Tukysa is a brand-name oral tablet prescribed for certain types of breast cancer and colorectal cancer. Tukysa contains the active ingredient tucatinib and is a targeted therapy.

The Food and Drug Administration (FDA) has approved Tukysa to treat the following in adults in certain situations:

  • breast cancer that’s HER2-positive and is either:
    • locally advanced (has spread into nearby tissues) and unresectable (can’t be removed with surgery), or
    • metastatic (has spread to other parts of the body)
  • colorectal cancer that’s RAS wild-type, HER2-positive, and is either unresectable or metastatic

HER2-positive cancer has abnormally high levels of a protein called HER2 that encourages cancer cell growth. RAS wild-type colorectal cancer lacks mutations (changes) to RAS genes. RAS gene mutations may also encourage cancer cell growth.

When used for breast cancer, Tukysa is taken in combination with two other cancer drugs: trastuzumab (Herceptin) and capecitabine (Xeloda). The drug is taken in combination with trastuzumab when treating colorectal cancer.

For more information, including details about Tukysa’s approved uses, see the “Tukysa uses” section.

Drug details

Here is some key information about Tukysa.

  • Drug class: kinase inhibitor
  • Drug form: oral tablet
  • Generic available? no
  • Prescription required? yes
  • Controlled substance? no
  • Year of FDA approval: 2020
  • Accelerated approval? yesTrusted Source, for colorectal cancer

Tukysa is available only as a brand-name medication. It’s not currently available in generic form. (A generic drug is an exact copy of the active ingredient in a brand-name medication.)

The Tukysa dosage your doctor prescribes will depend on several factors. These include:

  • how well your liver works
  • whether you take certain other medications
  • whether you develop certain side effects from the drug

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Tukysa comes as an oral tablet. It’s available in two strengths: 50 milligrams (mg) and 150 mg.

Dosage for advanced breast cancer

The usual dosage of Tukysa for advanced HER2-positive breast cancer is 300 mg taken twice per day.

Dosage for advanced colorectal cancer

The usual dosage of Tukysa for advanced RAS wild-type, HER2-positive colorectal cancer is 300 mg taken twice per day.

Dosage adjustments

If you have problems with your liver, your doctor may recommend that you take a dosage of Tukysa that’s lower than usual.

Your doctor may also lower your dosage of Tukysa or have you take a break from treatment if you develop certain side effects from the drug. These side effects may include diarrhea.

What if I miss a dose?

If you miss a dose of Tukysa, skip the missed dose and take your next dose as scheduled. You should not take an extra dose to make up for a missed dose.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Tukysa is meant to be used as a long-term treatment. If you and your doctor determine that Tukysa is safe and effective for you, you’ll likely take it long term.

You’ll probably take Tukysa for as long as the drug keeps your cancer from progressing and the side effects remain manageable.

Tukysa can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Tukysa. These lists don’t include all possible side effects.

For more information on the possible side effects of Tukysa, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Tukysa, you can do so through MedWatch.

Mild side effects

Mild side effects of Tukysa can include:

This is a partial list of mild side effects from Tukysa. To learn about other mild side effects, talk with your doctor or pharmacist, or see Tukysa’s prescribing information.

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Tukysa aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects include:

  • diarrhea
  • liver damage

For information about liver damage, see the next section.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Nausea and vomiting

It’s possible to have nausea and vomiting while you’re taking Tukysa. This is a common problem that’s caused by many cancer treatments, including Tukysa. It’s also a common problem with the cancer drugs used in combination with Tukysa. (For details about these drugs, see the “Tukysa use with other drugs” section.)

What to do for nausea and vomiting with Tukysa

If you frequently have nausea or vomiting with Tukysa, talk with your doctor. They may prescribe medication to help reduce your symptoms. They can also recommend other ways to help manage this problem.

If you vomit after taking a dose of Tukysa, don’t take an extra dose of the drug. Instead, just take your next dose as scheduled.

General tips that may be helpful in preventing or reducing nausea and vomiting include:

  • frequently eating small amounts of food instead of having larger meals less often
  • avoiding fatty or greasy foods
  • frequently sipping on clear liquids throughout the day

Liver damage

Tukysa can sometimes cause liver damage, which is also called hepatotoxicity. So you may have problems with how well your liver works while you’re taking Tukysa. Symptoms of liver problems can include:

  • jaundice (yellowing of your skin and the whites of your eyes)
  • dark urine or pale stools
  • pain in your upper right abdomen
  • itching
  • bruising or bleeding more easily than usual
  • fatigue

Monitoring for liver damage

While you’re taking Tukysa, you’ll have frequent blood tests to check the health of your liver. These blood tests are called liver function tests (LFTs). They measure the level of liver enzymes in your blood.

Liver enzymes are proteins that your liver uses to carry out its usual functions. Damage to liver cells causes liver enzymes to be released into your blood. If your blood test results show raised levels of liver enzymes, your liver may be damaged.

What to do for liver damage with Tukysa

If you have any symptoms of liver damage while you’re taking Tukysa, see your doctor right away. Your doctor may order LFTs to assess the health of your liver.

If you do have liver damage, your doctor may recommend that you stop taking Tukysa for a while. And if or when you start taking Tukysa again, your doctor may lower your dosage of the drug.

But if you have severe liver damage from Tukysa, your doctor may recommend that you permanently stop taking the drug.

The Food and Drug Administration (FDA) approves prescription drugs such as Tukysa to treat certain conditions. Tukysa may also be used off-label for other conditions. Off-label use is when a drug that the FDA has approved to treat one condition is used to treat a different condition.

Tukysa for advanced breast cancer

Tukysa is FDA approved to treat a certain form of advanced breast cancer in adults. Specifically, Tukysa is approved to treat breast cancer that’s HER2-positive and is either:

  • locally advanced (has spread into nearby tissues) and unresectable (can’t be removed with surgery), or
  • metastatic (has spread to other parts of the body, which may include the brain)

HER2-positive cancer has abnormally high levels of a protein called HER2 that encourages cancer cell growth.

Tukysa is approved for use in adults who have already taken one or more anti-HER2 treatments in the past for their cancer. Examples of these treatments include:

For breast cancer, Tukysa is given in combination with two other cancer drugs: trastuzumab (Herceptin) and capecitabine (Xeloda).

Tukysa is a targeted therapy for HER2-positive breast cancer. Targeted therapies work by blocking specific proteins that help cancer cells grow and multiply. (Cells that multiply are making more cells.)

Effectiveness for advanced breast cancer

In a clinical trial, Tukysa was found to be safe and effective for treating advanced HER2-positive breast cancer. For details about this trial, see the Tukysa prescribing information.

Tukysa for advanced colorectal cancer

Tukysa is FDA approved to treat a certain form of advanced colorectal cancer in adults. (Colorectal cancer refers to cancer that occurs in the colon or rectum, which are parts of the large intestine.)

Specifically, Tukysa is approved to treat colorectal cancer that’s both RAS wild-type and HER2-positive. The cancer must also be either unresectable (can’t be removed with surgery) or metastatic (has spread to other parts of the body).

HER2-positive cancer has abnormally high levels of a protein called HER2 that encourages cancer cell growth. RAS wild-type colorectal cancer lacks mutations (changes) to RAS genes. RAS gene mutations may also encourage cancer cell growth.

Tukysa is approved for use in adults whose colorectal cancer progressed after treatment with all of the following chemotherapy drugs:

  • irinotecan
  • oxaliplatin
  • a fluoropyrimidine, such as floxuridine

Tukysa is a targeted therapy for HER2-positive colorectal cancer. Targeted therapies work by blocking specific proteins that help cancer cells grow and multiply. (Cells that multiply are making more cells.)

Effectiveness for advanced colorectal cancer

For treating colorectal cancer, Tukysa received accelerated approval. The FDA gives accelerated approval to certain drugs if early clinical trials suggest that they may be effective for treating a certain condition. This is followed by more clinical trials to confirm whether the drug provides actual benefit for people with that condition.

Accelerated approval can allow quicker access to new drugs that may be safe and effective for conditions that don’t have many treatment options.

For information about the clinical trial that helped Tukysa receive accelerated approval, see the drug’s prescribing information. After additional clinical trials, the FDA may fully approve the drug or withdraw the approval for treating colorectal cancer.

Tukysa and children

Tukysa isn’t FDA approved for use in children. The use of Tukysa hasn’t been studied in children.

Tukysa is approved to treat advanced HER2-positive breast cancer. HER2-positive cancer has abnormally high levels of a protein called HER2 that encourages cancer cell growth. The drug is also approved to treat advanced RAS wild-type, HER2-positive colorectal cancer. RAS wild-type colorectal cancer lacks mutations (changes) to RAS genes. (RAS gene mutations may also encourage cancer cell growth.)

For breast cancer, Tukysa is approved for use in combination with both trastuzumab (Herceptin) and capecitabine (Xeloda). For colorectal cancer, it’s approved for use only in combination with trastuzumab.

Before you start treatment, your doctor will go over the details of your treatment cycle (dosage schedules for each of the drugs you are taking for your condition).

Tukysa with trastuzumab (Herceptin)

Like Tukysa, trastuzumab is also a targeted therapy for HER2-positive cancer. Targeted therapies work by blocking specific proteins that help cancer cells grow. Both Tukysa and trastuzumab block the effect of the HER2 protein. But these drugs work in slightly different ways in your body.

Trastuzumab blocks part of the HER2 protein that sits on the surface of the cancer cells. Tukysa, on the other hand, blocks part of the HER2 protein that’s inside the cancer cells.

Tukysa is an oral tablet. Trastuzumab is an intravenous (IV) infusion (an injection into a vein given over a period of time), which a healthcare professional administers.

Tukysa tablets are taken twice per day, but trastuzumab infusions are given from once per week to once every 21 days, depending on the formulation of the drug used. You’ll receive these infusions at a doctor’s office or healthcare facility. Trastuzumab IV infusions typically last for about 30 to 90 minutes.

Tukysa with capecitabine (Xeloda)

Unlike Tukysa, which is a targeted therapy drug, capecitabine is a chemotherapy drug. Chemotherapy works by killing cells in your body that are rapidly multiplying (making more cells). Because some healthy cells multiply rapidly, chemotherapy affects them as well as cancer cells.

Like Tukysa, capecitabine comes as oral tablets that you take twice per day. You’ll take Tukysa every day. However, capecitabine treatment follows a 21-day cycle. For treating breast cancer, you take it every day for 14 days, followed by a 7-day break.

You need to take capecitabine within 30 minutes after you’ve eaten a meal in the morning and evening. To make dosing convenient, you can take Tukysa at the same time as you take capecitabine. But Tukysa can actually be taken with or without food.

There aren’t any known interactions between Tukysa and alcohol. However, drinking alcohol could worsen certain side effects of Tukysa, such as:

In addition, both alcohol and Tukysa can affect your liver function.

If you want to drink alcohol while you’re taking Tukysa, talk with your doctor about how much, if any, is safe to drink.

Tukysa can interact with several other medications. It can also interact with certain supplements.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Tukysa and other medications

This section lists medications that can interact with Tukysa. It doesn’t include all the medications that may interact with Tukysa.

Before taking Tukysa, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Tukysa and certain drugs used to treat infection

Taking Tukysa with certain drugs used to treat infection can increase your liver’s breakdown of Tukysa. This can lower the level of Tukysa in your body, making the drug less effective for you.

Examples of drugs used to treat infections that could lower the level of Tukysa in your body include:

  • rifabutin (Mycobutin)
  • rifampin (Rifadin)
  • rifapentine (Priftin)

Typically, these medications should be avoided while you’re taking Tukysa. If you have an infection that would usually be treated with one of these drugs, your doctor will likely recommend a different drug to treat the infection.

Tukysa and certain seizure medications

Taking Tukysa with certain seizure medications can increase your liver’s breakdown of Tukysa. This can lower the level of Tukysa in your body, making the drug less effective for you.

Examples of seizure medications that could lower the level of Tukysa in your body include:

  • carbamazepine (Carbatrol, Equetro, Tegretol)
  • phenobarbital
  • phenytoin (Dilantin, Phenytek)
  • primidone (Mysoline)

Typically, you should avoid these medications while you’re taking Tukysa. If you take one of these seizure drugs, your doctor will likely recommend a different seizure medication for you while you’re taking Tukysa.

Tukysa and certain drugs that can increase Tukysa levels

Taking certain drugs with Tukysa can prevent your liver from breaking down Tukysa. This can increase the level of Tukysa in your body, which raises your risk of side effects from the drug.

Examples of drugs that could increase Tukysa levels in your body include:

Typically, you should avoid gemfibrozil while you’re taking Tukysa. If you do take gemfibrozil, your doctor will likely recommend switching to a different medication to lower your lipid levels. But if you must take gemfibrozil, your doctor will decrease your dose of Tukysa to 100 mg twice per day.

If you take any of the other drugs listed with Tukysa, your doctor will closely monitor you for side effects of Tukysa.

Tukysa and certain drugs whose levels may be increased

If taken together, Tukysa can slow your body’s breakdown of certain other drugs. This can lead to increased levels of the other drugs in your body. And it can also increase your risk of side effects from those other drugs.

Examples of drugs whose levels may be increased if they’re taken with Tukysa include:

If you take any of the drugs listed, talk with your doctor about whether it’s safe for you to take it with Tukysa. In some cases, your doctor may recommend taking a dosage of these drugs that’s lower than usual.

Tukysa and herbs and supplements

Tukysa is known to interact with an herb called St. John’s wort. But to be safe, talk with your doctor before taking any herbs or supplements with Tukysa. Your doctor can recommend whether it’s safe for you to do so.

Tukysa and St. John’s wort

Taking St. John’s wort (Hypericum perforatum) with Tukysa may lower the level of Tukysa in your body. This could make Tukysa less effective for you. Because of this interaction, you should not take St. John’s wort with Tukysa.

Tukysa and foods

There aren’t any foods that have been specifically reported to interact with Tukysa. If you have any questions about eating certain foods with Tukysa, talk with your doctor.

As with all medications, the cost of Tukysa can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Note that you’ll have to get Tukysa at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications such as Tukysa. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Before approving coverage for Tukysa, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide whether the drug will be covered.

If you’re not sure whether you’ll need to get prior authorization for Tukysa, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Tukysa, or if you need help understanding your insurance coverage, help is available.

Seattle Genetics, the manufacturer of Tukysa, offers a program called SeaGen Secure. Through this program, you can find out about insurance coverage of Tukysa. And you can also learn about cost savings options that are available.

For more information and to find out if you’re eligible for support, call 855-4SECURE (855-473-2873) or visit the program website.

Generic version

Tukysa isn’t available in a generic form. A generic drug is an exact copy of the active ingredient in a brand-name medication. Generics tend to cost less than brand-name drugs.

Other drugs are available that can treat your condition. Some drugs for these conditions may be a better fit for you than others. If you’re interested in finding an alternative to Tukysa, talk with your doctor. They can tell you about other medications that may work well for you.

Alternatives for advanced breast cancer

Examples of other drugs that may be used to treat advanced HER2-positive breast cancer include:

Alternatives for advanced colorectal cancer

Currently, there aren’t any alternatives to Tukysa approved for treating RAS wild-type, HER2-positive colorectal cancer. However, this may not be the case in the future. Ask your doctor whether any alternatives have become available for this type of cancer.

You may wonder how Tukysa compares with other medications that are prescribed for similar uses. Here we look at how Tukysa and Kadcyla are alike and different.

Ingredients

Tukysa contains the active ingredient tucatinib, which is a targeted therapy for certain types of HER2-positive cancer.

Targeted therapies work by blocking specific proteins that help cancer cells grow and multiply. HER2-positive cancer has abnormally high levels of a protein called HER2 that promotes cancer cell growth.

Kadcyla contains the active ingredient ado-trastuzumab emtansine, which is made with:

  • trastuzumab (Herceptin), another targeted therapy for HER2-positive breast cancer
  • emtansine, a chemotherapy drug

Uses

Tukysa is FDA approved to treat HER2-positive breast cancer that is:

  • locally advanced (has spread into nearby tissues) and unresectable (can’t be removed with surgery), or
  • metastatic (has spread to other parts of the body)

Tukysa is used for adults who have already taken one or more anti-HER2 treatments in the past for their cancer. For this use, Tukysa is taken in combination with two other breast cancer treatments: trastuzumab (Herceptin) and capecitabine (Xeloda).

Tukysa is also FDA approved to treat colorectal cancer that’s both RAS wild-type and HER2-positive. (RAS wild-type colorectal cancer lacks certain changes to RAS genes.) The cancer must also be either unresectable or metastatic.

For this use, Tukysa is prescribed for adults whose colorectal cancer progressed after treatment with certain chemotherapy drugs. In this case, Tukysa is taken in combination with trastuzumab.

Kadcyla is FDA approved to treat the following types of breast cancer:

  • HER2-positive metastatic breast cancer in people who previously received both trastuzumab and a taxane-containing drug (either separately or together).
  • HER2-positive early stage breast cancer that needs adjuvant treatment after both presurgery therapy (with trastuzumab and a taxane-containing drug) and surgery. With early stage breast cancer, the cancer hasn’t spread beyond the breast or the lymph nodes in the armpits.

Drug forms and administration

Tukysa comes as oral tablets that you take twice per day.

Kadcyla is administered by a healthcare professional through intravenous (IV) infusion (an injection into a vein given over a period of time) once every 21 days.

Side effects and risks

Tukysa and Kadcyla can cause some similar side effects but some different ones as well. This section gives examples of these side effects.

Mild side effects

The table that follows contains some of the more common mild side effects that can occur with Tukysa, with Kadcyla, or with both drugs (when taken individually).

Mild side effectsTukysaKadcyla
stomatitis✓
hand-foot syndrome✓
decreased appetite✓
anemia✓
rash✓
muscle, bone, or joint pain✓
constipation✓
diarrhea✓
nosebleeds✓
nausea and vomiting✓✓
fatigue✓✓
headache✓✓
abdominal pain✓✓

Serious side effects

These lists contain examples of serious side effects that can occur with Tukysa, with Kadcyla, or with both drugs (when taken individually).

Serious side effectsTukysaKadcyla
severe diarrhea✓
severe bleeding✓
thrombocytopenia✓
heart problems that cause a weak heartbeat✓
lung problems, such as pneumonitis✓
nerve damage that causes pain, numbness, or other sensations in your hands and feet✓
infusion reactions, which may cause flushing, shortness of breath, and low blood pressure✓
allergic reaction✓
liver damage✓✓

Kadcyla has boxed warnings for heart problems that cause a weak heartbeat and for liver damage. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous. Your doctor can tell you more about these boxed warnings.

Effectiveness

Tukysa and Kadcyla have different FDA-approved uses, but they’re both used to treat HER2-positive metastatic breast cancer.

These drugs haven’t been directly compared in clinical trials. But clinical trials have found both Tukysa and Kadcyla to be effective in treating this form of breast cancer.

Costs

The actual price you’ll pay for Tukysa or Kadcyla depends on your insurance plan and your location. It also depends on whether you receive the drug from a pharmacy or medical facility.

Tukysa and Kadcyla are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

You may wonder how Tukysa compares with other medications that are prescribed for similar uses. Here we look at how Tukysa and Perjeta are alike and different.

Ingredients

Tukysa contains the active ingredient tucatinib, which is a targeted therapy for certain types of HER2-positive cancer.

Targeted therapies work by blocking specific proteins that help cancer cells grow and multiply. HER2-positive cancer has abnormally high levels of a protein called HER2 that promotes cancer cell growth.

Perjeta contains the active ingredient pertuzumab. It’s also a targeted therapy for HER2-positive cancer, specifically breast cancer.

Uses

Tukysa is FDA approved to treat HER2-positive breast cancer that is:

  • locally advanced (has spread into nearby tissues) and unresectable (can’t be removed with surgery), or
  • metastatic (has spread to other parts of the body)

Tukysa is used for adults who have already taken one or more anti-HER2 treatments in the past for their cancer. For this use, Tukysa is taken in combination with two other breast cancer treatments, called trastuzumab (Herceptin) and capecitabine (Xeloda).

Tukysa is also FDA approved to treat colorectal cancer that’s both RAS wild-type and HER2-positive. (RAS wild-type colorectal cancer lacks certain changes to RAS genes.) The cancer must also be either unresectable or metastatic.

For this use, Tukysa is prescribed for adults whose colorectal cancer progressed after treatment with certain chemotherapy drugs. In this case, Tukysa is taken in combination with trastuzumab.

Perjeta is approved to treat the following types of breast cancer:

  • HER2-positive metastatic breast cancer in people who haven’t had anti-HER2 therapy or chemotherapy in the past for metastatic disease: Chemotherapy describes traditional drugs used to treat cancer. For this use, Perjeta is given with both trastuzumab and docetaxel (Taxotere).
  • HER2-positive breast cancer that’s inflammatory, early stage, or locally advanced: With early stage breast cancer, the cancer hasn’t spread beyond the breast or lymph nodes in the armpits. For this use, Perjeta is given as neoadjuvant therapy (presurgery treatment that’s used to shrink the tumor). And Perjeta is given with both trastuzumab and chemotherapy.
  • HER2-positive early stage breast cancer that has a high risk of recurrence: With recurrence, the cancer comes back after improving with treatment in the past. For this use, Perjeta is given as adjuvant treatment (therapy that is meant to prevent cancer from coming back). It’s given with both trastuzumab and chemotherapy.

Drug forms and administration

Tukysa comes as oral tablets that you take twice per day.

Perjeta is administered by a healthcare professional through intravenous (IV) infusion (an injection into a vein given over a period of time) once every 3 weeks.

Side effects and risks

Tukysa and Perjeta can cause very similar side effects, but some different ones as well. This section gives examples of these side effects.

Mild side effects

The table that follows contains some of the more common mild side effects that can occur with Tukysa, with Perjeta, or with both drugs (when taken individually).

Mild side effectsTukysaPerjeta
hand-foot syndrome✓
abdominal pain✓
hair loss✓
diarrhea✓
peripheral neuropathy✓
nausea and vomiting✓✓
fatigue✓✓
rash✓✓
headache✓✓
anemia✓✓
stomatitis✓✓
decreased appetite✓✓

Serious side effects

The table that follows contains examples of serious side effects that can occur with Tukysa or with Perjeta. There are few serious side effects common to both drugs (when taken individually).

Serious side effectsTukysaPerjeta
diarrhea✓
liver damage✓
heart problems that cause a weak heartbeat✓
infusion reaction, which may cause fever, headache, fatigue, or allergic reaction✓
allergic reaction✓
neutropenia✓

Perjeta has a boxed warning for heart problems that cause a weak heartbeat. This is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous. Your doctor can tell you more about this boxed warning.

Effectiveness

Tukysa and Perjeta have different approved uses, but they’re both used to treat HER2-positive metastatic breast cancer.

These drugs haven’t been directly compared in clinical trials. But clinical trials have found both Tukysa and Perjeta to be effective in treating this form of breast cancer.

Costs

The actual price you’ll pay for either Tukysa or Perjeta depends on your insurance plan and your location. It also depends on whether you receive the drug from a pharmacy or medical facility.

Tukysa and Perjeta are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

You should take Tukysa according to your doctor’s or healthcare professional’s instructions.

When to take

Tukysa should be taken twice per day, in the morning and evening. You should take your doses at the same time each day, about 12 hours apart.

To help make sure that you don’t miss a dose of Tukysa, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Tukysa with food

You can take Tukysa either with or without food.

Can Tukysa be crushed, split, or chewed?

You should not crush, split, or chew Tukysa. Tukysa should be swallowed whole. Be sure not to take tablets that are broken, cracked, or damaged in any way.

If you have difficulty swallowing Tukysa whole, talk with your doctor or pharmacist.

Here you’ll find out about Tukysa’s mechanism of action. (“Mechanism of action” means how a drug works.)

What happens in HER2-positive cancer

Tukysa is used to treat advanced forms of HER2-positive breast or colorectal cancer.

Cancer occurs when cells start to multiply uncontrollably. (Cells that multiply are making more cells.) With HER2-positive cancer, a protein called HER2 is involved in making this process happen.

HER2, which stands for human epidermal growth factor receptor 2, is a protein produced by the HER2 gene. HER2 proteins are receptors (attachment sites) that sit on the surface of certain cells. They turn on pathways inside the cells that help the cells grow, multiply, and repair themselves.

Sometimes the HER2 gene can become faulty and make extra copies of itself. The extra copies of the gene cause extra HER2 proteins to be made. These extra HER2 proteins cause cells to grow and multiply much faster than usual. This occurs more often with certain types of cancer, such as breast cancer.

When certain types of cancer are diagnosed, a sample of tissue is tested for HER2 status. If the tissue has higher than normal levels of either HER2 proteins or HER2 genes, the cancer is called HER2-positive. If the tissue doesn’t have higher than normal levels of these proteins or genes, it’s called HER2-negative.

What Tukysa does

Tukysa is a targeted therapy for certain types of HER2-positive cancer. Tukysa works by attaching to HER2 receptors and turning them off. This stops the HER2 receptors from turning on pathways that make cancer cells grow and multiply. As a result, the drug helps slow the growth and spread of HER2-positive cancer.

How long does it take to work?

Tukysa starts working on your cancer cells as soon as you’ve taken your first dose of the drug. However, you may not notice Tukysa working inside your body. This is because the drug doesn’t treat symptoms of breast or colorectal cancer. It helps to stop the cancer from getting worse.

Your doctor will order certain tests during your Tukysa treatment to check how well the drug is working for you. If you have questions about the tests you’ll need to have during treatment, talk with your doctor.

If taken during pregnancy, Tukysa could harm a developing fetus. Because of this, you should not take Tukysa if you’re pregnant or planning to become pregnant.

If you can become pregnant, you’ll need to have a pregnancy test to make sure you’re not pregnant before starting Tukysa. Be sure to tell your doctor right away if you think you could be pregnant while you’re taking Tukysa.

Tukysa and fertility

Animal studies suggest that Tukysa could reduce fertility in males and females. (Fertility means the ability to become pregnant or cause someone to become pregnant.)

Animal studies don’t always predict what will happen in humans. However, if you’d like to plan a pregnancy, talk with your doctor before starting Tukysa. Your doctor can discuss with you the risks and benefits of using this medication.

Note: Sex and gender exist on spectrums. Use of the terms “male” and “female” in this article refers to sex assigned at birth.

Tukysa can harm a fetus if it’s taken during pregnancy. For more information about taking Tukysa during pregnancy, see the “Tukysa and pregnancy” section.

If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Tukysa.

For females using Tukysa

Females who are sexually active and can become pregnant should use birth control while taking Tukysa. And they should continue to use birth control for at least 1 week after stopping Tukysa.

For males using Tukysa

Males who are sexually active with a partner who could become pregnant should use birth control while taking Tukysa. And they should continue using birth control for at least 1 week after stopping Tukysa.

It’s not known whether Tukysa passes into breast milk, or whether it can affect how your body makes breast milk.

However, it’s recommended that you do not breastfeed while you’re taking Tukysa. And you should continue to avoid breastfeeding for at least 1 week after you stop taking this drug.

If you’re currently breastfeeding, talk with your doctor about the safety of using Tukysa. They’ll help you decide whether you should either continue breastfeeding or start taking Tukysa.

Here are answers to some frequently asked questions about Tukysa.

Is Tukysa a chemotherapy drug?

No, Tukysa isn’t a chemotherapy drug. (Chemotherapy describes traditional drugs used to treat cancer.) Chemotherapy drugs kill all the cells in your body that are rapidly multiplying (making more cells). So chemotherapy can kill some healthy cells along with cancer cells.

Instead, Tukysa is a targeted therapy drug. These therapies act more precisely on cancer cells than chemotherapy drugs do. Targeted therapy drugs work by blocking specific proteins in cancer cells. These proteins make the cancer cells multiply more rapidly than healthy cells do.

Specifically, Tukysa blocks the action of a protein called HER2. HER2 stands for human epidermal growth factor receptor 2. This protein is present in large amounts in breast cancer and colorectal cancer that are HER2-positive. It’s responsible for the rapid growth and spread of these types of cancer.

But keep in mind that Tukysa is approved for use in combination with a chemotherapy drug called capecitabine (Xeloda) for breast cancer.

In addition, for both the cancers it treats, Tukysa is used with another targeted therapy called trastuzumab (Herceptin). Like Tukysa, trastuzumab also targets the HER2 protein. But it does so in a different way than Tukysa does.

These drugs work to attack cancer cells from several different angles to help treat advanced forms of HER2-positive cancer.

Will Tukysa cure my cancer?

No, there’s currently no known cure for cancer. However, taking Tukysa could help you live longer without your cancer getting worse or spreading further.

To learn more about Tukysa’s effectiveness, refer to the Tukysa prescribing information or talk with your doctor.

Can males with breast cancer take Tukysa?

Yes, Tukysa is approved for use in both males and females with certain forms of HER2-positive breast cancer. For information about this condition, see the “Tukysa uses” section.

Learn more about male breast cancer.

Note: Sex and gender exist on spectrums. Use of the terms “male” and “female” in this article refers to sex assigned at birth.

Will I need to have lab tests done while I’m using Tukysa?

Yes. You’ll need to have blood tests to monitor the health of your liver while you’re taking Tukysa. This monitoring is done because Tukysa can sometimes damage the liver. The blood tests you’ll have done are called liver function tests (LFTs). They measure the levels of certain substances that can be released into your blood if you have liver damage.

You’ll typically have LFTs done every 3 weeks while you’re taking Tukysa. Your doctor will also likely order LFTs if you have any symptoms of liver problems. (To learn more about possible symptoms of liver issues, see the “Tukysa side effects” section.)

Keep in mind that Tukysa is used with one or two other drugs, depending on the cancer being treated: capecitabine (Xeloda) and trastuzumab (Herceptin). So during Tukysa treatment, you’ll also have certain lab tests done to check for side effects of the other drug or drugs you’re taking.

Your doctor will also order various tests to check whether the prescribed treatment regimen is working for your cancer.

If you have questions about the lab tests you’ll need to have while you’re using Tukysa, talk with your doctor.

Is Tukysa safe for older adults to take?

Yes, in general, it’s safe for adults ages 65 years and older to take Tukysa. However, older adults may be more likely to have certain side effects from the drug.

In clinical trials, serious side effects that occurred more often in people ages 65 years and over included severe diarrhea, nausea, and vomiting.

There weren’t enough people ages 75 years and over in the study to determine whether side effects were more common in this age group.

If you have questions about the safety of using Tukysa given your age, talk with your doctor.

Can I use Tukysa if I have liver or kidney problems?

It depends on how severe the problems are. If you have mild or moderate issues with your liver or kidneys, it’s usually fine to take Tukysa.

However, if you have severe kidney problems, Tukysa isn’t recommended as a breast cancer treatment option. This is because Tukysa is used in combination with capecitabine to treat breast cancer. And capecitabine cannot be used by people with severe kidney problems.

The manufacturer of Tukysa has not provided recommendations for taking Tukysa to treat colorectal cancer in people with severe kidney problems.

It’s important to note that Tukysa is cleared from your body by your liver. So if you have severe liver problems, Tukysa can build up inside your body. This could raise your risk of side effects from Tukysa. And keep in mind that Tukysa itself can also cause severe liver damage.

While you’re taking Tukysa, you’ll have blood tests often to check the health of your liver. If you have severe liver problems, your doctor will prescribe you a dosage of Tukysa that’s lower than usual. If your liver function gets worse while you’re taking Tukysa, your doctor may lower your dosage of the drug. Or they may have you stop treatment with Tukysa, either temporarily or permanently.

Before taking Tukysa, talk with your doctor about your health history. Tukysa may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

  • liver problems
  • pregnancy
  • breastfeeding

Note: For more information about the potential negative effects of Tukysa, see the “Tukysa side effects” section.

You should not use more Tukysa than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Tukysa

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

How long a medication remains good can depend on many factors, including how and where you store the medication.

Tukysa tablets should be stored at a room temperature of 68°F to 77°F (20°C to 25°C).

Keep Tukysa tablets in their original container. You should not transfer them to another bottle. And be sure to securely replace the lid after taking a dose. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Tukysa tablets will keep for 3 months after you’ve opened a new bottle of tablets. To help remember when you opened a new bottle, write the date you did so on the bottle’s label.

If there are any tablets left in the bottle 3 months after you opened it, you should safely dispose of them. Your doctor or pharmacist can tell you how to do this.

Disclaimer: Medical News Today 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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