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Overview: Ziihera is an intravenous (IV) medicine used to treat certain types of cancer, such as gallbladder, bile duct, stomach, or esophageal cancer. It stops certain cells from growing. Common side effects include diarrhea, infusion reactoins, stomach upset, and tiredness. Tell your health care provider right away if you get new or worsening diarrhea, and follow all instructions about how to prevent and treat diarrhea. Get emergency help if you have trouble breathing or shortness of breath. 

Uses

What is Ziihera used for?

Ziihera (zanidatamab-hrii) is commonly used to treat the following conditions. 

Ziihera may also be used for other conditions as determined by your health care provider.

How does Ziihera work (mechanism of action)?

Your health care provider can test your cancer to see if it should respond to Ziihera. Ziihera is an antibody (protein) that is attracted to some cancer cells. It stops cancer from growing by attacking these cancer cells. 

How is Ziihera supplied (dosage forms)?

Brands and other names

  • Ziihera

Dosage forms and strengths

Ziihera is available in an injectable form that is given by a health care provider.

How should I store Ziihera?

Ziihera is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of Ziihera?

The most common side effects of Ziihera are listed below. These side effects may vary depending on the condition that is being treated. Tell your health care provider if you have any of these side effects that bother you.

  • Diarrhea (see below)
  • Infusion reactions (see below)
  • Stomach pain
  • Tiredness
  • Nausea or vomiting
  • Decreased appetite
  • Rash
  • Low potassium levels
  • Pain, burning, tingling, numbness, or weakness in your arms, hands, legs, or feet

There may be other side effects of Ziihera that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Ziihera?

While less common, the most serious side effects of Ziihera are described below, along with what to do if they happen.

Severe Allergic Reactions. Ziihera may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Diarrhea. Diarrhea is common with Ziihera, and it can sometimes be severe or even life-threatening. If your diarrhea is severe, your dose of Ziihera may need to be changed or you may need to stop using Ziihera. Follow all instructions from your health care provider about how to prevent or treat diarrhea, including drinking fluids or taking antidiarrheal medicine. Call your health care provider right away if you have any of the following symptoms.

  • New or worsening diarrhea
  • Diarrhea that does not go away
  • Diarrhea with weakness, dizziness, or fever

Infusion Reactions. Ziihera can cause reactions that can be serious when it is given to you. Your health care provider may give you certain medicines before getting Ziihera to reduce your risk of these reactions. Your infusion may need to be slowed or stopped if you have these reactions. Tell your health care provider right away if you have any of the following symptoms during or after your infusion.

  • Fever or chills
  • Redness of your face and neck
  • Trouble breathing or shortness of breath
  • Chest pain or discomfort
  • Rash
  • Dizziness or lightheadedness
  • Nausea or vomiting

Heart Problems. Ziihera may affect how well your heart is able to pump blood. It may also increase your risk of heart failure. Tell your health care provider right away if you have any of the following symptoms.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs
  • Unusually fast weight gain
  • Unusual tiredness
  • Dizziness or lightheadedness
  • Abnormal heartbeat
  • Loss of consciousness

Warnings & Precautions

Who should not use Ziihera?

Allergies to Ingredients. People who are allergic to any of the following should not use Ziihera.

  • Zanidatamab
  • Ziihera
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Ziihera.

What should I know about Ziihera before using it?

Ziera is usually given by a health care provider in a hospital or clinic. Your health care provider may have you use certain medicines before receiving Ziihera to reduce your risk of side effects. Your first few doses of Ziihera may be given to you very slowly (over 2 hours or more). If you tolerate it well, future doses may be able to be given to you over a shorter period of time (over an hour).

Keep all appointments, including lab appointments, while you are using Ziihera.

Ziihera stays in your body for a while (up to 4 months) after your last dose. Talk to your health care provider if you have any questions or concerns.   

People who are age 65 and older can be at greater risk of some side effects from Ziihera. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before using Ziihera?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Ziihera is right for you.

In particular, make sure that you discuss any of the following.

Heart Problems. Tell your health care provider if you have or had any heart problems, including heart failure.

Pregnancy. Ziihera may cause harm to a fetus. If you can become pregnant, you will likely need a negative pregnancy test before you can start using Ziihera. You should also use effective birth control while you are using Ziihera and for 4 months after your last dose. Tell your health care provider if you are pregnant, think you are pregnant, or plan to become pregnant.

Breastfeeding. It is not known if Ziihera passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use Ziihera while breastfeeding.

How can I get more information about Ziihera?

For more information about Ziihera, you can visit the manufacturer’s website at www.ziihera.com or call them at 800-520-5568.

Interactions

Does Ziihera interact with foods or drinks?

There are no known interactions between Ziihera and foods or drinks.

It is unknown if drinking alcohol will affect Ziihera, but heavy drinking can slow your immune response and make it harder for your body to fight cancer. Also, the risk of tiredness may be increased if you drink alcohol while using Ziihera.

Does Ziihera interact with other medicines (drug interactions)?

There are no known interactions between Ziihera and other medicines. Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Ziihera?

If you or someone else has used too much Ziihera, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Ziihera?

Ziihera is usually given by a health care provider in a hospital or clinic. Your health care provider will make sure you are receiving Ziihera as scheduled. Missing doses of Ziihera can cause it to not work as well. So it is important not to miss or skip doses, unless your health care provider tells you to.

If you miss an appointment to get your Ziihera dose, call to make another appointment as soon as possible.