Trastuzumab is an active pharmaceutical ingredient in the Her2 (Human Epidermal Growth Factor Receptor 2) Inhibitors group (L01FD). The information below is compiled per regulator from the product labels on record, with direct links to the original documents.
GBOfficial regulatory label· revised May 29, 2026[1]
Breast cancer Metastatic breast cancer Herceptin is indicated for the treatment of adult patients with HER2 positive metastatic breast cancer: (MBC): - as monotherapy for the treatment of those patients who have received at least two chemotherapy regimens for their metastatic disease.
Prior chemotherapy must have included at least an anthracycline and a taxane unless patients are unsuitable for these treatments. Hormone receptor positive patients must also have failed hormonal therapy, unless patients are unsuitable for these treatments.
- in combination with paclitaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease and for whom an anthracycline is not suitable. - in combination with docetaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease.
- in combination with an aromatase inhibitor for the treatment of postmenopausal patients with hormone-receptor positive MBC, not previously treated with trastuzumab. Early breast cancer Herceptin is indicated for the treatment of adult patients with HER2 positive early breast cancer.
CACanada· Health Canada
16 products
Uses
CAOfficial regulatory label· revised December 23, 2025[2]
Indications have been granted on the basis of similarity between HERZUMA® and the reference biologic drug HERCEPTIN®. • Early Breast Cancer (EBC) HERZUMA® (trastuzumab) is indicated for the treatment of patients with early stage breast cancer with ECOG 0-1 status, whose tumours overexpress HER2, • following surgery and after chemotherapy • following adjuvant chemotherapy consisting of doxorubicin and cyclophosphamide, in combination with paclitaxel or docetaxel • in combination with adjuvant chemotherapy consisting of docetaxel and carboplatin.
For detailed information on the inclusion criteria for the clinical trials of trastuzumab in EBC according to the TNM (Tumour, Node, Metastasis) classification system, see Part II: Clinical Trial – Reference Biologic Drug section. Based on the analysis of the HERA trial, the benefit of the adjuvant treatment with trastuzumab for low risk patients not given adjuvant chemotherapy are unknown.
e. concurrent versus sequential, anthracycline containing versus non-anthracycline containing) was not studied. • Metastatic Breast Cancer (MBC) HERZUMA® is indicated for the treatment of patients with MBC whose tumours overexpress HER2.
EUEuropean Union· EMA
10 products
Uses
EUOfficial regulatory label· revised May 18, 2026[3]
Breast cancer Metastatic breast cancer Zercepac is indicated for the treatment of adult patients with HER2 positive metastatic breast cancer (MBC): - as monotherapy for the treatment of those patients who have received at least two chemotherapy regimens for their metastatic disease.
Prior chemotherapy must have included at least an anthracycline and a taxane unless patients are unsuitable for these treatments. Hormone receptor positive patients must also have failed hormonal therapy, unless patients are unsuitable for these treatments.
- in combination with paclitaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease and for whom an anthracycline is not suitable. - in combination with docetaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease.
- in combination with an aromatase inhibitor for the treatment of postmenopausal patients with hormone-receptor positive MBC, not previously treated with trastuzumab. Early breast cancer Zercepac is indicated for the treatment of adult patients with HER2 positive early breast cancer (EBC).
Drug interactions
Known interactions involving Trastuzumab. Select one for details. This list is informational and not a complete interaction checker.
Interaction data compiled from DDInter (academic, CC-BY). Severity classification only - this is not a complete interaction checker and not medical advice.
[1]MHRA (UK) · PLGB000310859 · revised May 29, 2026
[2]Health Canada (DPD) · 02480794 · revised December 23, 2025
[3]European Medicines Agency · EMEA/H/C/005209 · revised May 18, 2026
Information on this page is compiled from public regulatory records. Drugvu is not affiliated with any regulator or pharmaceutical manufacturer. This is not medical advice. Always consult a qualified healthcare professional.
(EBC). 1). - following adjuvant chemotherapy with doxorubicin and cyclophosphamide, in combination with paclitaxel or docetaxel. - in combination with adjuvant chemotherapy consisting of docetaxel and carboplatin. 1). 1). Metastatic gastric cancer Herceptin in combination with capecitabine or 5-fluorouracil and cisplatin is indicated for the treatment of adult patients with HER2 positive metastatic adenocarcinoma of the stomach or gastro-esophageal junction who have not received prior anti-cancer treatment for their metastatic disease.
Herceptin should only be used in patients with metastatic gastric cancer (MGC) whose tumours have HER2 overexpression as defined by IHC2+ and a confirmatory SISH or FISH result, or by an IHC 3+ result. 1).
How to take
GBOfficial regulatory label· revised May 29, 2026[1]
1). 4), and should be administered by a healthcare professional only. It is important to check the product labels to ensure that the correct formulation (intravenous or subcutaneous fixed dose) is being administered to the patient, as prescribed.
Herceptin intravenous formulation is not intended for subcutaneous administration and should be administered via an intravenous infusion only. 8). g. trastuzumab emtansine or trastuzumab deruxtecan). Posology Metastatic breast cancer Three-weekly schedule The recommended initial loading dose is 8 mg/kg body weight.
The recommended maintenance dose at three-weekly intervals is 6 mg/kg body weight, beginning three weeks after the loading dose. Weekly schedule The recommended initial loading dose of Herceptin is 4 mg/kg body weight. The recommended weekly maintenance dose of Herceptin is 2 mg/kg body weight, beginning one week after the loading dose.
Administration in combination with paclitaxel or docetaxel In the pivotal trials (H0648g, M77001), paclitaxel or docetaxel was administered the day following the first dose of Herceptin (for dose, see the Summary of Product Characteristics (SmPC) for paclitaxel or docetaxel) and immediately after the subsequent doses of Herceptin if the preceding dose of Herceptin was well tolerated.
Administration in combination with an aromatase inhibitor In the pivotal trial (BO16216) Herceptin and anastrozole were administered from day 1. There were no restrictions on the relative timing of Herceptin and anastrozole at administration (for dose, see the SmPC for anastrozole or other aromatase inhibitors).
Early breast cancer Three-weekly and weekly schedule As a three-weekly regimen the recommended initial loading dose of Herceptin is 8 mg/kg body weight. The recommended maintenance dose of Herceptin at three-weekly intervals is 6 mg/kg body weight, beginning three weeks after the loading dose.
As a weekly regimen (initial loading dose of 4 mg/kg followed by 2 mg/kg every week) concomitantly with paclitaxel following chemotherapy with doxorubicin and cyclophosphamide. 1 for chemotherapy combination dosing. Metastatic gastric cancer Three-weekly schedule The recommended initial loading dose is 8 mg/kg body weight.
The recommended maintenance dose at three-weekly intervals is 6 mg/kg body weight, beginning three weeks after the loading dose. Breast cancer and gastric cancer Duration of treatment Patients with MBC or MGC should be treated with Herceptin until progression of disease.
1). Dose reduction No reductions in the dose of Herceptin were made during clinical trials. Patients may continue therapy during periods of reversible, chemotherapy- induced myelosuppression but they should be monitored carefully for complications of neutropenia during this time.
Refer to the SmPC for paclitaxel, docetaxel or aromatase inhibitor for information on dose reduction or delays. If left ventricular ejection fraction (LVEF) percentage drops ≥ 10 points from baseline AND to below 50 %, treatment should be suspended and a repeat LVEF assessment performed within approximately 3 weeks.
If LVEF has not improved, or has declined further, or if symptomatic congestive heart failure (CHF) has developed, discontinuation of Herceptin should be strongly considered, unless the benefits for the individual patient are deemed to outweigh the risks.
All such patients should be referred for assessment by a cardiologist and followed up. Missed doses If the patient has missed a dose of Herceptin by one week or less, then the usual maintenance dose (weekly regimen: 2 mg/kg; three-weekly regimen: 6 mg/kg) should be administered as soon as possible.
Do not wait until the next planned cycle. Subsequent maintenance doses should be administered 7 days or 21 days later according to the weekly or three-weekly schedules, respectively. If the patient has missed a dose of Herceptin by more than one week, a re- loading dose of Herceptin should be administered over approximately 90 minutes (weekly regimen: 4 mg/kg; three-weekly regimen: 8 mg/kg) as soon as possible.
Subsequent Herceptin maintenance doses (weekly regimen: 2 mg/kg; three-weekly regimen 6 mg/kg respectively) should be administered 7 days or 21 days later according to the weekly or three-weekly schedules respectively. Special populations Dedicated pharmacokinetic studies in the elderly and those with renal or hepatic impairment have not been carried out.
In a population pharmacokinetic analysis, age and renal impairment were not shown to affect trastuzumab disposition. Paediatric population There is no relevant use of Herceptin in the paediatric population. Method of administration Herceptin loading dose should be administered as a 90-minute intravenous infusion.
Do not administer as an intravenous push or bolus. Herceptin intravenous infusion should be administered by a health-care provider prepared to manage anaphylaxis and an emergency kit should be available. Patients should be observed for at least six hours after the start of the first infusion and for two hours after the start of the subsequent infusions for symptoms like fever and chills or other infusion-related symptoms […]
This is not medical advice. Consult a qualified healthcare professional.
Side effects & warnings
GBOfficial regulatory label· Adverse reactions· revised May 29, 2026[1]
Summary of the safety profile Amongst the most serious and/or common adverse reactions reported in Herceptin usage (intravenous and subcutaneous formulations) to date are cardiac dysfunction, infusion-related reactions, haematotoxicity (in particular neutropenia), infections and pulmonary adverse reactions.
Tabulated list of adverse reactions In this section, the following categories of frequency have been used: very common (≥1/10), common (≥1/100 to <1/10), uncommon (≥1/1,000 to <1/100), rare (≥1/10,000 to <1/1,000), very rare (<1/10,000), not known (cannot be estimated from the available data).
Within each frequency grouping, adverse reactions are presented in order of decreasing seriousness. Presented in Table 1 are adverse reactions that have been reported in association with the use of intravenous Herceptin alone or in combination with chemotherapy in pivotal clinical trials and in the post-marketing setting.
All the terms included are based on the highest percentage seen in pivotal clinical trials. In addition, terms reported in the post marketing setting are included in Table 1. Table 1 Undesirable Effects Reported with Intravenous Herceptin Monotherapy or in Combination with Chemotherapy in Pivotal Clinical Trials (N = 8386) and in Post- Marketing System organ class Adverse reaction Frequency Infection Very common Nasopharyngitis Very common Neutropenic sepsis Common Cystitis Common Influenza Common Sinusitis Common Skin infection Common Rhinitis Common Upper respiratory tract infection Common Urinary tract infection Common Infections and infestations Pharyngitis Common Malignant neoplasm progression Not knownNeoplasms benign, malignant and unspecified (incl.
Cysts and polyps) Neoplasm progression Not known Febrile neutropenia Very common Anaemia Very common Neutropenia Very common White blood cell count decreased/leukopenia Very common Thrombocytopenia Very common Hypoprothrombinaemia Not known Blood and lymphatic system disorders Immune thrombocytopenia Not known Hypersensitivity Common +Anaphylactic reaction Rare Immune system disorders +Anaphylactic shock Rare Weight decreased/Weight loss Very common Anorexia Very common Tumour lysis syndrome Not known Metabolism and nutrition disorders Hyperkalaemia Not known Insomnia Very common Anxiety Common Psychiatric disorders Depression Common 1Tremor Very common Dizziness Very common Headache Very common Paraesthesia Very common Dysgeusia Very common Peripheral neuropathy Common Hypertonia Common Nervous system disorders Somnolence Common Conjunctivitis Very common Lacrimation increased Very common Eye disorders Dry eye Common System organ class Adverse reaction Frequency Papilloedema Not known Retinal haemorrhage Not known Ear and labyrinth disorders Deafness Uncommon 1 Blood pressure decreased Very common 1 Blood pressure increased Very common 1 Heart beat irregular Very common 1Cardiac flutter Very common Ejection fraction decreased* Very common +Cardiac failure (congestive) Common +1Supraventricular tachyarrhythmia Common Cardiomyopathy Common 1Palpitation Common Pericardial effusion Uncommon Cardiogenic shock Not known Cardiac disorders Gallop rhythm present Not known Hot flush Very common +1 Hypotension Common Vascular disorders Vasodilatation Common +Dyspnoea Very common Cough Very common Epistaxis Very common Rhinorrhoea Very common +Pneumonia Common Asthma Common Lung disorder Common +Pleural effusion Common +1Wheezing Uncommon Pneumonitis Uncommon +Pulmonary fibrosis Not known +Respiratory distress Not known +Respiratory failure Not known +Lung infiltration Not known +Acute pulmonary oedema Not known +Acute respiratory distress syndrome Not known +Bronchospasm Not known +Hypoxia Not known +Oxygen saturation decreased Not known Laryngeal oedema Not known Orthopnoea Not known Pulmonary oedema Not known Respiratory, thoracic and mediastinal disorders Interstitial lung disease Not known Diarrhoea Very common Vomiting Very common Gastrointestinal disorders Nausea Very common System organ class Adverse reaction Frequency 1 Lip swelling Very common Abdominal pain Very common Dyspepsia Very common Constipation Very common Stomatitis Very common Haemorrhoids Common Dry mouth Common Hepatocellular injury Common Hepatitis Common Liver tenderness Common Hepatobiliary disorders Jaundice Rare Erythema Very common Rash Very common 1 Swelling face Very common Alopecia Very common Nail disorder Very common Palmar-plantar erythrodysaesthesia syndrome Very common Acne Common Dry skin Common Ecchymosis Common Hyperhydrosis Common Maculopapular rash Common Pruritus Common Onychoclasis Common Dermatitis Common Urticaria Uncommon Skin and subcutaneous tissue disorders Angioedema Not known Arthralgia Very common 1Muscle tightness Very common Myalgia Very common Arthritis Common Back pain Common Bone pain Common Muscle spasms Common Neck Pain Common Musculoskeletal and connective tissue disorders Pain in extremity Common Renal disorder Common Glomerulonephritis membranous Not known Glomerulonephropathy Not known Renal and urinary disorders Renal failure Not known Oligohydramnios Not known Renal hypoplasia Not known Pregnancy, puerperium and perinatal conditions Pulmonary hypoplasia Not known Reproductive system and breast disorders Breast inflammation/mastitis Common System organ class Adverse reaction Frequency Asthenia Very common Chest pain Very common Chills Very common Fatigue Very common Influenza-like symptoms Very common Infusion related reaction Very common Pain Very common Pyrexia Very common Mucosal inflammation Very common Peripheral oedema Very common Malaise Common General disorders and administration site conditions Oedema Common Injury, poisoning and procedural complications Contusion Common + Denotes adverse reactions that have been reported in association with a fatal outcome.
1 Denotes adverse reactions that are reported largely in association with Infusion-related reactions. Specific percentages for these are not available. * […]
GBOfficial regulatory label· Warnings and precautions· revised May 29, 2026[1]
Traceability In order to improve the traceability of biological medicinal products, the trade name and the batch number of the administered product should be clearly recorded. 1). Currently no data from clinical trials are available on re-treatment of patients with previous exposure to Herceptin in the adjuvant setting.
Cardiac dysfunction General considerations Patients treated with Herceptin are at increased risk for developing CHF (New York Heart Association [NYHA] Class II-IV) or asymptomatic cardiac dysfunction. These events have been observed in patients receiving Herceptin therapy alone or in combination with paclitaxel or docetaxel, particularly following anthracycline (doxorubicin or epirubicin) containing chemotherapy.
8). g. hypertension, documented coronary artery disease, CHF, LVEF of <55%, older age. All candidates for treatment with Herceptin, but especially those with prior anthracycline and cyclophosphamide (AC) exposure, should undergo baseline cardiac assessment including history and physical examination, electrocardiogram (ECG), echocardiogram, and/or multigated acquisition (MUGA) scan or magnetic resonance imaging.
Monitoring may help to identify patients who develop cardiac dysfunction. Cardiac assessments, as performed at baseline, should be repeated every 3 months during treatment and every 6 months following discontinuation of treatment until 24 months from the last administration of Herceptin.
A careful risk-benefit assessment should be made before deciding to treat with Herceptin. 2). Patients who receive anthracyclines after stopping Herceptin may possibly be at increased risk of cardiac dysfunction. If possible, physicians should avoid anthracycline-based therapy for up to 7 months after stopping Herceptin.
If anthracyclines are used, the patient’s cardiac function should be monitored carefully. Formal cardiological assessment should be considered in patients in whom there are cardiovascular concerns following baseline screening. g. every 12 weeks).
Monitoring may help to identify patients who develop cardiac dysfunction. g. every 6 - 8 weeks). If patients have a continued decrease in left ventricular function, but remain asymptomatic, the physician should consider discontinuing therapy if no clinical benefit of Herceptin therapy has been seen.
This is not medical advice. Consult a qualified healthcare professional.
Who should not take it
GBOfficial regulatory label· Contraindications· revised May 29, 2026[1]
1 • Severe dyspnoea at rest due to complications of advanced malignancy or requiring supplementary oxygen therapy.
This is not medical advice. Consult a qualified healthcare professional.
The benefits of treatment with trastuzumab in patients who do not overexpress HER2 (HER2 expression 0 as defined by a validated immunohistochemical [IHC] assay) or who exhibit lower-level expression (HER2 expression 1+ as defined by a validated IHC assay, and the subgroup of patients with HER2 overexpression 2+ as defined by a validated IHC assay that corresponds to 1+ scoring by the investigative clinical trial assay), are unclear (see WARNINGS AND PRECAUTIONS: Selection of Patients / Diagnostic Tests).
HERZUMA® can be used in combination with pertuzumab and docetaxel for the treatment of patients with HER2-positive metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease. For information on the use of HERZUMA® in combination with pertuzumab and docetaxel, consult the Product Monograph for pertuzumab.
page 5 / 117 • Metastatic Gastric Cancer (MGC) HERZUMA® in combination with capecitabine or intravenous 5-fluorouracil and cisplatin is indicated for the treatment of patients with HER2 positive metastatic adenocarcinoma of the stomach or gastro-esophageal junction who have not received prior anti-cancer treatment for their metastatic disease.
HERZUMA® should only be administered to patients with MGC whose tumours have HER2 overexpression as defined by IHC 2+ confirmed by FISH+, or IHC 3+ as determined by an accurate and validated assay. 1 Pediatrics The safety and effectiveness of HERZUMA® in pediatric patients (< 18 years of age) have not been established.
2 Geriatrics The reported clinical experience is not adequate to determine whether older patients respond differently to trastuzumab treatment than younger patients (see WARNINGS AND PRECAUTIONS, Geriatrics).
How to take
CAOfficial regulatory label· revised December 23, 2025[2]
1 Dosing Considerations There is a risk of medication errors between HERZUMA® (trastuzumab) and KADCYLA® (trastuzumab emtansine). In order to prevent medication errors, it is important to check the vial labels to ensure that the drug being prepared and administered is HERZUMA® (trastuzumab) and not KADCYLA® (trastuzumab emtansine).
Ensure that the recommended HERZUMA® (trastuzumab) dose is administered (see Recommended Dose and Dosage Adjustment section). HERZUMA® should be prescribed using both the trade name and non-proprietary name. Do not substitute HERZUMA® for or with KADCYLA® (trastuzumab emtansine).
When using in combination with pertuzumab and docetaxel for treatment of patients with HER- 2-positive metastatic breast cancer, consult Product Monographs for pertuzumab and docetaxel for further information, such as dose adjustment, sequence of administration of each medication and duration of treatment.
2 Recommended Dose and Dosage Adjustment Early Breast Cancer (EBC) 3-Weekly Schedule: The recommended initial loading dose is 8 mg/kg HERZUMA® (trastuzumab) administered as a 90-minute infusion. The recommended maintenance dose is 6 page 7 / 117 mg/kg HERZUMA® 3 weeks later and then 6 mg/kg repeated at 3-weekly intervals administered as infusions over approximately 90 minutes.
If the prior dose was well tolerated, the dose can be administered as a 30-minute infusion. Do not administer as an IV push or bolus (see Preparation for Administration).
Weekly schedule:
As a weekly regimen, the recommended initial loading dose of HERZUMA® is 4 mg/kg followed by 2 mg/kg every week. See clinical trial – reference biological drug section for chemotherapy combination dosing.
Metastatic Breast Cancer (MBC) Weekly schedule:
The recommended initial loading dose is 4 mg/kg HERZUMA® administered as a 90-minute infusion. The recommended weekly maintenance dose is 2 mg/kg HERZUMA® and can be administered as a 30-minute infusion if the initial loading dose was well tolerated.
HERZUMA® may be administered in an outpatient setting. Do not administer as an IV push or bolus (see Preparation for Administration).
Metastatic Gastric Cancer (MGC) 3-Weekly Schedule:
The recommended initial loading dose is 8 mg/kg HERZUMA® administered as a 90-minute infusion. The recommended maintenance dose is 6 mg/kg HERZUMA® 3 weeks later and then 6 mg/kg repeated at 3-weekly intervals administered as infusions over approximately 90 minutes.
If the prior dose was well tolerated, the dose can be administered as a 30-minute infusion. Do not administer as an IV push or bolus (see Preparation for Administration) Duration of Treatment In clinical studies, patients with MBC or MGC were treated with trastuzumab until progression of disease.
Patients with EBC should be treated for 1 year or until disease recurrence or unacceptable cardiac toxicity, whichever occurs first (see WARNINGS AND PRECAUTIONS, Cardiovascular). Extending treatment in EBC beyond one year is not recommended (see Clinical Trials – Reference Biological Drug, Early Breast Cancer (EBC), HERA).
Dose Reduction No reductions in the dose of trastuzumab were made during clinical trials. Patients may continue therapy with HERZUMA® during periods of reversible, chemotherapy-induced myelosuppression, but they should be monitored carefully for complications of neutropenia during this time.
The specific instructions to reduce or hold the dose of chemotherapy should be followed. Table 1 depicts the criteria for permanent discontinuation of trastuzumab for cardiac dysfunction in pivotal studies in adjuvant breast cancer.
Table 1 Criteria for Permanent Discontinuation for Cardiac Dysfunction in Pivotal Studies in Adjuvant Breast Cancer STUDY If Symptomatic CHF If Held for Asymptomatic LVEF Decrease (per algorithm used in each study protocol) HERA required required if trastuzumab held for 2 consecutive cycles NSABP B-31, NCCTG N9831 and BCIRG-006 required required if trastuzumab held for 2 consecutive cycles, or for 3 intermittent cycles; investigator may choose to discontinue permanently sooner page 8 / 117 Dose Holding Monitoring of Cardiac Function (also see WARNINGS AND PRECAUTIONS, Cardiovascular, Cardiotoxicity) Table 2 Recommendations for Continuation or Withdrawal of HERZUMA® Therapy in Asymptomatic Patients Based on Serial Measurements of Left Ventricular Ejection Fraction (LVEF)a (Adapted from the Canadian Consensus Guidelines*) Relationship of LVEF to LLN Asymptomatic decrease in LVEF from baseline ≤ 10 percentage points 10–15 percentage points ≥ 15 percentage points Within radiology facility’s normal limits Continue HERZUMA® Continue HERZUMA® Hold HERZUMA® and repeat MUGA or ECHO after 4 weeks 1–5 percentage points below LLN Continue HERZUMA® b Hold HERZUMA® and repeat MUGA or ECHO after 4 weeks b,c Hold HERZUMA® and repeat MUGA or ECHO after 4 weeks c,d ≥6 percentage points below LLN Continue HERZUMA® and repeat MUGA or ECHO after 4 weeksd Hold HERZUMA® and repeat MUGA or ECHO after 4 weeks c,d Hold HERZUMA® and repeat MUGA or ECHO after 4 weeks c,c a Based on NSABP B-31 trial protocol.
Modified to include recommendations for cardiology consultation or treatment of cardiac dysfunction (or both) when appropriate, as indicated in the subsequent footnotes. b Consider cardiac assessment and initiation of angiotensin converting-enzyme inhibitor therapy.
c After two holds, consider permanent discontinuation of HERZUMA®. d Initiate angiotensin converting-enzyme inhibitor therapy and refer to cardiologist. LLN = lower limit of normal; MUGA = multiple-gated acquisition scan; ECHO = echocardiography.
*Source: Mackey JR, Clemons M, Côté MA, et al. Cardiac management during adjuvant trastuzumab therapy: recommendations of the Canadian Trastuzumab Working Group. Curr Oncol. 2008 Jan;15(1):24-35. For the frequency of cardiac monitoring see WARNINGS AND PRECAUTIONS, Cardiovascular, Cardiotoxicity.
Health Canada has not authorized an indication for pediatric use (see […]
This is not medical advice. Consult a qualified healthcare professional.
Side effects & warnings
CAOfficial regulatory label· Adverse reactions· revised December 23, 2025[2]
The adverse drug reaction profiles reported in clinical studies that compared HERZUMA® to the reference biologic drug were comparable. The description of adverse reactions in this section is based on clinical experience with the reference biologic drug.
1 Clinical Trial Adverse Drug Reactions Because clinical trials are conducted under very specific conditions the adverse reaction rates observed in the clinical trials may not reflect the rates observed in practice and should not be compared to the rates in the clinical trials of another drug.
Adverse drug reaction information from clinical trials is useful for identifying drug-related adverse events and for approximating rates. Early Breast Cancer (EBC) HERA (adjuvant sequential: use of trastuzumab following surgery and after chemotherapy) Please see WARNINGS AND PRECAUTIONS: Cardiovascular/Cardiotoxicity/Early Breast Cancer – Table 5~8 for a description of the absolute numbers and rates of cardiac endpoints in HERA as well as the median time to return to baseline LVEF/ stabilizations of LVEF in the HERA trial.
The HERA trial is a randomized, open label study in patients with HER2 positive EBC. Table 14 displays adverse events which were reported after 8 years of median follow up in ≥ 1% of patients, by study treatment. 0 Classification Adverse Event Term Observation Only trastuzumab 1 year N = 1744 N = 1682 No.
* 69 out of the total 93 Cardiac Failure Congestive events reported in the 1-year trastuzumab arm occurred within 365 […]
CAOfficial regulatory label· Warnings and precautions· revised December 23, 2025[2]
Please see the Serious Warnings and Precautions Box at the beginning of Part I:
Health Professional Information. General Therapy with HERZUMA® should only be initiated under supervision of a physician experienced in the treatment of cancer patients. page 13 / 117 When using in combination with pertuzumab and docetaxel, consult Product Monographs for pertuzumab and docetaxel for further information on these drugs.
In order to improve traceability of biological medicinal products, the trade name and the batch number of the administered product should be clearly recorded (or stated) in the patient file. Early Breast Cancer (EBC) The safety of the various combination chemotherapy regimens prior to trastuzumab therapy was not separately analyzed in the HERA trial.
The data provided in the Product Monograph reflects the safety and efficacy of trastuzumab for the recommended 1 year treatment duration.
Benzyl Alcohol:
Benzyl alcohol, used as a preservative in BWFI, has been associated with toxicity in neonates and children up to 3 years old. For patients with a known hypersensitivity to benzyl alcohol (the preservative in BWFI), reconstitute HERZUMA® with Sterile Water for Injection (SWFI).
Use SWFI-reconstituted HERZUMA® immediately and discard the vial (see DOSAGE AND ADMINISTRATION).
Cardiovascular Cardiotoxicity:
Administration of HERZUMA® can result in the development of ventricular dysfunction and congestive heart failure. In the adjuvant treatment setting, the incidence of cardiac dysfunction was higher in patients who received trastuzumab plus chemotherapy versus chemotherapy alone.
In patients with EBC, an increase in the incidence of symptomatic and asymptomatic cardiac events was observed when trastuzumab was administered after anthracycline-containing chemotherapy compared to administration with a non-anthracycline regimen of docetaxel and carboplatin.
The incidence was more marked when trastuzumab was administered concurrently with a taxane than when administered sequentially to a taxane. In the metastatic setting, the incidence and severity of cardiac dysfunction were particularly high in patients who received trastuzumab concurrently with anthracyclines and cyclophosphamide.
This is not medical advice. Consult a qualified healthcare professional.
Who should not take it
CAOfficial regulatory label· Contraindications· revised December 23, 2025[2]
• HERZUMA® (trastuzumab) is contraindicated in patients with known hypersensitivity to trastuzumab, Chinese Hamster Ovary (CHO) cell proteins, or any ingredient in the formulation, including any non-medicinal ingredient, or component of the container.
For a complete listing, see Dosage Forms, Strengths, Composition and Packaging. • When using in combination with pertuzumab and docetaxel, consult Product Monographs for pertuzumab and docetaxel for further information on these drugs.
This is not medical advice. Consult a qualified healthcare professional.
1). - following adjuvant chemotherapy with doxorubicin and cyclophosphamide, in combination with paclitaxel or docetaxel. - in combination with adjuvant chemotherapy consisting of docetaxel and carboplatin. 1). 1). Metastatic gastric cancer Zercepac in combination with capecitabine or 5-fluorouracil and cisplatin is indicated for the treatment of adult patients with HER2 positive metastatic adenocarcinoma of the stomach or gastro-oesophageal junction who have not received prior anti-cancer treatment for their metastatic disease.
Zercepac should only be used in patients with metastatic gastric cancer (MGC) whose tumours have HER2 overexpression as defined by IHC2+ and a confirmatory SISH or FISH result, or by an IHC 3+ result. 1). 4
How to take
EUOfficial regulatory label· revised May 18, 2026[3]
1). 4) and should be administered by a healthcare professional only. Zercepac intravenous formulation is not intended for subcutaneous administration and should be administered via an intravenous infusion only. g. trastuzumab emtansine or trastuzumab deruxtecan).
Posology Metastatic breast cancer Three-weekly schedule The recommended initial loading dose is 8 mg/kg body weight. The recommended maintenance dose at three-weekly intervals is 6 mg/kg body weight, beginning three weeks after the loading dose.
Weekly schedule The recommended initial loading dose of Zercepac is 4 mg/kg body weight. The recommended weekly maintenance dose of Zercepac is 2 mg/kg body weight, beginning one week after the loading dose. Administration in combination with paclitaxel or docetaxel In the pivotal trials (H0648g, M77001), paclitaxel or docetaxel was administered the day following the first dose of trastuzumab (for dose, see the Summary of Product Characteristics (SmPC) for paclitaxel or docetaxel) and immediately after the subsequent doses of trastuzumab if the preceding dose of trastuzumab was well tolerated.
Administration in combination with an aromatase inhibitor In the pivotal trial (BO16216) trastuzumab and anastrozole were administered from day 1. There were no restrictions on the relative timing of trastuzumab and anastrozole at administration (for dose, see the SmPC for anastrozole or other aromatase inhibitors).
Early breast cancer Three-weekly and weekly schedule As a three-weekly regimen the recommended initial loading dose of Zercepac is 8 mg/kg body weight. The recommended maintenance dose of Zercepac at three-weekly intervals is 6 mg/kg body weight, beginning three weeks after the loading dose.
As a weekly regimen (initial loading dose of 4 mg/kg followed by 2 mg/kg every week) concomitantly with paclitaxel following chemotherapy with doxorubicin and cyclophosphamide. 1 for chemotherapy combination dosing. 5 Metastatic gastric cancer Three-weekly schedule The recommended initial loading dose is 8 mg/kg body weight.
The recommended maintenance dose at three-weekly intervals is 6 mg/kg body weight, beginning three weeks after the loading dose. Breast cancer and gastric cancer Duration of treatment Patients with MBC or MGC should be treated with Zercepac until progression of disease.
1). Dose reduction No reductions in the dose of Zercepac were made during clinical trials. Patients may continue therapy during periods of reversible, chemotherapy-induced myelosuppression but they should be monitored carefully for complications of neutropenia during this time.
Refer to the SmPC for paclitaxel, docetaxel or aromatase inhibitor for information on dose reduction or delays. If left ventricular ejection fraction (LVEF) percentage drops ≥ 10 points from baseline AND to below 50%, treatment should be suspended and a repeat LVEF assessment performed within approximately 3 weeks.
If LVEF has not improved, or has declined further, or if symptomatic congestive heart failure (CHF) has developed, discontinuation of Zercepac should be strongly considered, unless the benefits for the individual patient are deemed to outweigh the risks.
All such patients should be referred for assessment by a cardiologist and followed up. Missed doses If the patient has missed a dose of Zercepac by one week or less, then the usual maintenance dose (weekly regimen: 2 mg/kg; three-weekly regimen: 6 mg/kg) should be administered as soon as possible.
Do not wait until the next planned cycle. Subsequent maintenance doses should be administered 7 days or 21 days later according to the weekly or three-weekly schedules, respectively. If the patient has missed a dose of Zercepac by more than one week, a re-loading dose of Zercepac should be administered over approximately 90 minutes (weekly regimen: 4 mg/kg; three-weekly regimen: 8 mg/kg) as soon as possible.
Subsequent Zercepac maintenance doses (weekly regimen: 2 mg/kg; three-weekly regimen 6 mg/kg respectively) should be administered 7 days or 21 days later according to the weekly or three-weekly schedules respectively. Special populations Dedicated pharmacokinetic studies in the elderly and those with renal or hepatic impairment have not been carried out.
In a population pharmacokinetic analysis, age and renal impairment were not shown to affect trastuzumab disposition. Paediatric population There is no relevant use of Zercepac in the paediatric population. Method of administration Zercepac is for intravenous use only.
The loading dose should be administered as a 90-minute 6 intravenous infusion. Do not administer as an intravenous push or bolus. Zercepac intravenous infusion should be administered by a healthcare provider prepared to manage anaphylaxis and an emergency kit should be available.
8). Interruption or slowing the rate of the infusion may help control such symptoms. The infusion may be resumed when symptoms abate. If the initial loading dose was well tolerated, the subsequent doses can be administered as a 30-minute infusion.
For instructions on reconstitution of Zercepac intravenous formulation […]
This is not medical advice. Consult a qualified healthcare professional.
Side effects & warnings
EUOfficial regulatory label· Adverse reactions· revised May 18, 2026[3]
Summary of the safety profile Amongst the most serious and/or common adverse reactions reported in trastuzumab usage to date are cardiac dysfunction, infusion-related reactions, haematotoxicity (in particular neutropenia), infections and pulmonary adverse reactions.
12 Tabulated list of adverse reactions In this section, the following categories of frequency have been used: very common (1/10), common (1/100 to <1/10), uncommon (≥1/1,000 to <1/100), rare (≥1/10,000 to <1/1,000), very rare (<1/10,000), not known (cannot be estimated from the available data).
Within each frequency grouping, adverse reactions are presented in order of decreasing seriousness. Presented in Table 1 are adverse reactions that have been reported in association with the use of intravenous trastuzumab alone or in combination with chemotherapy in pivotal clinical trials and in the post-marketing setting.
All the terms included are based on the highest percentage seen in pivotal clinical trials. In addition, terms reported in the post marketing setting are included in Table 1. Table 1 Undesirable effects reported with intravenous trastuzumab monotherapy or in combination with chemotherapy in pivotal clinical trials (N = 8386) and in post-marketing System organ class Adverse reaction Frequency Infections and infestations Infection Very common Nasopharyngitis Very common Neutropenic sepsis Common Cystitis Common Influenza Common Sinusitis Common Skin infection Common Rhinitis Common Upper respiratory tract infection Common Urinary tract infection Common Pharyngitis Common Neoplasms benign, malignant and unspecified (incl.
Cysts and polyps) Malignant neoplasm progression Not known Neoplasm progression Not known Blood and lymphatic system disorders Febrile neutropenia Very common Anaemia Very common Neutropenia Very common White blood cell count decreased/leukopenia Very common Thrombocytopenia Very common Hypoprothrombinaemia Not known Immune thrombocytopenia Not known Immune system disorders Hypersensitivity Common +Anaphylactic reaction Rare +Anaphylactic shock Rare Metabolism and nutrition disorders Weight decreased/Weight loss Very common Anorexia Very common Tumour lysis syndrome Not known Hyperkalaemia Not known Psychiatric disorders Insomnia Very common Anxiety Common Depression Common Nervous system disorders 1Tremor Very common Dizziness Very common Headache Very common Paraesthesia Very common Dysgeusia Very common Peripheral neuropathy Common 13 System organ class Adverse reaction Frequency Hypertonia Common Somnolence Common Eye disorders Conjunctivitis Very common Lacrimation increased Very common Dry eye Common Papilloedema Not known Retinal haemorrhage Not known Ear and labyrinth disorders Deafness Uncommon Cardiac disorders 1Blood pressure decreased Very common 1 Blood pressure increased Very common 1 Heart beat irregular Very common 1Cardiac flutter Very common Ejection fraction decreased* Very common +Cardiac failure (congestive) Common +1Supraventricular tachyarrhythmia Common Cardiomyopathy Common 1Palpitation Common Pericardial effusion Uncommon Cardiogenic shock Not known Gallop rhythm present Not known Vascular disorders Hot flush Very common +1Hypotension Common Vasodilatation Common Respiratory, thoracic and mediastinal disorders +Dyspnoea Very common Cough Very common Epistaxis Very common Rhinorrhoea Very common +Pneumonia Common Asthma Common Lung disorder Common +Pleural effusion Common +1Wheezing Uncommon Pneumonitis Uncommon +Pulmonary fibrosis Not known +Respiratory distress Not known +Respiratory failure Not known +Lung infiltration Not known +Acute pulmonary oedema Not known +Acute respiratory distress syndrome Not known +Bronchospasm Not known +Hypoxia Not known +Oxygen saturation decreased Not known Laryngeal oedema Not known Orthopnoea Not known Pulmonary oedema Not known Interstitial lung disease Not known Gastrointestinal disorders Diarrhoea Very common Vomiting Very common Nausea Very common 1 Lip swelling Very common Abdominal pain Very common Dyspepsia Very common Constipation Very common 14 System organ class Adverse reaction Frequency Stomatitis Very common Haemorrhoids Common Dry mouth Common Hepatobiliary disorders Hepatocellular injury Common Hepatitis Common Liver tenderness Common Jaundice Rare Skin and subcutaneous tissue disorders Erythema Very common Rash Very common 1Swelling face Very common Alopecia Very common Nail disorder Very common Palmar-plantar erythrodysaesthesia syndrome Very common Acne Common Dry skin Common Ecchymosis Common Hyperhydrosis Common Maculopapular rash Common Pruritus Common Onychoclasis Common Dermatitis Common Urticaria Uncommon Angioedema Not known Musculoskeletal and connective tissue disorders Arthralgia Very common 1Muscle tightness Very common Myalgia Very common Arthritis Common Back pain Common Bone pain Common Muscle spasms Common Neck Pain Common Pain in extremity Common Renal and urinary disorders Renal disorder Common Glomerulonephritis membranous Not known Glomerulonephropathy Not known Renal failure Not known Pregnancy, puerperium and perinatal conditions Oligohydramnios Not known Renal hypoplasia Not known Pulmonary hypoplasia Not known Reproductive system and breast disorders Breast inflammation/mastitis Common General disorders and administration site conditions Asthenia Very common Chest pain Very common Chills Very common Fatigue Very common Influenza-like symptoms Very common Infusion related reaction Very common Pain Very common Pyrexia Very common Mucosal inflammation Very common Peripheral oedema Very common Malaise Common 15 System organ class Adverse reaction Frequency Oedema Common Injury, poisoning and procedural complications Contusion Common + Denotes adverse reactions that have been reported in association with a fatal outcome.
1 Denotes adverse reactions that are reported largely in association with Infusion-related reactions. Specific percentages for these are not available. * Observed with combination […]
EUOfficial regulatory label· Warnings and precautions· revised May 18, 2026[3]
Traceability In order to improve traceability of biological medicinal products, the trade name and the batch number of the administered product should be clearly recorded. 1). Currently no data from clinical trials are available on re-treatment of patients with previous exposure to Zercepac in the adjuvant setting.
Cardiac dysfunction General considerations Patients treated with Zercepac are at increased risk for developing CHF (New York Heart Association [NYHA] Class II-IV) or asymptomatic cardiac dysfunction. These events have been observed in patients receiving trastuzumab therapy alone or in combination with paclitaxel or docetaxel, particularly following anthracycline (doxorubicin or epirubicin) containing chemotherapy.
8). g. hypertension, documented coronary artery disease, CHF, LVEF of <55%, older age. All candidates for treatment with Zercepac, but especially those with prior anthracycline and cyclophosphamide (AC) exposure, should undergo baseline cardiac assessment including history and physical examination, electrocardiogram (ECG), echocardiogram, and/or multigated acquisition (MUGA) scan or magnetic resonance imaging.
Monitoring may help to identify patients who develop cardiac dysfunction. Cardiac assessments, as performed at baseline, should be repeated every 3 months during treatment and every 6 months following discontinuation of treatment until 24 months from the last administration of Zercepac.
A careful risk-benefit assessment should be made before deciding to treat with Zercepac. 2). Patients who receive 7 anthracyclines after stopping Zercepac may possibly be at increased risk of cardiac dysfunction. If possible, physicians should avoid anthracycline-based therapy for up to 7 months after stopping Zercepac.
If anthracyclines are used, the patient’s cardiac function should be monitored carefully. Formal cardiological assessment should be considered in patients in whom there are cardiovascular concerns following baseline screening. g. every 12 weeks).
Monitoring may help to identify patients who develop cardiac dysfunction. g. every 6 - 8 weeks). If patients have a continued decrease in left ventricular function, but remain asymptomatic, the physician should consider discontinuing therapy if no clinical benefit of Zercepac therapy has been seen.
This is not medical advice. Consult a qualified healthcare professional.
Who should not take it
EUOfficial regulatory label· Contraindications· revised May 18, 2026[3]
1 Severe dyspnoea at rest due to complications of advanced malignancy or requiring supplementary oxygen therapy.
This is not medical advice. Consult a qualified healthcare professional.
The safety of continuation or resumption of Herceptin in patients who experience cardiac dysfunction has not been prospectively studied. If LVEF percentage drops ≥10 points from baseline AND to below 50%, treatment should be suspended and a repeat LVEF assessment performed within approximately 3 weeks.
If LVEF has not improved, or declined further, or symptomatic CHF has developed, discontinuation of Herceptin should be strongly considered, unless the benefits for the individual patient are deemed to outweigh the risks. All such patients should be referred for assessment by a cardiologist and followed up.
If symptomatic cardiac failure develops during Herceptin therapy, it should be treated with standard medicinal products for CHF. Most patients who developed CHF or asymptomatic cardiac dysfunction in pivotal trials improved with standard CHF treatment consisting of an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) and a beta-blocker.
The majority of patients with cardiac symptoms and evidence of a clinical benefit of Herceptin treatment continued on therapy without additional clinical cardiac events. Metastatic breast cancer Herceptin and anthracyclines should not be given concurrently in combination in the MBC setting.
Patients with MBC who have previously received anthracyclines are also at risk of cardiac dysfunction with Herceptin treatment, although the risk is lower than with concurrent use of Herceptin and anthracyclines. Early breast cancer For patients with EBC, cardiac assessments, as performed at baseline, should be repeated every 3 months during treatment and every 6 months following discontinuation of treatment until 24 months from the last administration of Herceptin.
In patients who receive anthracycline-containing chemotherapy further monitoring is recommended, and should occur yearly up to 5 years from the last administration of Herceptin, or longer if a continuous decrease of LVEF is observed.
Patients with history of myocardial infarction (MI), angina pectoris requiring medical treatment, history of or existing CHF (NYHA Class II –IV), LVEF of < 55%, other cardiomyopathy, cardiac arrhythmia requiring medical treatment, clinically significant cardiac valvular disease, poorly controlled hypertension (hypertension controlled by standard medical treatment eligible), and hemodynamic effective pericardial effusion were excluded from adjuvant and neoadjuvant EBC pivotal trials with Herceptin and therefore treatment cannot be recommended in such patients.
Adjuvant treatment Herceptin and anthracyclines should not be given concurrently in combination in the adjuvant treatment setting. In patients with EBC an increase in the incidence of symptomatic and asymptomatic cardiac events was observed when Herceptin was administered after anthracycline- containing chemotherapy compared to administration with a non-anthracycline regimen of docetaxel and carboplatin and was more marked when Herceptin was administered concurrently […]
The incidence of cardiac adverse events was also higher in patients with previous exposure to anthracyclines based on post-market data. 8 days), trastuzumab may persist in the circulation for approximately 24 weeks (range: 22-28 weeks) after stopping treatment with HERZUMA®.
Since the use of an anthracycline during this period could possibly be associated with an increased risk of cardiac dysfunction, a thorough assessment of the risks versus the potential benefits is recommended in addition to careful cardiac monitoring.
If possible, physicians should avoid anthracycline based therapy while trastuzumab persists in the circulation. Patients who receive HERZUMA® either as a component of adjuvant treatment or as a treatment for metastatic HER2 positive breast cancer may experience signs and symptoms of cardiac dysfunction such as dyspnea, increased cough, paroxysmal nocturnal dyspnea, peripheral edema, S3 gallop, or reduced ejection fraction.
Cardiac dysfunction associated with therapy with HERZUMA® may be severe and has been associated with disabling cardiac failure, death, and mural thrombosis leading to stroke. Left ventricular function should be evaluated in all patients prior to and during treatment with HERZUMA®.
If LVEF drops 10 ejection points from baseline and/or to below 50%, HERZUMA® page 14 / 117 should be withheld and a repeat LVEF assessment performed within approximately 3 weeks. If LVEF has not improved, or declined further, discontinuation of HERZUMA® should be strongly considered, unless the benefits for the individual patient are deemed to outweigh the risks.
The scientific basis of cardiac dysfunction has been incompletely investigated in pre-clinical studies. Extreme caution should be exercised in treating patients with pre-existing cardiac dysfunction, and in EBC, in those patients with an LVEF of 55% or less.
Candidates for treatment with HERZUMA® as part of adjuvant treatment for operable breast cancer or for MBC, especially those with prior anthracycline and cyclophosphamide (AC) exposure, should undergo thorough baseline cardiac assessment including history and physical exam, electrocardiogram (ECG) and either 2D echocardiogram or multiple gated acquisition (MUGA) scan.
A careful risk-benefit assessment should be made before deciding to treat with HERZUMA®. Cardiac assessments, as performed at baseline, should be repeated every 3 months during treatment and every 6 months following discontinuation of treatment until 24 months from the last administration of HERZUMA®.
In patients with EBC who receive anthracycline containing chemotherapy further monitoring is recommended, and should occur yearly up to 5 years from the last administration of HERZUMA®, or longer if a continued decrease of LVEF is observed.
Monitoring may help to identify patients who develop cardiac dysfunction. g. every 6-8 weeks). If patients have a continued decrease in left ventricular function, but remain asymptomatic, the physician should consider discontinuing therapy unless the benefits for the individual patient are deemed to outweigh the risks.
If symptomatic cardiac failure develops during therapy with HERZUMA®, it should be treated with the standard medications for this purpose. Discontinuation of HERZUMA® should be strongly considered in patients who develop clinically significant congestive heart failure.
In the MBC clinical trials, approximately two-thirds of patients with cardiac dysfunction were treated for cardiac symptoms, most patients responded to appropriate medical therapy […]
The safety of continuation or resumption of Zercepac in patients who experience cardiac dysfunction has not been prospectively studied. If LVEF percentage drops ≥10 points from baseline AND to below 50%, treatment should be suspended and a repeat LVEF assessment performed within approximately 3 weeks.
If LVEF has not improved, or declined further, or symptomatic CHF has developed, discontinuation of Zercepac should be strongly considered, unless the benefits for the individual patient are deemed to outweigh the risks. All such patients should be referred for assessment by a cardiologist and followed up.
If symptomatic cardiac failure develops during Zercepac therapy, it should be treated with standard medicinal products for CHF. Most patients who developed CHF or asymptomatic cardiac dysfunction in pivotal trials improved with standard CHF treatment consisting of an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) and a beta-blocker.
The majority of patients with cardiac symptoms and evidence of a clinical benefit of trastuzumab treatment continued on therapy without additional clinical cardiac events. Metastatic breast cancer Zercepac and anthracyclines should not be given concurrently in combination in the MBC setting.
Patients with MBC who have previously received anthracyclines are also at risk of cardiac dysfunction with Zercepac treatment, although the risk is lower than with concurrent use of Zercepac and anthracyclines. Early breast cancer For patients with EBC, cardiac assessments, as performed at baseline, should be repeated every 3 months during treatment and every 6 months following discontinuation of treatment until 24 months from the last administration of Zercepac.
In patients who receive anthracycline-containing chemotherapy further monitoring is recommended, and should occur yearly up to 5 years from the last administration of Zercepac, or longer if a continuous decrease of LVEF is observed.
Patients with history of myocardial infarction (MI), angina pectoris requiring medical treatment, history of or existing CHF (NYHA Class II –IV), LVEF of <55%, other cardiomyopathy, cardiac arrhythmia requiring medical treatment, clinically significant cardiac valvular disease, poorly controlled hypertension (hypertension controlled by standard medical treatment eligible), and hemodynamic effective pericardial effusion were excluded from adjuvant and neoadjuvant EBC pivotal trials with trastuzumab and therefore treatment cannot be recommended in such patients.
Adjuvant treatment Zercepac and anthracyclines should not be given concurrently in combination in the adjuvant treatment setting. 8 In patients with EBC an increase in the incidence of symptomatic and asymptomatic cardiac events was observed when trastuzumab was administered after anthracycline-containing chemotherapy compared to administration with a non-anthracycline regimen of docetaxel and carboplatin and was more marked when trastuzumab was administered concurrently with […]