Drug interactions
Doxorubicin + Trastuzumab
Severity: Major
Doxorubicin and Trastuzumab: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Trastuzumab causes cardiac dysfunction, and doxorubicin causes cumulative dose-related cardiomyopathy. Combination or close sequencing markedly increases the incidence of heart failure and LVEF decline.
What this interaction means in plain words
Doxorubicin and Trastuzumab can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Doxorubicin belongs to Oncology; Trastuzumab belongs to Oncology.
Why it happens
Additive cardiotoxicity: anthracycline myocyte injury combined with inhibition of HER2-mediated cardioprotective signaling.
What to do
Avoid concurrent use and allow a long interval after anthracycline therapy. Assess LVEF before and regularly during treatment, and withhold trastuzumab if significant decline occurs.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Doxorubicin
Other interactions of Trastuzumab
Frequently asked questions
Can I take Doxorubicin with Trastuzumab?
MediHelp rates the interaction as major. Doxorubicin and Trastuzumab can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Trastuzumab causes cardiac dysfunction, and doxorubicin causes cumulative dose-related cardiomyopathy. Combination or close sequencing markedly increases the incidence of heart failure and LVEF decline.
How serious is the interaction between Doxorubicin and Trastuzumab?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use and allow a long interval after anthracycline therapy. Assess LVEF before and regularly during treatment, and withhold trastuzumab if significant decline occurs.
What other medicines interact with Doxorubicin?
MediHelp also lists interactions of Doxorubicin with, for example, Adenovirus types 4 and 7 live, Belatacept, Cobicistat. The full list is on the Doxorubicin page.
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