What is the most important information I should know about pembrolizumab?
Pembrolizumab can cause side effects in many different parts of your body. Some side effects may need to be treated with other medicine, and your cancer treatments may be delayed. You will need frequent medical tests to help your doctor determine if it is safe for you to keep receiving pembrolizumab.
Call your doctor at once if you have: chest pain, cough, shortness of breath, severe muscle pain or weakness, diarrhea and severe stomach pain, blood in your stools, bruising or bleeding, dark urine, yellowing of the skin or eyes, a hormonal disorder (frequent headaches, feeling light-headed, rapid heartbeats, a deeper voice, increased thirst or urination, feeling cold, weight gain or loss), or a change in the amount or color of your urine.
What is pembrolizumab?
Pembrolizumab is a cancer medicine that is used alone or in combination with other medicines to treat certain types of cancer such as:
- skin cancer (melanoma or Merkel cell carcinoma);
- lung cancer;
- head and neck cancer;
- classical Hodgkin lymphoma;
- primary mediastinal large B-cell lymphoma;
- cancer of the kidney, bladder, and urinary tract;
- liver cancer;
- cancer of the cervix or uterus;
- advanced stomach or esophageal cancer; or
- a type of cancer that laboratory testing proves to have certain specific DNA mutations, including colorectal cancer.
Pembrolizumab is often given when the cancer has spread to other parts of the body or cannot be surgically removed, or when other cancer treatments did not work or have stopped working.
For some types of cancer, pembrolizumab is given only if your tumor tests positive for "PD-L1", or if the tumor has a specific genetic marker (an abnormal "EGFR," "ALK," or "HER2/neu" gene).
Pembrolizumab may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before receiving pembrolizumab?
Tell your doctor if you have ever had:
- lung disease or a breathing disorder;
- liver disease;
- diabetes, or a thyroid disorder;
- an autoimmune disorder such as lupus, Crohn's disease, or ulcerative colitis; or
- an organ transplant or stem cell transplant.
You may need to have a negative pregnancy test before starting this treatment. Do not use pembrolizumab if you are pregnant. It could harm the unborn baby. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 4 months after your last dose. Tell your doctor right away if you become pregnant.
Do not breast-feed while using pembrolizumab, and for at least 4 months after your last dose.
How is pembrolizumab given?
Your doctor will perform a blood test to make sure pembrolizumab is the right treatment for your condition.
Pembrolizumab is given as an infusion into a vein, usually once every 3 weeks. A healthcare provider will give you this injection.
This medicine must be given slowly, and the infusion can take at least 30 minutes to complete.
You will need frequent medical tests to help your doctor determine if it is safe for you to keep receiving pembrolizumab. Do not miss any follow-up visits.
What happens if I miss a dose?
Call your doctor for instructions if you miss an appointment for your pembrolizumab injection.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while receiving pembrolizumab?
This medicine can pass into body fluids (urine, feces, vomit). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.
What are the possible side effects of pembrolizumab?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Some side effects may occur during the injection. Tell your caregiver if you feel dizzy, light-headed, itchy, hot, sweaty, chilled, or have trouble breathing.
Pembrolizumab affects your immune system, and can cause side effects in many different parts of your body. Some side effects may need to be treated with other medicine. Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.
Call your doctor at once if you have:
- new or worsening cough, chest pain, shortness of breath;
- pale skin, easy bruising or bleeding;
- numbness, tingling, burning pain, redness, rash, or blisters on your hands or feet;
- severe muscle weakness, severe or ongoing muscle aches, joint pain;
- diarrhea or increased stools, severe stomach pain, bloody or tarry stools;
- a change in the amount or color of your urine;
-
liver problems --loss of appetite, right-sided stomach pain, easy bruising or bleeding, dark urine, jaundice (yellowing of the skin or eyes);
-
low levels of sodium in the body --confusion, slurred speech, severe weakness, loss of coordination, feeling unsteady; or
-
signs of a hormonal disorder --frequent or unusual headaches, feeling light-headed, rapid heartbeats, hoarse or deepened voice, increased hunger or thirst, increased urination, constipation, hair loss, muscle pain, sweating, feeling cold, weight changes.
Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.
Common side effects (some are more likely with combination chemotherapy) may include:
- nausea, vomiting, stomach pain, loss of appetite, diarrhea, constipation;
- low sodium levels, abnormal liver or thyroid function tests;
- fever, feeling weak or tired;
- cough, hoarse voice, feeling short of breath;
- itching, rash, hair loss;
- increased blood pressure;
- pain in your muscles, bones, or joints; or
- soreness in or around your mouth, nose, eyes, throat, or vagina.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect pembrolizumab?
Other drugs may affect pembrolizumab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.
Where can I get more information?
Your pharmacist can provide more information about pembrolizumab.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
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