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Hyaluronidase / pertuzumab / trastuzumab Side Effects

Medically reviewed by Last updated on Nov 2, 2023.

Applies to hyaluronidase / pertuzumab / trastuzumab: subcutaneous solution.


Subcutaneous route (Solution)

CardiomyopathyPertuzumab/trastuzumab/hyaluronidase-zzxf administration can result in subclinical and clinical cardiac failure manifesting as congesting heart failure, and decreased LVEF, with greatest risk when administered concurrently with anthracyclines. Evaluate cardiac function prior to and during treatment. Discontinue pertuzumab/trastuzumab/hyaluronidase-zzxf for cardiomyopathy.Embryo-fetal ToxicityExposure to pertuzumab/trastuzumab/hyaluronidase-zzxf can result in embryo-fetal death and birth defects. Advise patients of these risks and the need for effective contraception.Pulmonary ToxicityDiscontinue pertuzumab/trastuzumab/hyaluronidase-zzxf for anaphylaxis, angioedema, interstitial pneumonitis, or acute respiratory distress syndrome.

Serious side effects

Along with its needed effects, hyaluronidase / pertuzumab / trastuzumab 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 hyaluronidase / pertuzumab / trastuzumab:

More common

Less common


Incidence not known

Other side effects

Some side effects of hyaluronidase / pertuzumab / 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:

More common

For Healthcare Professionals

Applies to hyaluronidase / pertuzumab / trastuzumab: subcutaneous solution.


Very common (10% or more): Hemoglobin low (90%), absolute lymphocytes low (89%), leukocyte count low (82%), neutrophils low (68%), anemia (36%), platelets low (27%), neutropenia (22%)

Common (1% to 10%): Leukopenia, febrile neutropenia[Ref]


Common (1% to 10%): Hypersensitivity[Ref]


Common (1% to 10%): Influenza-like illness[Ref]


Very common (10% or more): Radiation skin injury (19%), injection site reaction (15%), procedural pain (13%)

Common (1% to 10%): Injection site pain[Ref]


Very common (10% or more): Myalgia (25%), arthralgia (24%), pack pain (10%)

Common (1% to 10%): Bone pain, pain in extremity, muscle spasms, musculoskeletal pain[Ref]


Common (1% to 10%): Lacrimation increased, dry eye[Ref]


Very common (10% or more): Decreased appetite (17%), potassium low (17%), albumin low (16%), potassium high (13%), sodium low (13%), weight loss (11%)

Common (1% to 10%): Hypokalemia, glucose low, sodium high[Ref]


Very common (10% or more): Insomnia (17%)[Ref]


Common (1% to 10%): Urinary tract infection[Ref]


Very common (10% or more): Alanine aminotransferase high (58%), aspartate aminotransferase high (50%)

Common (1% to 10%): Bilirubin high


Very common (10% or more): Cough (15%), epistaxis (12%), upper respiratory infection (11%), dyspnea (10%)

Common (1% to 10%): Rhinorrhea, nasopharyngitis, paronychia

Frequency not reported: Dyspnea, interstitial pneumonitis, pulmonary infiltrates, pleural effusions, non-cardiogenic pulmonary edema, pulmonary insufficiency/hypoxia, acute respiratory distress syndrome, pulmonary fibrosis, exacerbation of chemotherapy-induced neutropenia[Ref]


Very common (10% or more): Asthenia (31%), fatigue (29%), pyrexia (13%)

Common (1% to 10%): Edema peripheral, malaise

Frequency not reported: Embryofetal toxicity[Ref]

Nervous system

Very common (10% or more): Dysgeusia (17%), headache (17%), peripheral sensory neuropathy (16%), peripheral neuropathy (12%), dizziness (13%), paresthesia (10%)[Ref]


Very common (10% or more): Creatinine high (84%)[Ref]


Very common (10% or more): Hot flush (12%), left ventricular cardiac dysfunction (LVEF)

Common (1% to 10%): Ejection fraction decreased

Frequency not reported: Hypertension, arrhythmias, left ventricular cardiac dysfunction, disabling cardiac failure, cardiomyopathy, cardiac death[Ref]


Very common (10% or more): Alopecia (77%), rash (16%), dry skin (15%)

Common (1% to 10%): Nail discoloration, erythema, dermatitis, nail disorder, palmar-plantar erythrodysesthesia syndrome

Uncommon (0.1% to 1%): Pruritus[Ref]


Very common (10% or more): Nausea (60%), diarrhea (60%), stomatitis (25%), constipation (22%), vomiting (20%), mucosal inflammation (15%), dyspepsia (14%)

Common (1% to 10%): Hemorrhoids, abdominal pain, abdominal pain upper[Ref]


1. Product Information. Phesgo (hyaluronidase / pertuzumab / trastuzumab). Genentech. 2020.

Further information

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.