This product contains 3 ingredients: pertuzumab, trastuzumab, and hyaluronidase. It is used to treat breast cancer. Pertuzumab and trastuzumab belong to a class of medications known as monoclonal antibodies. These medications work by slowing or stopping the growth of cancer cells. This product also contains hyaluronidase, which helps your body absorb pertuzumab and trastuzumab given by injection under the skin.

This medication is given by slow injection (over about 5 to 8 minutes) under the skin by a health care professional. It is given as directed by your doctor in the thigh, usually once every 3 weeks. The injection site and side should be changed each time to lessen injury under the skin. The dosage and length of treatment are based on your medical condition and response to treatment.

Use this medication regularly to get the most benefit from it. To help you remember, mark your calendar with a reminder.

See also Warning section.

Redness, irritation, or pain at the injection site may occur. Nausea, vomiting, diarrhea, constipation, dizziness, tiredness, headache, flushing, weakness, trouble sleeping, muscle/joint/back pain, stomach/abdominal pain, changes in how food tastes, and loss of appetite may also occur. Nausea and vomiting can be severe. In some cases, your doctor may prescribe medication to prevent or relieve nausea and vomiting. Eating several small meals, not eating before treatment, or limiting activity may help lessen some of these effects. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Pain or sores in the mouth and throat may occur. Brush your teeth carefully/gently, avoid using mouthwash that contains alcohol, and rinse your mouth often with cool water mixed with baking soda or salt. It may also be best to eat soft, moist foods.

Temporary hair loss may occur. Normal hair growth should return after treatment has ended.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

• easy bruising/bleeding
• bone pain
• numbness/tingling
• mental/mood changes
• chest pain

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

This medication may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse. Tell your doctor right away if you have any signs of infection (such as sore throat that doesn't go away, fever, chills).

This medication can commonly cause a rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe reaction. Get medical help right away if you develop any rash.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

See also Warning section.

Before using this product, tell your doctor or pharmacist if you are allergic to pertuzumab, trastuzumab, or hyaluronidase; or to any trastuzumab deruxtecan, or trastuzumab emtansine products; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• current/recent infection
• heart problems (such as heart failure, irregular heartbeat)
• high blood pressure
• lung problems
• previous cancer treatments (including radiation treatment)

This medication can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.

Tell your health care professional that you are using this medication before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be at greater risk for loss of appetite, anemia, numbness/tingling, changes in how food tastes, or heart problems (such as heart failure) while using this drug.

Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using this medication. This medication may harm an unborn baby. Your doctor should order a pregnancy test before you start this medication. Ask about the use of reliable forms of birth control during treatment and for 7 months after the last dose. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.

It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding while using this medication and for 7 months after stopping treatment.

See also Warning section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Trastuzumab is very similar to trastuzumab deruxtecan and trastuzumab emtansine. Do not use a trastuzumab deruxtecan or trastuzumab emtansine product while using a trastuzumab product.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669.

Lab and/or medical tests (such as heart function, complete blood count, blood pressure) should be done before you start using this medication and while you are using it. Keep all medical and lab appointments.

It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.

Not applicable. This medication is given in a hospital or clinic and will not be stored at home.

Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).