Trodelvy Side Effects: What They Are and How to Manage Them - Healthline
If you're considering treatment options for certain kinds of cancer, your doctor might suggest Trodelvy (sacituzumab govitecan-hziy). It's a prescription drug used to treat some kinds of bladder cancer* and triple-negative breast cancer.
Specifically, Trodelvy is prescribed for breast cancer or bladder cancer that's locally advanced or metastatic.† It's usually taken long term, unless you have bothersome side effects or your condition gets worse.
Trodelvy is given by a healthcare professional as an intravenous (IV) infusion. This is an injection into your vein given over time.
The active ingredient in Trodelvy is sacituzumab govitecan-hziy. This is a kind of
Like other drugs, Trodelvy can cause mild or serious side effects. Keep reading to learn more.
* Trodelvy received
† Locally advanced or metastatic means the cancer cells have spread from where they first developed.
Some people may experience mild or serious side effects during Trodelvy treatment. Examples of Trodelvy's commonly reported side effects include:
* Trodelvy has a
† To learn more about this side effect, see the "Side effects explained" section below.
Treatment with Trodelvy can cause mild side effects. Examples of mild side effects that have been reported with Trodelvy include:
* To learn more about this side effect, see the "Side effects explained" section below.
In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And do not stop treatment with Trodelvy unless your doctor recommends it.
Trodelvy may cause mild side effects other than the ones listed above. See the Trodelvy prescribing information for details.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you'd like to notify the FDA about a side effect you've had with Trodelvy, visit MedWatch.
Serious side effects are possible with Trodelvy treatment. Serious side effects that have been reported with Trodelvy include:
If you develop serious side effects while receiving Trodelvy, call your doctor right away. If the side effects seem life threatening or if you think you're having a medical emergency, immediately call 911 or your local emergency number.
* Trodelvy has a
† For more information, see the "Side effects explained" section below.
Learn more about some of the side effects Trodelvy may cause.
Hair loss
Hair loss is a possible side effect of Trodelvy. It was among the drug's more common side effects in studies.
What might help
Talk with your doctor if you have hair loss while receiving Trodelvy. They may recommend ways to manage this side effect.
Severe diarrhea
Trodelvy has a
Diarrhea was one of Trodelvy's more common side effects in studies. In most cases, this side effect was mild or moderate. Severe diarrhea was reported, but this was much less common.
What might help
If you're having diarrhea, contact your doctor. Due to the risk of severe diarrhea, they'll likely check to see if you have an infection that could be causing it.
If your diarrhea isn't caused by an infection, your doctor will likely recommend a medication to treat it. Some examples include:
They may also recommend replacing fluids and electrolytes (minerals) that you've lost due to diarrhea.
Until your diarrhea goes away or becomes less severe, your doctor will also likely have you temporarily stop treatment with Trodelvy. Once you can safely resume treatment, your doctor may lower your Trodelvy dose.
Severe or life threatening neutropenia
Trodelvy has a
With neutropenia, you have a low level of neutrophils, a kind of white blood cell. Neutrophils help your body fight infection. When your neutrophil level gets too low, your body can't respond to infections like usual.
Severe neutropenia was among the more common side effects in studies of Trodelvy. Neutropenia itself doesn't cause noticeable symptoms in most cases. But your doctor will monitor you for this condition. And you should watch for any signs of infection, such as:
Rarely, people receiving Trodelvy in studies developed febrile neutropenia. This is a life threatening kind of neutropenia that causes a fever above 101°F (38.3°C) or a fever that's higher than 100.4°F (38°C) for one hour or more.
What might help
During Trodelvy treatment, you'll have blood tests to monitor your neutrophil level. If your level decreases below a certain amount, your doctor will likely have you temporarily pause treatment with Trodelvy.
If you develop febrile neutropenia, your doctor will pause your treatment. You might also need antibiotics and treatment in the hospital.
In most cases, neutrophil levels return to usual 2 to 3 weeks after stopping Trodelvy. Your doctor may also recommend medication to help your body make neutrophils.
Once your neutrophil level returns to normal, you and your doctor will decide whether you'll resume Trodelvy treatment. If you do continue treatment, your doctor will likely lower your Trodelvy dose.
If you develop neutropenia more than twice, it's likely that your doctor will have you stop Trodelvy treatment.
Severe nausea and vomiting
Nausea and vomiting are among Trodelvy's more common side effects. But severe nausea and vomiting were rarely reported in studies.
What might help
Your doctor will prescribe medications for you to take before each Trodelvy infusion, to help prevent nausea and vomiting. You'll likely also take medications to help prevent or treat these side effects at home during Trodelvy treatment. Examples of medications your doctor may prescribe include:
Your doctor can provide more information about these medications.
If you have severe or bothersome nausea or vomiting, be sure to talk with your doctor. They might be able to recommend other ways to help manage these side effects.
Infusion reactions
Trodelvy can cause infusion reactions. These are symptoms that occur soon after an intravenous (IV) infusion of Trodelvy. (An IV infusion is an injection into your vein given over time.)
Symptoms usually develop within 24 hours of receiving a Trodelvy infusion. They can also develop days or weeks after an infusion. Symptoms may include:
- fever or chills
- trouble breathing
- itchiness
- feeling dizzy or lightheaded
- hives (a rash that causes itchy, raised patches of skin)
- low blood pressure
- flushing (temporary warmth, redness, or deepening of skin color)
- skin rash
- swelling in your face, lips, throat, or tongue
Infusion reactions can be life threatening in some cases.
Note: Some of these symptoms can also be a sign of an allergic reaction to Trodelvy. This side effect is described just below in "Allergic reaction."
What might help
Be sure to contact your doctor if you have symptoms of an infusion reaction at any time. This is important to do, even if it's been a while since your most recent infusion.
To help prevent infusion reactions, your doctor will prescribe medications for you to take before each Trodelvy infusion. These medications may include:
A healthcare professional will monitor you during your Trodelvy infusions. You'll also be monitored for at least 30 minutes after each infusion to watch for symptoms of a reaction.
If you develop symptoms of a reaction, the person giving your infusion may slow down how quickly the drug is being infused. Or they might stop your Trodelvy infusion. You might also be given medications to treat the reaction. If you have life threatening symptoms, your doctor will have you permanently stop Trodelvy treatment.
Allergic reaction
Like most drugs, Trodelvy can cause an allergic reaction in some people. Serious allergic reactions weren't common in the drug's studies.
Symptoms can be mild or serious and can include:
- skin rash
- itchiness
- flushing
- swelling under your skin, usually in your eyelids, lips, hands, or feet
- swelling of your mouth, tongue, or throat, which can make it hard to breathe
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter antihistamine you take by mouth, such as Benadryl, to manage your symptoms. Or they may recommend a product you apply to your skin, such as hydrocortisone cream.
If your doctor confirms you had a mild allergic reaction to Trodelvy, they'll decide if you should continue receiving it.
If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you had a serious allergic reaction to Trodelvy, they may have you switch to a different treatment.
Keeping track of side effectsDuring Trodelvy treatment, consider keeping notes on any side effects you're having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.
Your side effect notes can include things such as:
- when the side effect started
- what your symptoms were and how they affected your daily activities
- what other medications you were also taking, and what dose
- any other information you feel is important
Keeping notes and sharing them with your doctor will help your doctor learn more about how Trodelvy affects you. And your doctor can use this information to adjust your treatment plan if needed.
There are certain precautions to consider before beginning treatment with Trodelvy. This includes two boxed warnings.
Boxed warnings
Trodelvy has two
- Risk of severe diarrhea. Treatment with Trodelvy can cause severe diarrhea. If this occurs, your doctor might recommend pausing Trodelvy to treat the diarrhea.
- Risk of severe or life threatening neutropenia. Trodelvy can cause severe or life threatening neutropenia. With this condition, you have a low level of neutrophils (a kind of white blood cell). This can raise your risk of infection.
To learn more, see the "Side effects explained" section above.
Other warnings
Trodelvy may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you start receiving Trodelvy. The list below includes factors to consider.
Liver problems. Your doctor may not prescribe Trodelvy if you have moderate or severe liver problems, such as hepatitis (a liver infection). Your doctor will determine whether Trodelvy is safe for you, depending on your liver function.
Reduced activity of the UGT1A1 gene. You may be at higher risk of some side effects of Trodelvy if you have reduced activity of a gene called UGT1A1. Specifically, this may increase your risk of a low red blood cell level, neutropenia, and a severe kind of neutropenia called febrile neutropenia. (For more information, see "Side effects explained" above.) Your doctor can determine whether Trodelvy treatment is safe for you.
Allergic reaction. If you've had an allergic reaction to Trodelvy or any of its ingredients, your doctor will likely not prescribe Trodelvy. Ask your doctor what other medications are better options for you.
Alcohol and Trodelvy
It should be safe to drink alcohol during Trodelvy treatment. But drinking alcohol could make you more likely to have some side effects or could worsen certain side effects. These include:
If you drink alcohol, ask your doctor about how much is safe for you to drink while you're receiving Trodelvy.
Pregnancy and breastfeeding with Trodelvy
Trodelvy is not safe to receive during pregnancy. And you should not breastfeed while receiving Trodelvy or for at least one month after your last dose.
If you can become pregnant, your doctor will have you take a pregnancy test to check that you're not pregnant before prescribing Trodelvy. They'll also recommend using birth control during treatment and for at least 6 months after your last dose.
If you're pregnant, breastfeeding, or planning either, talk with your doctor about your cancer treatment options.
Like most medications, Trodelvy can cause side effects. These might be mild or serious.
Before starting treatment with Trodelvy, talk with your doctor. Ask questions to help you become familiar with this medication and its side effects. Some examples to help get you started are:
- Are there ways I can lower my risk of side effects?
- Does my medical history put me at higher risk of any side effects?
- If I have side effects, can I try a lower dose of Trodelvy?
- How do Trodelvy's side effects compare with those caused by other treatment options?
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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