The Basics
Approved in 2013, Ado-trastuzumab Emtansine (T-DM1 or Kadcyla) is a targeted therapy for a type of breast cancer. This drug combines a protein called Trastuzumab with a chemotherapy called DM1.
Your doctor would generally prescribe you the drug if you have prior therapy experience for spreading cancer or the cancer has come back during or within six months of completing adjuvant therapy (which is the treatment given after surgery). It is injected into the vein by a doctor in a medical facility.
The most common (≥ 25%) side effects of Kadycla are fatigue, nausea, muscle pain, excessive bleeding, low platelet count, headache, constipation, elevated liver enzymes, nerve problems, and nosebleeds. In severe cases, the drug may also cause liver failure and heart problems.
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Make sure you read the IMPORTANT WARNING section at the end of this article.
How should I take ado-trastuzumab emtansine (Kadcyla)?
Ado-trastuzumab emtansine or Kadcyla is injected slowly into a vein. It is given over 90 minutes during the first dose by a doctor or nurse in a medical facility. The remaining doses may be given over 30 minutes. It is usually injected once every 3 weeks.
Be sure to tell your doctor how you feel during your treatment with ado-trastuzumab emtansine. You can help them by tracking your side effects in Ankr.
What are the side effects of ado-trastuzumab emtansine (Kadcyla)?
Common side effects
- constipation
- diarrhea
- upset stomach
- sores in the mouth and throat
- dry mouth
- taste changes
- joint or muscle pain
- headache
- dry, red, or teary eyes
- blurry vision
- trouble falling asleep or staying asleep
- tiredness
- unusual sensation and body reactions at the site of injection
- fever
- chills
- nosebleeds
- unusual bleeding or bruising
- pain, burning, or tingling in the hands or feet
- muscle weakness
- trouble moving
- hives
- itching
- nausea
- vomiting
- loss of appetite
- muscle cramps
- spasms
- cough
- extreme tiredness
Serious side effects
- difficulty urinating
- pain when urinating
- other signs of infection
- bloody or black, tarry stools
- vomiting blood or brown material that resembles coffee grounds
- rash
- difficulty breathing or swallowing
- dark urine
- decreased amount of urine
- stomach pain
- seizures
- hallucinations
- shortness of breath
- flushing
- dizziness
- lightheadedness
- fainting
- fast, irregular, or pounding heartbeat
Ado-trastuzumab emtansine may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online or by phone (1-800-332-1088).
Use the free Ankr platform or Ankr app to track your symptoms.
What special precautions should I follow?
Before receiving ado-trastuzumab emtansine or Kadcyla
- tell your doctor about your allergies
- tell your doctor about other intakes
- tell your doctor if you are of Asian descent
- tell your doctor
- about any other disease or symptom in the past or now
While you are on ado-trastuzumab emtansine or Kadcyla
- if you become pregnant while taking Kadcyla, call your doctor immediately. It may harm the fetus.
- tell your doctor if you are breastfeeding or plan to breastfeed. You should not breastfeed while receiving Kadcyla and for at least 7 months after your final dose.
You can better manage these conditions by using ankr app.
I forgot a dose. What should I do?
Skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
In case of an emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.
Symptoms of overdose may include the following:
- nosebleeds and other unusual bleeding or bruising
- bloody or black, tarry stools
- vomiting blood or brown material that resembles coffee grounds
What special dietary instructions should I follow?
Talk to your doctor about eating grapefruit and drinking grapefruit juice while receiving this medication.
Brand names
- Kadcyla®
Last Revised – 02/22/2023, FDA update- 05/03/2019, SG
Ado-trastuzumab emtansine may cause serious or life-threatening liver problems. Tell your doctor if you have or had liver disease, including hepatitis. Your doctor will regularly order laboratory tests before and during your treatment to see if ado-trastuzumab emtansine affects your liver. Your doctor may tell you you should not receive this medication if the tests show you have liver problems. Tell your doctor and pharmacist about all your medications, so they can check whether they may increase the risk of developing liver damage during your treatment with ado-trastuzumab emtansine. Call your doctor immediately if you experience any of the following symptoms: nausea, vomiting, extreme tiredness, lack of energy, loss of appetite, pain in the upper right part of the stomach, yellowing of the skin or eyes, dark-coloured urine, flu-like symptoms, confusion, drowsiness, or unclear speech.
Ado-trastuzumab emtansine also may cause serious or life-threatening heart problems. Tell your doctor if you have or have ever had heart disease, a heart attack, chest pain, or irregular heartbeats. Your doctor will order tests before and during your treatment to see if your heart is working well enough for you to safely receive ado-trastuzumab emtansine. Your doctor may tell you that you should not receive this medication if the tests show your heart’s ability to pump blood has decreased. If you experience any of the following symptoms, call your doctor immediately: cough; shortness of breath; swelling of the arms, hands, feet, ankles or lower legs; weight gain (more than 5 pounds [about 2.3 kilograms] in 24 hours); dizziness; loss of consciousness; or fast, irregular, or pounding heartbeat.
Tell your doctor if you are pregnant or if you or your partner plan to become pregnant. Ado-trastuzumab emtansine may harm your unborn baby. If you can become pregnant, you will need to have a negative pregnancy test before beginning treatment with ado-trastuzumab emtansine. You should use birth control to prevent pregnancy during your treatment and for 7 months after your final dose. If you are a male and your partner can become pregnant, you should use birth control while receiving this medication for 4 months after your final dose. Talk to your doctor about birth control methods that will work for you. Call your doctor immediately if you or your partner become pregnant during your treatment with ado-trastuzumab emtansine.
Talk to your doctor about the risks of receiving ado-trastuzumab emtansine injection.
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