Enhertu Disease Interactions

Patients treated with fam-trastuzumab deruxtecan may be at increased risk of developing left ventricular dysfunction. Treatment with fam-trastuzumab deruxtecan has not been studied in patients with a history of clinically significant cardiac disease or LVEF less than 50% prior to initiation of treatment. Assess LVEF prior to initiation of treatment and at regular intervals during treatment as clinically indicated. Manage LVEF decrease through treatment interruption. Permanently discontinue fam-trastuzumab deruxtecan if LVEF of less than 40% or absolute decrease from baseline of greater than 20% is confirmed. Treatment should be permanently discontinued in patients with symptomatic congestive heart failure (CHF).

Fam-trastuzumab deruxtecan has not been studied in patients with severe hepatic impairment (total bilirubin >3 to 10 times ULN and any AST). No dose adjustment is required in patients with mild (total bilirubin =ULN and any AST >ULN or total bilirubin >1 to 1.5 times ULN and any AST) or moderate (total bilirubin >1.5 to 3 times ULN and any AST) hepatic impairment. However, closely monitor patients with moderate hepatic impairment, due to potentially increased exposure, and possible increase of related toxicities.

Fam-trastuzumab deruxtecan has not been studied in patients with severe renal impairment. Caution is advised if used in these patients. No dose adjustment is required in patients with mild (creatinine clearance (CrCl) =60 and <90 mL/min) or moderate (CrCl =30 and <60 mL/min) renal impairment.