Acute Porphyria Drug Database

L01FD01 - Trastuzumab
Not porphyrinogenic
NP

Rationale
No CYP-affinity. No conceivable effects on PXR activation. However, side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Chemical description
Trastuzumab is a recombinant DNA-derived humanized anti-HER2 monoclonal antibody.
Therapeutic characteristics
Trastuzumab is an antineoplastic agent used in the treatment of breastcancer. It is administered as an intravenous infusion. Often administered together with paclitaxel, docetaxel or aromatase inhibitor e.g. anastrozol. Common adverse reactions of trastuzumab that can be confused with an acute porphyric attack are vomiting and nausea. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Metabolism and pharmacokinetics
Metabolized as endogenous IgG. Non-CYP metabolism.
Published experience
Used uneventfully for the treatment of breast cancer in AIP woman (Kristiansen, 2006).
IPNet drug reports
No.

References

  1. Scientific articles
  2. Kristiansen C, Langkjer ST. Treatment and treatment considerations in a patient with advanced breast cancer and acute intermittent porphyria. Acta Oncol 2006;45(3):337-9. #2036
  3. Drug reference publications
  4. McEvoy GK, editor. Trastuzumab. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (10.05.10). #2037
  5. Sweetman SC, editor. Martindale: The complete drug reference. Trasuzumab. Pharmaceutical Press 2009. #2039
  6. Summary of Product Characteristics
  7. Norwegian medicines agency. Summary of Product Characteristics (SPC). Herceptin. #2038

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