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Anti-HER2 monoclonal antibody

Trastuzumab (Specialist drug)

Brand names: Herceptin, Herzuma, Ontruzant

Adult dose

Dose: Specialist initiation only — refer to BNF/SmPC
Route: IV/SC
Frequency: every 3 weeks

Clinical pearls

  • HER2-positive breast and gastric cancer
  • Specialist oncology — baseline + serial echo

Contraindications

  • Severe LV dysfunction
  • Severe hypersensitivity
  • Pregnancy

Side effects

  • Cardiotoxicity (LV dysfunction)
  • Infusion reactions
  • Pulmonary toxicity
  • Diarrhoea
  • Cytopenias

Interactions

  • Anthracyclines (cardiac additive)
  • Live vaccines

Monitoring

  • LVEF
  • FBC
  • Pulmonary symptoms

Reference: BNF; NICE TA34/TA208; SmPC; https://bnf.nice.org.uk/drugs/trastuzumab-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.