Herceptin Side Effects
Generic Name: trastuzumab
Medically reviewed by Drugs.com. Last updated on Sep 23, 2020.
Note: This document contains side effect information about trastuzumab. Some of the dosage forms listed on this page may not apply to the brand name Herceptin.
Common side effects of Herceptin include: febrile neutropenia, infection, asthenia, dizziness, fever, headache, nausea, pain, skin rash, vomiting, abdominal pain, back pain, diarrhea, flu-like symptoms, insomnia, neutropenia, pharyngitis, rhinitis, chills, and anorexia. Other side effects include: urinary tract infection, anemia, arthralgia, depression, edema, ostealgia, paresthesia, sinusitis, and tachycardia. See below for a comprehensive list of adverse effects.
For the Consumer
Applies to trastuzumab: intravenous powder for solution
Intravenous route (Powder for Solution)
Administration of trastuzumab products can result in subclinical and clinical cardiac failure, with the greatest risk and severity upon concurrent administration with anthracyclines. Evaluate cardiac function prior to and during treatment. Discontinue trastuzumab-dkst in patients receiving adjuvant therapy and withhold trastuzumab-dkst for a clinically significant decrease in left ventricular function. Serious and fatal infusion reactions and pulmonary toxicity may occur during or within 24 hours after administration. Discontinue trastuzumab-dkst if signs of anaphylaxis, angioedema, interstitial pneumonitis, or acute respiratory distress syndrome are noted. Exposure during pregnancy can result in oligohydramnios, in some cases complicated by pulmonary hypoplasia, skeletal abnormalities, and neonatal death. Advise patients of these risks and the need for effective contraception.
Side effects requiring immediate medical attention
Along with its needed effects, trastuzumab (the active ingredient contained in Herceptin) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking trastuzumab:
- Black, tarry stools
- bleeding gums
- blood in the urine or stools
- chest pain
- cracked lips
- decreased frequency or amount of urine
- difficult or labored breathing
- difficulty in swallowing
- dry mouth
- increased blood pressure
- increased thirst
- irregular heartbeat
- loss of appetite
- lower back or side pain
- mood changes
- muscle aches, pain, or cramps
- numbness or tingling in the hands, feet, or lips
- painful or difficult urination
- pale skin
- peeling of the skin
- pinpoint red spots on the skin
- sore throat
- sores, ulcers, or white spots on the lips, tongue, or inside the mouth
- stuffy or runny nose
- swelling of the face, fingers, or lower legs
- swollen glands
- tightness in the chest
- troubled breathing
- troubled breathing with exertion
- unusual bleeding or bruising
- unusual tiredness or weakness
- weight gain
- Bladder pain
- bloody nose
- blurred vision
- body aches or pain
- burning or stinging of the skin
- cloudy urine
- dilated neck veins
- ear congestion
- extreme tiredness or weakness
- fast, irregular, pounding, or racing heartbeat or pulse
- frequent urge to urinate
- general feeling of discomfort or illness
- irregular breathing
- joint pain
- loss of voice
- nasal congestion
- pain or tenderness around the eyes and cheekbones
- painful cold sores or blisters on the lips, nose, eyes, or genitals
- pounding in the ears
- trouble sleeping
- Chest discomfort
- hives, itching, skin rash
- joint stiffness or swelling
- neck tenderness or swelling
- redness of the skin
- tightness in the chest
Side effects not requiring immediate medical attention
Some side effects of trastuzumab may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- difficulty in moving
- feeling of warmth
- muscle stiffness
- redness of the face, neck, arms and occasionally, upper chest
- sudden sweating
- back pain
- bone pain
- discoloration of the fingernails or toenails
- lack or loss of strength
- muscle spasm
- stomach upset or pain
- upper stomach pain
For Healthcare Professionals
Applies to trastuzumab: intravenous powder for injection
The most common adverse events were fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, dyspnea, rash, neutropenia, anemia, stomatitis, weight loss, thrombocytopenia, mucosal inflammation, nasopharyngitis, dysgeusia, and myalgia.[Ref]
Very common (10% or more): Neutropenia (78%), leukopenia (52%), anemia (36%), febrile neutropenia (23%), thrombocytopenia (16%)
Frequency not reported: Hypoprothrombinemia[Ref]
Common (1% to 10%): Hypertension, hypotension, asymptomatic cardiac dysfunction, ejection fraction decreased, palpitation, cardiac arrhythmia, cardiac failure, heart beat irregular, cardiac flutter, lymphedema, hot flush, thrombotic adverse event, supraventricular tachyarrhythmia, vasodilation
Uncommon (0.1% to 1%): Ventricular dysfunction, pericardial effusion
Very common (10% or more): Infusion-related reactions (54%)
Common (1% to 10%): Hypersensitivity, allergic reaction
Very common (10% or more): Cough (43%), dyspnea (42%), rhinitis (22%), Grade 2 to 5 pulmonary toxicity (14%), nasopharyngitis (13%), wheezing, epistaxis, rhinorrhea
Uncommon (0.1% to 1%): Pulmonary infiltrates, pulmonary hypertension, interstitial pneumonitis
Frequency not reported: Pulmonary insufficiency, pulmonary fibrosis, respiratory distress, respiratory failure, lung infiltration, acute pulmonary edema, acute respiratory distress syndrome, bronchospasm, hypoxia, oxygen saturation decreased, laryngeal edema, pulmonary edema, orthopnea
Postmarketing reports: Bronchospasm, hypoxia, pleural effusions, non-cardiogenic pulmonary edema[Ref]
Very common (10% or more): Infection (47%), herpes simplex (38%), antibody to trastuzumab (the active ingredient contained in Herceptin) (15%), flu syndrome (12%)
Uncommon (0.1% to 1%): Sepsis[Ref]
Very common (10% or more): Renal impairment/failure (18%)
Common (1% to 10%): Grade 3 or 4 renal failure, renal disorder, hyperbilirubinemia
Frequency not reported: Glomerulonephritis membranous, glomerulonephropathy, renal failure
Very common (10% or more): Nausea (76%), vomiting (53%), diarrhea (45%), abdominal pain (34%), stomatitis (24%), anorexia (14%)
Very common (10% or more): Headache (44%), asthenia (42%), fatigue (35%), insomnia (29%), dizziness (24%), paresthesia (23%), peripheral neuritis (23%), neuropathy (13%), dysgeusia (10%), dizziness (13%), tremor, hypoesthesia
Common (1% to 10%): Hypertonia, somnolence, ataxia
Rare (less than 0.1%): Paresis
Frequency not reported: Brain edema[Ref]
Uncommon (0.1% to 1%): Urticaria
Frequency not reported: Angioedema[Ref]
Very common (10% or more): Arthralgia (37%), back pain (34%), bone pain (24%), muscle tightness, myalgia
Very common (10% or more): Anorexia (31%), hypokalemia (28%), weight loss (23%)
Frequency not reported: Hyperkalemia
Postmarketing reports: Volume overload[Ref]
Very common (10% or more): Asthenia (62%), pain (61%), fever (56%), chills (41%), accidental injury (13%)
Common (1% to 10%): Malaise
Uncommon (0.1% to 1%): Deafness
Rare (less than 0.1%): Sudden death
Postmarketing reports: Oligohydramnios or oligohydramnios sequence (including pulmonary hypoplasia, skeletal abnormalities, and neonatal death)[Ref]
Common (1% to 10%): Hepatocellular injury, hepatitis, liver tenderness
Rare (less than 0.1%): Jaundice
Frequency not reported: Hepatic failure[Ref]
Very common (10% or more): Conjunctivitis, lacrimation increased
Common (1% to 10%): Dry eye
Very common (10% or more): Depression (20%), insomnia (14%)
Common (1% to 10%): Anxiety, thinking abnormal
Uncommon (0.1% to 1%): Depression[Ref]
Uncommon (0.1% to 1%): Autoimmune thyroiditis[Ref]
Frequency not reported: Malignant neoplasm progression, neoplasm progression[Ref]
1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
2. "Product Information. Ogivri (trastuzumab)." Mylan GmbH, Morgantown, WV.
3. Cerner Multum, Inc. "Australian Product Information." O 0
4. "Product Information. Herceptin (trastuzumab)." Genentech, South San Francisco, CA.
Frequently asked questions
- What are the biosimilars of Herceptin?
- What is the difference between Herceptin and Herceptin Hylecta?
- What is the difference between Herzuma and Herceptin?
- How many biosimilars have been approved in the United States?
- How long can you stay on Herceptin and Perjeta?
- How long does Herceptin stay in your body?
- What is Herceptin? Is Herceptin a chemo drug? How does it work?
- How effective is Herceptin for Breast & Gastric Cancer?
- Does Herceptin (trastuzumab) stop menstrual periods?
- Do Herceptin (trastuzumab) injections hurt?
- What is the difference between Ogivri and Herceptin?
- How is Herceptin Injection and Herceptin Hylecta administered?
More about Herceptin (trastuzumab)
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
- Compare Alternatives
- Support Group
- Pricing & Coupons
- En Español
- 7 Reviews
- Drug class: HER2 inhibitors
- FDA Approval History
Related treatment guides
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.