Ziihera (zanidatamab-hrii)
Previously treated unresectable or metastatic HER2-positive (IHC 3+) biliary tract cancer in adults ยท Oncology (HER2-positive biliary tract cancer)
About Ziihera
Ziihera (zanidatamab-hrii) is a Bispecific HER2-directed antibody (IV infusion) manufactured by Jazz Pharmaceuticals (in collaboration with Zymeworks), used in the treatment of previously treated unresectable or metastatic HER2-positive (IHC 3+) biliary tract cancer in adults. It received FDA approval in 2024 under the Accelerated pathway.
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Note: Zanidatamab BTC.
Accessing Ziihera through Reserve Meds
We help patients in the Middle East, India, Africa, and other regions access Ziihera via established Named Patient Program (NPP) and personal-import pathways. Every order requires a prescription from a licensed physician in the destination country.
What we need from you
- A prescription from a licensed physician in your country of residence.
- A clinical justification from the prescribing physician (why Ziihera for this patient).
- Destination-country NPP or personal-import paperwork (we help prepare these).
- Patient consent for cross-border drug import under the applicable pathway.
Typical timeline
From request to delivery, most orders for Ziihera are completed in 2-6 weeks. Timing varies by destination country regulatory review speed and physician documentation turnaround.
Indication context
Previously treated unresectable or metastatic HER2-positive (IHC 3+) biliary tract cancer in adults. The condition falls within Oncology (Biliary). For patients with this condition in countries where Ziihera is not yet registered, NPP access is typically the primary legal pathway for obtaining treatment.
About the manufacturer
Ziihera is manufactured by Jazz Pharmaceuticals (in collaboration with Zymeworks). We source drug supply exclusively through DSCSA-compliant US specialty wholesalers, ensuring every unit is authentic, serialized, and chain-of-custody documented.
International regulatory status
- United States: FDA approved (2024).
- EMA (EU): Approved.
- MHRA (UK): Not approved.
- Other countries: Approval status varies. Reserve Meds coordinates access under each destination country's NPP pathway.
Start a request for Ziihera
If you or a family member needs Ziihera and it is not available in your country, submit a request. Our clinical team will review eligibility and reach out as our first cohort opens.
Ziihera, country access pages
Information on how patients in different countries access Ziihera through Named Patient Program pathways.
- Ziihera in United Arab Emirates, The UAE recognises a formal Named Patient / compassionate-use pathway via MOHAP and the Department of Health Abu Dhabi (DoH). Physicians apply on behalf of individual patients for drugs not registered in-country.
- Ziihera in Saudi Arabia, The Saudi Food and Drug Authority (SFDA) operates a Personal Import / Unregistered Medicine pathway for named patients, typically requiring physician justification and hospital ethics-committee review.
- Ziihera in India, India's CDSCO permits import of unapproved drugs under Rule 36 for personal use by patients with a prescription from a registered medical practitioner. Named Patient import is common for rare-disease indications.
- Ziihera in Kuwait, Kuwait's Ministry of Health operates a Personal Import pathway for specialty drugs not registered locally, typically through a hospital pharmacy with physician attestation.
- Ziihera in Qatar, Qatar's MoPH permits unregistered drug import under a named-patient pathway with physician and MoPH approval; Hamad Medical Corp frequently sponsors.
- Ziihera in Bahrain, Bahrain's NHRA accepts named-patient import requests for rare-disease and specialty drugs not registered locally.
Safety, interactions, and handling
Drug interactions: Before dispatch, our clinical team reviews every patient's full medication list against published FDA drug-interaction data. If a significant interaction is identified, we notify the prescribing physician and hold shipment until an alternative dose or timing is confirmed.
Contraindications: This medication is not appropriate for every patient. Refer to the US FDA label for full contraindication list. Patients with active infection, pregnancy, known hypersensitivity, or specific organ-system comorbidities may be excluded. Prescribing-physician judgement applies.
Cold chain and storage: Biologics, monoclonals, and cell/gene therapies require validated cold-chain shipping (2-8°C) with continuous temperature monitoring. On arrival we document temperature logs; out-of-spec shipments are flagged and replaced.
Adverse event reporting: Any adverse event should be reported to both the local national regulator and to Reserve Meds's pharmacovigilance team at [email protected]. We forward serious events to the US manufacturer within 15 days per ICH E2D guidance.
Last medically reviewed: 2026-04-22 (see Trust & Compliance).
Access by country
Reserve Meds publishes a detailed country deep-dive for Ziihera in every market we coordinate. Each page below covers the destination-country regulatory pathway (named-patient framework), real costs in local currency and USD, indicative timelines, physician-credential requirements, and cold-chain handling for the route into that country. Tap any country to read the full deep-dive.
Frequently asked questions
How can I get Ziihera if it is not approved or available in my country?
Reserve Meds coordinates US-sourced Ziihera for patients through a physician-led, named-patient cross-border pathway. Your treating physician provides the prescription and clinical justification; Reserve Meds prepares the named-patient documentation for your country and arranges DSCSA-compliant US sourcing and delivery to your physician or hospital pharmacy.
Can I access Ziihera through named-patient or compassionate-use import?
Yes. Named-patient access (also called compassionate use or personal import) is the core route Reserve Meds operates for Ziihera. Eligibility and paperwork depend on the regulator in your country, and Reserve Meds maps the specific pathway for each market it coordinates.
Do I need a prescription to access Ziihera through Reserve Meds?
Yes. Reserve Meds is not a pharmacy and does not prescribe. A valid prescription and clinical justification from your treating physician are required, and all clinical decisions remain with your physician.
How does Reserve Meds deliver Ziihera to a patient?
Reserve Meds sources Ziihera from a DSCSA-compliant US specialty supplier with full traceability and coordinates delivery to your treating physician or hospital pharmacy, with appropriate handling for the product.
How long does it take, and what does Ziihera cost through Reserve Meds?
After a short intake, the clinical team responds within one business day with case-specific feasibility, an indicative timeline, and a formal written quote. Cost depends on the destination, the prescribed regimen, and the duration of therapy, and is confirmed in writing before anything proceeds.
How do I start a request for Ziihera?
Submit a 60-second intake through the Reserve Meds patient portal, or message the concierge team on WhatsApp. A named coordinator follows up within 24 hours.