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Phesgo (pertuzumab/ trastuzumab/ hyaluronidase-zzxf)
pertuzumab/ trastuzumab/ hyaluronidase
Black Box Warnings .
Cardiomyopathy
subclinical and clinical cardiac failure can occur; incidence and severity highest in combo with anthracyclines; evaluate left ventricular function prior to and during tx; if clinically significant decr. left ventricular function, D/C tx in patients receiving adjuvant tx and withhold tx in patients with metastatic breast CA
Embryo-Fetal Toxicity
exposure during pregnancy or within 7mo prior to conception can result in embryo-fetal death and birth defects, including oligohydramnios and oligohydramnios sequence manifesting as pulmonary hypoplasia, skeletal abnormalities, and neonatal death; advise patients of risks and need for effective contraception
Pulmonary Toxicity
can result in serious and fatal cases; D/C tx if anaphylaxis, angioedema, interstitial pneumonitis, or ARDS; monitor patients until signs/symptoms resolve completely
Adult Dosing .
Dosage forms: INJ (vial): 1200 mg/600 mg/30,000 units per 15 mL, 600 mg/600 mg/20,000 units per 10 mL
Special Note
- [equivalency or interchangeability info]
- Info: not interchangeable with ado-trastuzumab emtansine, fam-trastuzumab deruxtecan, pertuzumab, or other trastuzumab-containing products
- [drug name clarification]
- Info: nonproprietary name = pertuzumab/trastuzumab/hyaluronidase-zzxf
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing including toxicity-related dose adjustments
HER2-positive breast CA, early
- [neoadjuvant tx]
- Dose: 1200 mg/600 mg/30,000 units SC x1 on day 1 of 21-day cycle for cycle 1, then 600 mg/600 mg/20,000 units SC x1 on day 1 of 21-day cycle; Info: for patients with locally advanced, inflammatory, or early stage disease with either >2cm in diameter or node positivity; give x3-6 cycles in neoadjuvant setting as part of multi-drug chemo regimen, then continue in adjuvant setting for total of 18 cycles
- [adjuvant tx]
- Dose: 1200 mg/600 mg/30,000 units SC x1 on day 1 of 21-day cycle for cycle 1, then 600 mg/600 mg/20,000 units SC x1 on day 1 of 21-day cycle for cycles 2-18; Info: for patients with high recurrence risk; give x3-6 cycles as part of multi-drug chemo regimen, then continue as monotherapy for total of 18 cycles
HER2-positive breast CA, metastatic
- [600 mg/600 mg/20,000 units SC x1 on day 1 of 21-day cycle, starting cycle 2]
- Start: 1200 mg/600 mg/30,000 units SC x1 on day 1 of 21-day cycle for cycle 1; Info: use with docetaxel
renal dosing
- [see below]
- CrCl >30: no adjustment; CrCl <30: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.