siltuximab

Fever, chills, infection (may be severe)

You have a fever if your temperature taken in your mouth (oral temperature) is:

• 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.

While you are getting chemotherapy treatments:

• Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
• Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
• Do not eat or drink anything hot or cold right before taking your temperature.
• Wash your hands often.
• Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Diarrhea

May happen days to weeks after you get your treatment.

If you have diarrhea :

• Take anti-diarrhea medication if your health care team prescribed it.
• Avoid foods or drinks with artificial sweetener (e.g. chewing gum, “diet” drinks), coffee and alcohol.
• Eat many small meals and snacks instead of 2 or 3 large meals.
• Drink at least 6 to 8 cups of liquids each day. Talk to your health care team if you can’t drink 6-8 cups of liquids each day when you have diarrhea. You may need special liquids with salt and sugar, called Oral Rehydration Therapy.

​See the Diarrhea pamphlet for more information.

Mild swelling in arms and legs; puffiness

To help prevent swelling :

• Eat a low-salt diet.
• Avoid tight fitting clothing.
• If you have swelling in your legs, keep your feet up when sitting.

Rash; dry or itchy skin

Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away.

To prevent and treat dry skin,

• Use 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.

Tingling, numb fingers and toes

• May slowly get better after your treatment ends.
• Contact your health care team if you have trouble doing up buttons, writing, picking up small objects, have pain or trouble moving.

Nausea and vomiting (generally mild)

May occur in hours to days after your treatment. It is easier to prevent nausea than to treat it if it happens. 

If you have nausea or vomiting:

• Take anti-nausea medication(s) as prescribed to you by your doctor. 
• 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 (e.g. coffee, tea) and alcohol.
• Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.

Night sweats

• Avoid triggers such as spicy food, alcohol and caffeine (tea, coffee, and soft drinks),
• Exercise regularly. Ask your health care team what exercises are appropriate for you before you start any new exercise.
• Quitting smoking may also help.
• Keep cool; dress lightly or in layers that you can easily remove and drink plenty of liquids unless you have been told otherwise.

Pains or cramps in the belly

• If you have constipation or diarrhea it may be causing the pain in your belly.
• If the pain is severe, gets worse or doesn’t go away, talk to your health care team about other possible causes.

Rapid killing of cells when you start treatment

• If mild, this may cause gout and joint pains. In some more severe cases, it may cause fevers, kidney problems, confusion and be life-threatening.
• Your doctor may prescribe medication to prevent these effects.
• Drink plenty of liquids (6 to 8 cups per day, unless you have been told otherwise) and pee frequently.

Abnormal cholesterol or fat levels in the blood

Your doctor may check your cholesterol levels regularly with a blood test.

Salt imbalances

It may cause muscle twitching, severe weakness or cramping, confusion and irregular heartbeat.

High blood pressure

• Check your blood pressure regularly. Your doctor may prescribe medication to treat high blood pressure.
• If you have a severe headache, severe dizziness, or if you faint get emergency help right away as it may be a sign your blood pressure is too high or too low.

Unusual bleeding or bruising (may be severe)

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Constipation

To help treat constipation :

• If you have not had a bowel movement in 2 to 3 days you may need to take a laxative. Ask your health care team what to do.

See the Constipation Pamphlet for more information.

Abnormal kidney lab tests

• Signs of a kidney problem include swelling, passing very little or no pee, or new unusual weight gain. If you have these signs, call your health team or go to your closest emergency department.
• To prevent bladder or kidney problems, drink lots of water or other liquids. Your doctor may ask you to drink at least 6 to 8 cups (2 L) per day on treatment days, unless you have been told otherwise.
• Your doctor may check your kidney function regularly.

Headache, dizziness; mild joint or muscle pain

• Take your pain medication as prescribed by your doctor.
• You can take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
• Talk to your doctor or pharmacist first before taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin. These medication may increase bleeding risk.
• Rest often and try light exercise as it may help.

Abnormal liver lab tests

• You may have yellowish skin or eyes, unusually dark pee or pain on the right side of your belly. Talk to your health care team if this happens.
• Your doctor may monitor your liver regularly with a blood test.