positive breast cancer: given after surgery, and sometimes before it, to lower the risk of the cancer returning.
• Metastatic HER2-positive breast cancer: treats advanced disease, alone or combined with chemotherapy.
• HER2-positive metastatic gastric cancer: treats advanced stomach or gastro-oesophageal junction cancer with chemotherapy in patients not previously treated.
• Combination with chemotherapy: often used alongside taxane or other regimens to improve response in suitable patients.

• Trastuzumab targets HER2, a receptor protein that sits on the surface of some breast and stomach cancer cells and drives them to grow and divide. By binding to HER2, trastuzumab blocks the growth signals these cancers depend on and slows or stops their proliferation. It also flags the cancer cells for destruction by the immune system. Because it acts on HER2-positive cells, healthy tissue without this target is largely spared.

Report any new symptom during treatment, especially breathlessness, cough, or ankle swelling, which may signal heart or lung effects.

Common Side Effects

• Fever, chills, and infusion reactions: common, especially with the first infusion.
• Nausea, vomiting, and diarrhoea: frequent digestive effects during treatment.
• Fatigue, headache, and muscle pain: general effects across treatment cycles.
• Low blood counts: reduced white cells or platelets, particularly with chemotherapy.

Serious or Rare Side Effects

• Heart failure and reduced heart function: trastuzumab can weaken the heart, more so with anthracycline chemotherapy; report breathlessness, swelling, or a fast heartbeat.
• Serious infusion reactions: severe reactions including anaphylaxis; stop the infusion and seek emergency care for breathing difficulty or collapse.
• Lung toxicity and harm in pregnancy: seek urgent care for severe breathlessness, and use effective contraception, as it can seriously harm an unborn baby.

Trastuzumab needs careful cardiac monitoring and patient selection before and during treatment.

• Check heart function first: measure heart pump function before starting, monitor it during treatment, and stop for significant decline.
• Confirm HER2 status: treat only patients whose cancer tests positive for HER2 overexpression.
• Take extra care with anthracyclines: combined use raises the risk of heart damage, so monitor closely.
• Monitor for infusion reactions: watch during and after infusions and manage reactions promptly.
• Prevent pregnancy: use effective contraception during treatment and for seven months after the last dose.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze, and use the prepared solution within the recommended time.

Review trastuzumab against the patient’s other cancer treatments and heart medicines before each cycle.

Major Interactions (Avoid)

• Anthracycline chemotherapy (doxorubicin, epirubicin): combined or recent use markedly raises the risk of heart failure, so monitor heart function closely.
• Ado-trastuzumab emtansine: do not substitute or combine, as these are distinct products with different dosing.

Moderate Interactions (Monitor Closely)

• Myelosuppressive chemotherapy: added bone marrow suppression can deepen low blood counts, so monitor counts.
• Other cardiotoxic drugs: overlapping effects on the heart call for careful cardiac monitoring during treatment.
• Live vaccines: use caution during treatment, particularly when trastuzumab is given alongside chemotherapy.