Pertuzumab is an IV medication that requires an echocardiogram and pregnancy test prior to administration. It must be diluted in normal saline and given as an IV infusion over 60 or 30-60 minutes, depending on the dose. Pertuzumab must be administered at least 30 minutes prior to docetaxel. Common side effects include nausea, diarrhea, neutropenia, fatigue, rash, peripheral neuropathy, and hair loss. Patients must be monitored for cardiac symptoms, left ventricular ejection fraction, and infusion reactions.

1. PERJETA® (pertuzumab)
Required Testing Prior to Administration
 ECHO: Due to risk of heart failure, every patient must have a baseline left ventricular ejection
fraction (LVEF). Do not administer if LVEF < 45%, or LVEF 45% to 49% with ≥ 10% absolute
decrease below pretreatment values
 In females of childbearing age: pregnancy test
IV Administration
 DO NOT mix with other drugs
 DO NOT dilute with D5W
 ONLY use in normal saline – sodium chloride 0.9%
 DO NOT use at Y-site
 Invert bag gently to mix; DO NOT shake
 Administer immediately after preparation, or store for up to 24 hours at 2 to 8 degrees C
 DO NOT give as an IV push or IV bolus
 Only give as an IV infusion: 840-mg dose over 60 minutes OR 420-mg dose over 30 to 60
minutes
 Dilute the desired dose in a PVC or non-PVC polyolefin infusion bag/tubing containing 250 mL
NS
 Order of Administration:
o Docetaxel must always be administered LAST, but either pertuzumab or trastuzumab
can be given first or second.
o Pertuzumab must be given at least 30 minutes prior to DOCETAXEL
o Observe patient for 30 to 60 minutes following pertuzumab infusion before
administering the next medication
Common Side Effects
 Nausea
 Diarrhea
 Neutropenia
 Fatigue
 Rash
 Peripheral neuropathy
 Hair loss
Monitoring
 Cardiac symptoms – monitor vital signs, fluid status, and assess for dyspnea
 LVEF – baseline, every 3 months for metastatic use or every 6 weeks in neoadjuvant use
 Infusion reactions - 60 minutes after first infusion and 30 minutes after subsequent infusions.
Depending on severity, infusion may need to be slowed, interrupted or discontinued completely.
Symptoms of infusion reactions include: fever, chills, fatigue, headache, hypersensitivity and
vomiting.
o Anaphylaxis treatment: MILD: Anti-histamines. SEVERE: Airway management,
epinephrine, cardiac monitoring, IV fluids