Drug reference

Trastuzumab

Anti-HER2 humanised monoclonal antibody · Antineoplastic

Also known as Herceptin, Ogivri, Kanjinti, Ontruzant, Trazimera, Herzuma

START

IV 8 mg/kg load then 6 mg/kg q3w (or weekly schedule); baseline + serial LVEF

TYPICAL MAX

Regimen-defined (6 mg/kg q3w; SC 600 mg q3w)

STOP IF

Symptomatic heart failure / significant LVEF decline, severe infusion/pulmonary reaction, pregnancy

WATCH

LVEF at baseline and every ~3 months (longer if prior anthracycline), infusion reactions, pulmonary symptoms

CDSCO approvedSchedule HATC L01FD01

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 30min · absorption onset
PEAK: 2h · end of infusion
t½: 4w · terminal t½ (~28 days)
DURATION: 3w · q3-week interval

EXCRETION

Proteolytic catabolism; not renal

route + CYP

INTERACTIONS

12 major

incl. contraindicated

PREGNANCY

Avoid — oligohydramnios, fetal/neonatal death; contraception during and 7 months after

FDA category + note

Top interactionssee all 12 →

Live VaccinesContraindicatedDatabaseKimi deep-research + Cla
AdalimumabSevereDatabaseDDInter
BaricitinibSevereDatabaseDDInter
CertolizumabSevereDatabaseDDInter

Available in India

31 branded formulations. Look up specific brands in the Drugs workspace.

Mechanism

Binds the extracellular domain IV of HER2 (ERBB2), inhibiting HER2-mediated proliferative signalling, mediating antibody-dependent cellular cytotoxicity and blocking HER2 shedding; effective in HER2-overexpressing tumours.

Indications

HER2-positive breast cancer (adjuvant, neoadjuvant, metastatic)HER2-positive metastatic gastric/gastro-oesophageal junction adenocarcinoma

Dosing

Adult: IV: 8 mg/kg loading then 6 mg/kg every 3 weeks (or 4 mg/kg then 2 mg/kg weekly). SC formulation 600 mg fixed every 3 weeks.
Pediatric: Not established.
Renal adjustment: No adjustment (antibody).
Hepatic adjustment: No specific adjustment.
Geriatric: Higher cardiotoxicity risk (esp. with anthracyclines); monitor LVEF.
Max dose: Regimen-defined (e.g. 6 mg/kg q3w; SC 600 mg q3w)

Pharmacokinetics

Onset

Antitumour over weeks

Peak effect

End of infusion

Duration

q1–3 week dosing

Half-life

~28 days (long; concentration-dependent clearance)

Bioavailability

100% IV (SC ~bioequivalent exposure)

Protein binding

Not applicable (antibody)

Metabolism

Proteolytic catabolism

Excretion

Not renally excreted

Contraindications

Severe hypersensitivity/anaphylaxis to trastuzumab
Significant baseline LV dysfunction (relative — cardiotoxicity)

Side effects

Common

Infusion reactions (first dose; fever, chills)Fatigue, headacheDiarrhoea, nauseaCytopenias (with chemo)

Serious

Cardiomyopathy / heart failure (boxed) — additive with anthracyclines
Severe infusion reactions/anaphylaxis
Pulmonary toxicity (interstitial lung disease, ARDS)
Embryo-fetal toxicity (oligohydramnios)

Pregnancy & lactation

Pregnancy

Avoid — oligohydramnios, fetal/neonatal death; contraception during and 7 months after

Lactation

Avoid during and for 7 months after last dose

Drug interactions

Live Vaccines

Contraindicated

Database

Immunocompromised oncology context

Avoid live vaccines

Source: Kimi deep-research + Cla

Adalimumab

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Baricitinib

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Certolizumab

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Cladribine

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Clozapine

Severe

Database

Drug interaction classified as: synergy.

Source: DDInter

Daunorubicin

Severe

Database

Clinical effect not specified

Source: DDInter

Deferiprone

Severe

Database

Clinical effect not specified

Source: DDInter

Doxorubicin

Severe

Database

Left ventricular dysfunction occurs in up to 20% of patients.

Not explicitly stated, but monitoring for cardiotoxicity is implied, and the text notes that combination with taxanes greatly reduces the risk of cardiac toxicity.

Source: DDInter

Epirubicin

Severe

Database

Significantly increased risk and severity of cardiac dysfunction, including congestive heart failure, left ventricular ejection fraction (LVEF) decline, and cardiomyopathy.

Avoid concomitant use. If sequential use is planned, ensure a sufficient washout period between the two drugs. Closely monitor cardiac function (e.g., LVEF) before, during, and after treatment with both agents. The cumulative dose of anthracyclines should be carefully considered.

Source: DDInter

Etanercept

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Fingolimod

Severe

Database

Clinical effect not specified

Source: DDInter