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Overview: Ziihera is an intravenous (IV) medicine used to treat certain types of gallbladder or bile duct cancer. It stops certain cells from growing. Common side effects include diarrhea and tiredness. Tell your healthcare provider right away if you get severe diarrhea. Get emergency help if you have trouble breathing. 

Uses

What is Ziihera used for?

Ziihera (zanidatamab-hrii) is commonly used to treat certain types of gallbladder or bile duct cancer (cholangiocarcinoma).

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

How does Ziihera work (mechanism of action)?

Your healthcare 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 healthcare provider.

How should I store Ziihera?

Ziihera is usually given by a healthcare 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. Tell your healthcare provider if you have any of these side effects that bother you.

  • Diarrhea (see below)
  • Stomach pain
  • Tiredness
  • Infusion reactions (see below)

There may be other side effects of Ziihera that are not listed here. Contact your healthcare 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. 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, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Diarrhea. Diarrhea is common with Ziihera, but it can sometimes be severe. Your dose of Ziihera may need to be changed or you may need to stop using Ziihera if if your diarrhea is severe. If you are given medicine to prevent or treat diarrhea, take it exactly as your healthcare provider tells you. Call your healthcare provider right away if medicine to prevent or treat diarrhea is not helping, or if you have any of the following.

  • Severe 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. You may use other medicines before getting Ziihera to reduce your risk of this reaction. Your infusion may need to be slowed or stopped if you have these reactions. Tell your healthcare 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
  • Chest pain
  • Rash
  • Dizziness or lightheadedness
  • Nausea or vomiting

Lung Inflammation. Ziihera can cause inflammation in your lungs, also called interstitial lung disease or pneumonitis. This can be serious or even life-threatening. Get emergency help if you have trouble breathing. You may also have a cough, fever, or chest pain.

Heart Failure. Ziihera may increase your risk of heart failure. Tell your healthcare provider right away if you have any of the following symptoms of heart failure.

  • 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.

  • Ziihera
  • Zanidatamab
  • 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 healthcare provider in a hospital or clinic. You may get other medicines before your dose of Ziihera to reduce your risk of side effects, especially an infusion reaction. Your first few doses of Ziihera may be given to you very slowly (over two 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 four months) after your last dose. Talk to your healthcare provider if you have any questions or concerns.   

What should I tell my healthcare provider before using Ziihera?

Tell your healthcare 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 determine if Ziihera is right for you.

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

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

Pregnancy. Ziihera may cause harm to an unborn baby. You may need a negative pregnancy test before you can start using Ziihera. You should use effective birth control while you are using Ziihera and for four months after your last dose. Tell your healthcare provider if you are, think you are, or plan to become pregnant.

Breastfeeding. It is not known if Ziihera passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you 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 healthcare 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 healthcare provider in a hospital. Your healthcare 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 healthcare provider tells you to.

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