Pembrolizumab (Generic Name)
Other Names: Keytruda®
About This Drug
Pembrolizumab is used to treat cancer. It is given in the vein (IV).
Possible Side Effects
- Decreased appetite (decreased hunger)
- Loose bowel movements (diarrhea)
- Constipation (not able to move bowels)
- Trouble breathing
- Muscle and bone pain
Note: Each of the side effects above was reported in 20% or greater of patients treated with pembrolizumab. Not all possible side effects are included above.
Warnings and Precautions
- This drug works with your immune system and can cause inflammation in any of your organs and tissues and can change how they work. This may put you at risk for developing serious medical problems which can very rarely be fatal.
- Colitis (swelling (inflammation) in the colon) - symptoms are loose bowel movements (diarrhea), stomach cramping, and sometimes blood in the bowel movements.
- Changes in liver function. Your liver function will be checked as needed.
- Changes in kidney function which can very rarely be fatal. Your kidney function will be checked as needed.
- Inflammation (swelling) of the lungs which can very rarely be fatal - you may have a dry cough or trouble breathing.
- This drug may affect some of your hormone glands (especially the thyroid, adrenals, pituitary and pancreas). Your hormone levels will be checked as needed.
- Blood sugar levels may change and you may develop diabetes. If you already have diabetes, changes may need to be made to your diabetes medication.
- Severe allergic skin reaction which can very rarely be fatal. You may develop blisters on your skin that are filled with fluid or a severe red rash all over your body that may be painful.
- Increased risk of organ rejection in patients who have received donor organs.
- Increased risk of complications in patients who will undergo a stem cell transplant after receiving pembrolizumab.
- While you are getting this drug in your vein (IV), you may have a reaction to the drug. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. These reactions may occur after your infusion. If this happens, call 911 for emergency care.
- This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
Treating Side Effects
- Ask your doctor or nurse about medicines that are available to help stop or lessen constipation, diarrhea and/or nausea.
- Drink plenty of fluids (a minimum of eight glasses per day is recommended).
- If you are not able to move your bowels, check with your doctor or nurse before you use any enemas, laxatives, or suppositories.
- To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
- If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping. Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
- Manage tiredness by pacing your activities for the day. Be sure to include periods of rest between energy-draining activities.
- Keeping your pain under control is important to your wellbeing. Please tell your doctor or nurse if you are experiencing pain.
- If you have diabetes, keep good control of your blood sugar level. Tell your nurse or your doctor if your glucose levels are higher or lower than normal.
- If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
- Infusion reactions may happen for 24 hours after your infusion. If this happens, call 911 for emergency care.
Food and Drug Interactions
- There are no known interactions of pembrolizumab with food.
- There are no known interactions of pembrolizumab with other medications.
- Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative agents are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative agents without your cancer doctor's help.
When to Call the Doctor
Call your doctor or nurse if you have any of the following symptoms and/or any new or
- Fever of 100.5 F (38 C) or higher
- Wheezing or trouble breathing
- Rash or itching
- Feeling dizzy or lightheaded
- Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or lightheadedness
- Nausea that stops you from eating or drinking, and/or that is not relieved by prescribed medicines
- Lasting loss of appetite or rapid weight loss of five pounds in a week
- Fatigue that interferes with your daily activities
- No bowel movement for 3 days or you feel uncomfortable
- Extreme weakness that interferes with normal activities
- Bad abdominal pain, especially in upper right area
- Decreased urine
- Unusual thirst or passing urine often
- Rash that is not relieved by prescribed medicines
- Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)
- Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
- Signs of infusion reactions such as fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain.
- If you think you are pregnant
- Pregnancy warning: This drug may have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 4 months after treatment. Let your doctor know right away if you think you may be pregnant.
- Breastfeeding warning: It is not known if this drug passes into breast milk. It is recommended that women do not breastfeed during treatment and for 4 months after treatment.
- Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children.
Revised June 2017