Trastuzumab

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 .

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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