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Chemotherapy and other systemic treatment regimens may change due to COVID-19. Find out more at Systemic Treatment Regimens During COVID-19.

pembrolizumab

( PEM broe LIZ ue mab )
Funding:
New Drug Funding Program
  • Pembrolizumab - Advanced Melanoma (Unresectable or Metastatic Melanoma) and Prior Ipilimumab
  • Pembrolizumab - Advanced Melanoma (Unresectable or Metastatic Melanoma) and No Prior Ipilimumab
  • Pembrolizumab - Advanced or Metastatic Non-Small Cell Lung Cancer (Second or Subsequent Line)
  • Pembrolizumab - Previously Untreated Locally Advanced or Metastatic Non-Small Cell Lung Cancer
  • Pembrolizumab – Previously Treated Locally Advanced or Metastatic Urothelial Carcinoma
  • Pembrolizumab - In Combination with Platinum and Pemetrexed for First Line Metastatic Non-Squamous Non-Small Cell Lung Cancer (NSCLC)
  • Pembrolizumab - In Combination with Carboplatin and Paclitaxel for First-Line Metastatic Squamous Non-Small Cell Lung Cancer (NSCLC)
  • Pembrolizumab - Relapsed Classical Hodgkin Lymphoma (cHL) Post-Autologous Stem Cell Transplant (ASCT) or ASCT Ineligible
  • Pembrolizumab - Adjuvant Treatment for Completely Resected Stage III or IV Melanoma
Other Name(s): Keytruda®
Appearance: solution mixed into larger bags of fluids

Medication Information Sheet
pembrolizumab (PEM broe LIZ ue mab)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Keytruda

 

Appearance:
solution

mixed into larger bags of fluids

 

What is this medication for?
  • For treating certain types of cancers such as skin cancer (called melanoma), lung cancer (called non-small cell) or bladder and urinary tract cancer that has spread or cannot be removed by surgery. It is also used to treat certain patients with Hodgkin lymphoma and a certain type of B-cell lymphoma.
  • Pembrolizumab is an immune therapy drug. For more information on immune therapy, click here.
What should I do before I have this medication?
  • Tell your health care team if you have or had any major medical conditions (such as diabetes) and especially if you have, had or will have:
    • an organ or stem cell transplant

    • immune conditions (such as thyroid problems, ulcerative colitis or Crohn's, rheumatoid arthritis or lupus)

    • liver, kidney or lung problems

    • active infections or

    • any allergies
       

Remember to:

  • Tell your health care team about all of the other medications you are taking especially if you are taking corticosteroids (such as prednisone).
  • Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding.
     
  • If there is ANY chance that you or your partner may become pregnant, you and your partner together must:
    • Use 2 effective forms of birth control at the same time while receiving this drug: Keep using birth control until at least 4 months after the last dose. Discuss with your healthcare team.
       
  • Do not breastfeed while using this drug.
     
  • This medication is unlikely to affect fertility (ability to get pregnant).
How is this medication given?
  • This drug is given by injection into a vein. Most people get pembrolizumab every 3 weeks. Talk to your health care team about your treatment schedule.

  • If you miss your treatment appointment, talk to your health care team to find out what to do.

What else do I need to know while on this medication?
  • This medication does not normally interfere with other medications.  Tell your health care team about all of your medications (prescription or over-the-counter medications, herbals and supplements). Check with your health care team before starting or stopping any of them.
     
  • For mild aches and pain or fever:
    • If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever. 
       
    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
       
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding. Talk to your health care team before you start or stop these medications.
       
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
       
  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.
What are the side effects of this medication?

The following table lists side effects that you may have when getting pembrolizumab . 

  • Pembrolizumab makes your immune system work harder. Your immune system is what fights infections and your cancer.

  • When your immune system is working harder, you may have side effects in your bowels, liver, lungs, skin, kidneys, hormones and other organs.

  • These side effects may be mild or may become serious or life-threatening in rare cases.

  • They may happen during your treatment or weeks to months after your treatment ends.

  • You may need urgent treatment (such as a corticosteroid for up to 4 weeks) to treat these side effects.

The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.

Read over the side effect table so that you know what to look for and when to get help. Keep this paper during your treatment so that you can refer to it if you need to.

Side effects and what to do

When to contact health care team

Common Side Effects (10-24 out of 100 people)

Fatigue (tiredness)

What to look for?

  • Feeling of tiredness or low energy that lasts a long time and does not go away with rest or sleep.


What to do?

  • Be active. Aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days.

  • Check with your health care team before starting any new exercise.

  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.

  • Ask family or friends to help you with things like housework, shopping, and child or pet care.

  • Eat well and drink at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).

  • Avoid driving or using machinery if you are feeling tired.

Ask your health care team for the Fatigue pamphlet for more information. 

Talk to your health care team if no improvement or if fatigue is severe.

Low Appetite, weight loss

What to look for?

  • Loss of interest in food or not feeling hungry

  • Weight loss
     

What to do?

  • Try to eat your favourite foods.

  • Eat small meals throughout the day.

  • You may need to take meal supplements to help keep your weight up.

  • Talk to your health care team if you have no appetite.

Ask your health care team for the Loss of appetite pamphlet for more information.

Talk to your health care team if no improvement or if severe.

Rash, itchiness, dry skin

You may experience itching with a mild rash. 


To prevent rash and treat dry skin:

  • Use a fragrance-free (unscented) skin moisturizer.

  • Protect your skin from the sun and the cold.

  • Use sunscreen with UVA and UVB protection and a SPF of at least 30.


In rare cases, rash may be severe

  • If the rash covers more than a third of your skin (for example your whole trunk or an arm AND a leg) or your skin blisters

Talk to your health care team for advice.

 

 

 

 

 

Talk to your health care team or go to the emergency room right away. 

Nausea and vomiting 
 

What to look for?

  • Nausea is feeling like you need to throw up, you may also feel light-headed.

  • You may feel nausea within hours to days after your treatment.
     

What to do?

To help prevent nausea:

  • It is easier to prevent nausea than to treat it once it happens.

  • Take your preventative anti-nausea medication(s) as prescribed, even if you do not feel like throwing up.

  • Drink clear liquids and have small meals. Get fresh air and rest.

  • Do not eat spicy, fried foods or foods with a strong smell.

  • Limit caffeine (like coffee, tea) and avoid alcohol.

 

If you have nausea or vomiting:

  • Take your rescue (as-needed) anti-nausea medication(s) as prescribed.

  • Ask your health care team for the Nausea & Vomiting pamphlet for more information.

     

Talk to your health care team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if severe.

Ask your health care team for the Nausea & Vomiting pamphlet for more information.

Talk to your health care team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if severe.

 

Other rare, but serious side effects are possible.

If you experience ANY of the following, talk to your cancer health care provider or get emergency medical help right away:

  • Blood in your stools or 4 to 6 bowel movements a day (if that is not normal for you). Rarely, diarrhea may be due to severe inflammation of your intestines

  • Yellow skin, eyes or dark, red-brown coloured urine

  • Muscle weakness, pain or difficulty moving your arms, legs or upper body

  • Trouble with eye or facial movements, including speaking, chewing or swallowing

  • Feeling numbness or pins and needles in your arms, fingers, legs or toes

  • Severe headache, confusion

  • Trouble sleeping, feeling irritable or overactive

  • Unexpected changes in your weight

  • Unusual darkening of skin

  • Headache or dizziness (when sitting or standing up)

  • Lower than normal blood pressure (if you measure this at home)

  • Trouble breathing, shortness of breath or coughing up blood

  • Pain in your chest or belly

  • Problems with your vision, eye pain and redness

  • Unable to pee or swelling of your body or legs

  • Peeing more than normal and feeling very thirsty

  • Fainting, irregular or rapid heartbeat

  • Feel more tired and weaker than normal, have pale skin

  • Unusual bleeding or bruising (such as bleeding from your gums, unusual or heavy nosebleeds, or red or pink coloured pee).  If you have bleeding that doesn’t stop, you must get emergency help.

  • Signs of an allergy such as severe rash, swollen lips, face or tongue, chest and throat tightness, during or shortly after the drug is given

  • Fever (oral temperature of 38.3°C (100.9°F) or higher at any time OR 38.0°C (or 100.4°F) or higher for at least one hour)

  • Rare immune problems after a stem cell transplant (if this applies to you). Your doctor may discuss these with you.
     

Who do I contact if I have questions or need help?           

My cancer health care provider is: ________________________________________________

During the day I should contact:__________________________________________________

Evenings, weekends and holidays:________________________________________________

 

Other Notes:

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For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.