How does this medication work? What will it do for me?

Pertuzumab is a monoclonal antibody that belongs specifically to the class of medications called antineoplastic agents. It is used along with other medications to treat breast cancer that is human epidermal growth-factor receptor 2 (HER2) positive, has metastasized (spread to other parts of the body), and has not been previously treated with chemotherapy or anti-HER2 therapy.

HER2 is a protein that often creates a more aggressive type of breast cancer than cancers that do not produce excessive amounts of HER2. Pertuzumab works by recognizing and attaching to these cancer cells. This may slow down or stop the cancer from growing and dividing.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each mL of preservative-free liquid concentrate for infusion contains 30 mg of pertuzumab. Nonmedicinal ingredients: glacial acetic acid, L-histidine, polysorbat 20, sucrose, and water for injection.

How should I use this medication?

The recommended starting dose of pertuzumab is 840 mg. It is given by intravenous (into a vein) infusion, usually into a specially prepared site on the skin. The medication is infused over 60 minutes. After the first dose, 420 mg of pertuzumab should be given by intravenous infusion over 30 to 60 minutes every 3 weeks.  The number of infusions you receive will depend on how well you respond to treatment.

Very careful handling of this medication is required, and it is always given in a hospital or similar setting with access to sterile equipment for preparation of the medication and facilities to treat medical emergencies, such as infusion reactions.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive pertuzumab, contact your doctor as soon as possible to reschedule your appointment.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you are allergic to pertuzumab or any ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • acne
  • bone, neck, chest or abdominal pain
  • changed sense of taste
  • constipation
  • cough
  • decreased appetite
  • diarrhea
  • dizziness
  • dry, itchy skin
  • hair loss
  • headache
  • increased tear production
  • nail inflammation
  • nausea
  • numb or tingling sensation in the legs and feet
  • trouble sleeping
  • vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • decreased number of white blood cells
  • diarrhea
  • fever
  • fluid in the lungs (difficulty breathing)
  • fluid retention (e.g., puffiness, swelling feet, ankles, feeling bloated)
  • inflammation of the nail bed where the nail and skin meet
  • joint or muscle pain
  • muscle weakness
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of heart failure (e.g., shortness of breath, fatigue, swelling in legs, ankles, feet)
  • signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
  • shortness of breath, trouble breathing

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
  • signs of an infusion reaction (e.g., fever, chills, dizziness, confusion, fast or slow heartbeat, irregular heart beat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Diarrhea: Pertuzumab may cause severe diarrhea. Your doctor may recommend that you keep a medication available to use in the event that you develop severe diarrhea. Because diarrhea can cause dehydration, which in turn can cause other medical problems, it is important to prevent or stop the diarrhea as soon as possible.

Heart problems: This medication may worsen symptoms of heart disease. It can cause the heart to become less effective at pumping the blood through your body. This may be more likely to occur if you have previously been treated with any of the medications in the family known as anthracyclines (e.g., doxorubicin, epirubicin).

If you have heart disease such as angina, congestive heart failure, or arrhythmia, discuss with your doctor how this medication may affect the medical condition, how the medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Contact your doctor as soon as possible if you develop symptoms of heart problems such as shortness of breath, chest pain, rapid heartbeat, or swollen ankles.

Infection: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). Avoid contact with people who have contagious infections and tell your doctor if you begin to notice signs of an infection, such as fever or chills.

Infusion reactions: This medication can cause a hypersensitivity or infusion reaction. Symptoms of this type of reaction generally appear during the infusion of the medication and may include flushing, chest pain, shortness of breath and a dramatic drop in blood pressure. These reactions can cause death if a health care provider is not informed immediately. If you experience any of these symptoms, or notice them happening to someone, let your nurse or doctor know immediately.

Kidney function: This medication has not been studied for use by people with decreased kidney function. If you have kidney disease or decreased kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: This medication has not been studied for use by people with decreased liver function. If you have liver disease or decreased liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Women who are of child-bearing age and their partners should use birth control while either partner is using this medication and for 7 months after the last dose. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if pertuzumab passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children. 

What other drugs could interact with this medication?

There may be an interaction between pertuzumab and any of the following:

  • belimumab

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.