Key takeaways

  • Trodelvy (sacituzumab govitecan-hziy) is a prescription drug used to treat certain types of breast cancer. Common side effects of Trodelvy include nausea, diarrhea, fatigue, and hair loss.
  • Some serious side effects of Trodelvy include blood clots, severe vomiting, severe infections, and infusion-related reactions.
  • Trodelvy has boxed warnings for severe diarrhea and neutropenia. (Boxed warnings are the most serious warnings from the FDA.) Because of these risks, your doctor will likely monitor you closely during your Trodelvy treatment.

Trodelvy is prescribed to treat breast cancer that is either triple-negative or HR-positive and HER2-negative. For doctors to prescribe this drug, the cancer must be locally advanced or metastatic. This means it has spread near the place where it started or to areas farther away.

Keep reading to learn about the common, mild, and serious side effects Trodelvy can cause. To learn more about Trodelvy, including its uses, dosage, and price, read this Trodelvy overview.

Trodelvy has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Side effects explained” section.

Some people may experience mild or serious side effects during Trodelvy treatment. Examples of Trodelvy’s commonly reported side effects include:

For more information about some of these side effects, see “Side effect specifics.”

Treatment with Trodelvy can cause mild side effects. Examples of mild side effects that have been reported with Trodelvy include:

  • abdominal pain
  • constipation
  • cough
  • decreased appetite
  • diarrhea
  • dizziness
  • feeling weak or tired
  • headache
  • joint pain
  • mouth sores
  • nausea and vomiting
  • skin rash
  • insomnia (trouble sleeping)
  • hair loss (see “Side effect specifics” for more information)

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 in this section. See the Trodelvy prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect during treatment with Trodelvy and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Serious side effects are possible with Trodelvy treatment. Serious side effects that have been reported with Trodelvy include:

For more information about some of these side effects, see “Side effect specifics.”

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.

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 boxed warning about the risk of severe diarrhea. Boxed warnings are the most serious warnings from the FDA. They alert doctors and patients about drug effects that may be dangerous.

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 have diarrhea during Trodelvy treatment, contact your doctor. Due to the risk of severe diarrhea, they’ll likely check to determine whether 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, such as Imodium A-D (loperamide). 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 boxed warning about the risk of severe or life threatening neutropenia.

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:

  • chills or fever
  • cough
  • nausea, vomiting, or diarrhea
  • shortness of breath

In rare cases, 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 1 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. Due to this risk, your doctor will check your neutrophil count regularly throughout your Trodelvy treatment.

If your count is low and you develop a fever, they may pause your Trodelvy treatment or lower your Trodelvy dosage. They may also prescribe a medication such as pegfilgrastim (Neulasta). This medication can help increase neutrophils if you have a higher risk of neutropenia.

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. Depending on how severe the neutropenia is, 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 a Trodelvy infusion.

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
  • 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 in the “Allergic reaction” section.

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:

  • Tylenol (acetaminophen) to help prevent fever
  • a histamine blocker such as Benadryl (diphenhydramine) or Pepcid (famotidine)
  • corticosteroids such as dexamethasone

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

For some people, Trodelvy can cause an allergic reaction. Serious allergic reactions weren’t common in the drug’s studies.

In general, symptoms of an allergic reaction can be mild or serious.

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 a treatment to manage your symptoms and can determine whether you should keep receiving Trodelvy.

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’ve had a serious allergic reaction to Trodelvy, they may have you switch to a different treatment.

There are certain precautions to consider before beginning treatment with Trodelvy. This includes two boxed warnings.

Boxed warnings

Trodelvy has boxed warnings about the risk of:

  • severe diarrhea
  • severe or life threatening neutropenia (low level of white blood cells)

To learn more, see the “Side effects explained” section.

Other precautions

Before starting Trodelvy treatment, discuss your health history with your doctor. Trodelvy 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:

  • reduced activity of the UGT1A1 gene
  • liver problems
  • previous allergic reaction to this or a similar drug
  • pregnancy
  • breastfeeding
  • alcohol consumption

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.