CLINICAL USE

Antineoplastic agent: Main indication is for HER2-expressing breast cancer

DOSE IN NORMAL RENAL FUNCTION

4 mg/kg then 2 mg/kg weekly Or 8 mg/kg initially then 6 mg/kg every 3 weeks Or according to local policy

PHARMACOKINETICS

  • Molecular weight                           : 148 000–185 000
  • %Protein binding                           : No data
  • %Excreted unchanged in urine     : No data
  • Volume of distribution (L/kg)       : 0.044
  • half-life – normal/ESRD (hrs)      : 1.7–28.5 days/ Probably unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function. Use with caution
  • <10           : Dose as in normal renal function. Use with caution

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                : Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HD                     : Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   : Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD      : Unknown dialysability. Dose as in GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • None known

    ADMINISTRATION

    Reconstition

    7.2 mL water for injection per 150 mg vial

    Route

    IV infusion

    Rate of Administration

    4 mg/kg over 90 minutes 2 mg/kg over 30 minutes

    Comments

    Allow to stand for 5 minutes after reconstitution Dilute dose in 250 mL sodium chloride 0.9%

    OTHER INFORMATION

    Distributes to normal cells, tumour cells and serum where HER2 antigens are found Remains in body for 24 weeks Doesn’t require hepatic or renal metabolism for elimination Nadir for bone-marrow depression is 4 weeks with recovery within 6 weeks Associated with cardiotoxicity May remain in circulation for up to 24 weeks .

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