Ado-Trastuzumab Emtansine (Kadcyla®)

About This Drug

Ado-trastuzumab emtansine is used to treat cancer. It is given in the vein (IV).

Possible Side Effects (More Common)

  • Decrease in the number of platelets. This may raise your risk of bleeding. 
  • Nausea 
  • Constipation (not able to move bowels)
  • Bleeding
  • Headache
  • Changes in your liver function - your liver function will be checked as needed
  • Nosebleed
  • Tiredness
  • Joint, muscle and/or bone pain
Note: Each of the side effects above was reported in 25% or greater of patients treated with ado-trastuzumab emtansine. Not all possible side effects are included above.

Warnings and Precautions

  • Inflammation (swelling) of the lungs. You may have a dry cough or trouble breathing.
  • While you are getting this drug in your vein (IV), you may have a reaction to the drug.  Sometimes you may be given medication to stop or lessen these side effects. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. These reactions may happen after your infusion.  If this happens, call 911 for emergency care.
  • Skin and tissue irritation may involve redness, pain, warmth, or swelling at the IV site. This happens if the drug leaks out of the vein and into nearby tissue.
  • Changes in your liver function which can rarely lead to liver failure. Your liver function will be checked as needed.
  • Changes in your heart function. Your heart function will checked as needed.
  • Abnormal bleeding, which can very rarely be fatal – symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding.
  • Effects on the nerves are called peripheral neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped but it does not get better in all people.

Important Information

  • Notify your doctor right away if you get pregnant during treatment or within 7 months of receiving treatment. There is a pregnancy exposure registry and a pregnancy pharmacovigilance program which monitors the effect on your pregnancy. It is recommended that you register with the MotHER pregnancy registry and report your pregnancy to Genentech. http://www.motherpregnancyregistry.com/
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day. 
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease your risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss. 
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Ask your doctor or nurse about medicines that are available to help stop or lessen constipation.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid). 
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • Infusion reactions may happen for 24 hours after your infusion. If this happens, call 911 for emergency care.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain. 
  • If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids.
  • If you have a nose bleed, sit with your head tipped slightly forward. Apply pressure by lightly pinching the bridge of your nose between your thumb and forefinger. Call your doctor if you feel dizzy or faint or if the bleeding doesn’t stop after 10 to 15 minutes.

Food and Drug Interactions

  • There are no known interactions of ado-trastuzumab emtansine with food. 
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are known drug interactions with ado-trastuzumab emtansine. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:​

  • ​Fever of 100.5 F (38 C) or higher
  • Chills
  • Pain in your chest
  • Dry cough
  • Trouble breathing
  • Swelling of legs, ankles, or feet 
  • Weight gain of 5 pounds in one week (fluid retention)
  • Easy bleeding or bruising 
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools ( bright red, or black/tarry)
  • Coughing up blood
  • No bowel movement in 3 days or when you feel uncomfortable
  • Nausea that stops you from eating or drinking  and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day 
  • Fatigue that interferes with your daily activities
  • Signs of infusion reaction: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain
  • Pain that does not go away, or is not relieved by prescribed medicines
  • Numbness, tingling, or pain your hands and feet
  • Nose bleed that doesn’t stop bleeding after 10 -15 minutes
  • Feeling dizzy or lightheaded
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • While you are getting this drug, please tell your nurse right away if you have any pain, redness, or swelling at the site of the IV infusion 
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Concerns

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 7 months after treatment. Men with female partners of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 4 months after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: Women should not breast feed during treatment and for 7 months after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.

Revised July 2017

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