Herceptin
Generic Name
Trastuzumab (Subcutaneous)
Manufacturer
Genentech (a member of the Roche Group)
Country
Switzerland/USA
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| herceptin 600 mg injection | ৳ 81,956.80 | N/A |
Description
Overview of the medicine
Herceptin 600 mg injection contains trastuzumab, a monoclonal antibody used to treat HER2-positive breast cancer and metastatic gastric cancer. It works by targeting and blocking the HER2 protein, which is overexpressed in certain aggressive cancers, thereby inhibiting cancer cell growth.
Uses & Indications
Dosage
Adults
For HER2-positive early breast cancer and metastatic breast cancer: 600 mg fixed dose administered subcutaneously every three weeks. For metastatic gastric cancer: typically IV, but SC may be used in certain settings under medical supervision.
Elderly
No specific dose adjustment required based on age, but close monitoring for cardiac function is advised.
Renal_impairment
No dose adjustment recommended for renal impairment.
How to Take
Administered by a healthcare professional as a subcutaneous injection, usually in the thigh, over 2-5 minutes. Should not be administered intravenously.
Mechanism of Action
Trastuzumab selectively binds to the extracellular domain of the human epidermal growth factor receptor 2 (HER2) protein, leading to inhibition of HER2-mediated signaling, induction of antibody-dependent cell-mediated cytotoxicity (ADCC), and prevention of HER2 receptor shedding.
Pharmacokinetics
Onset
Therapeutic effects may take weeks or months to be observed, as it's for cancer treatment.
Excretion
Primarily through catabolism of IgG, with minimal renal or hepatic elimination of intact antibody.
Half life
Approximately 28 days for subcutaneous formulation at steady state.
Absorption
Peak serum concentration (Cmax) achieved rapidly after subcutaneous administration. Bioavailability of SC is comparable to IV.
Metabolism
Expected to be metabolized by catabolic pathways like other IgG antibodies, not primarily via cytochrome P450 enzymes.
Side Effects
Contraindications
- Hypersensitivity to trastuzumab, hyaluronidase, or any excipients.
- Severe uncontrolled cardiac disease.
Drug Interactions
Radiation therapy
Potential for increased pulmonary toxicity with concurrent use.
Anthracycline-containing regimens
Increased risk of cardiotoxicity when co-administered. Concurrent use generally not recommended.
Storage
Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light. Keep in the original carton.
Overdose
There is no specific antidote for trastuzumab overdose. Management should involve supportive care and close monitoring for adverse reactions, especially cardiac dysfunction.
Pregnancy & Lactation
Pregnancy Category D. Can cause fetal harm. Advise pregnant women of the potential risk to the fetus. Not recommended during breastfeeding due to potential for serious adverse reactions in the breastfed infant.
Side Effects
Contraindications
- Hypersensitivity to trastuzumab, hyaluronidase, or any excipients.
- Severe uncontrolled cardiac disease.
Drug Interactions
Radiation therapy
Potential for increased pulmonary toxicity with concurrent use.
Anthracycline-containing regimens
Increased risk of cardiotoxicity when co-administered. Concurrent use generally not recommended.
Storage
Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light. Keep in the original carton.
Overdose
There is no specific antidote for trastuzumab overdose. Management should involve supportive care and close monitoring for adverse reactions, especially cardiac dysfunction.
Pregnancy & Lactation
Pregnancy Category D. Can cause fetal harm. Advise pregnant women of the potential risk to the fetus. Not recommended during breastfeeding due to potential for serious adverse reactions in the breastfed infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months when stored unopened as recommended. Once punctured, stability varies; refer to product leaflet.
Availability
Hospitals, oncology clinics, specialty pharmacies
Approval Status
FDA approved
Patent Status
Patent expired for original IV formulation; SC formulation may have ongoing patents.
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials (e.g., HannaH, SafeHER studies) demonstrated comparable efficacy and safety of Herceptin SC to IV for early and metastatic HER2-positive breast cancer.
Lab Monitoring
- Left Ventricular Ejection Fraction (LVEF) (before and during treatment)
- Complete Blood Count (CBC)
- Liver function tests (LFTs)
- Renal function tests
Doctor Notes
- Confirm HER2-positive status via validated testing prior to initiation.
- Monitor cardiac function (LVEF) every 3 months during treatment and for a period after completion.
- Educate patients on symptoms of cardiac toxicity and hypersensitivity reactions.
Patient Guidelines
- Report any signs of heart problems (e.g., shortness of breath, swelling) immediately.
- Avoid pregnancy during treatment and for 7 months after the last dose.
- Inform your doctor about all medications and supplements you are taking.
- Do not self-inject; administration must be by a healthcare professional.
Missed Dose Advice
If a dose is missed, administer it as soon as possible. If the next scheduled dose is less than 7 days away, wait and administer the next dose at its scheduled time. Do not double the dose. Consult your doctor immediately.
Driving Precautions
Herceptin may cause fatigue or dizziness. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy diet and lifestyle.
- Regular exercise as advised by your doctor.
- Avoid smoking and excessive alcohol consumption.
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