Pembrolizumab
About Pembrolizumab
Pembrolizumab is an advanced immunotherapy injection used to treat several types of serious or advanced cancers, including skin cancer, lung cancer, and bladder cancer. It works by helping your body's own immune system recognise and destroy cancer cells. This treatment is prescribed when other standard therapies have not worked or as a primary option to manage cancer growth.
Because this medication is given as an intravenous infusion, it is scheduled at regular intervals, typically every 3 or 6 weeks. You do not need to make any changes to your diet on the day of your infusion, and it can be received with or without food. Staying well-hydrated and consuming small, balanced meals before your appointment can help you feel more comfortable during the process.
Common side effects of this treatment include severe tiredness, mild skin rashes, itching, and nausea. Because this medicine stimulates your immune system, it can occasionally cause your body to attack normal tissues, leading to serious liver damage, lung inflammation, or severe bowel irritation. You must contact your medical team immediately if you develop a new cough, shortness of breath, severe stomach pain, or yellowing of your skin or eyes.
Before starting this treatment, discuss your medical history thoroughly with your oncologist. Do not take this if you have had a life-threatening allergic reaction to this medication in the past. It is especially important to tell your doctor if you have an active autoimmune disease, a history of lung inflammation, or have received an organ or stem cell transplant.
This medicine can interact with other treatments, particularly high-dose corticosteroids, which may lower its effectiveness by suppressing the immune system. If you are pregnant, planning to become pregnant, or breastfeeding, you must consult your doctor immediately, as this treatment can cause serious harm to an unborn baby.
Uses of Pembrolizumab
Medicinal Benefits
When taken consistently as directed, this medicine may provide the following health benefits:
- Supports targeted cancer treatment: This medicine helps your immune system recognise and attack cancer cells more effectively. By targeting cancer cells rather than directly damaging healthy cells like traditional chemotherapy, it may help control tumour growth while reducing damage to normal tissues.
- Helps improve quality of life: By slowing tumour growth or reducing the spread of cancer, this treatment may help relieve symptoms such as pain, breathing difficulties, or persistent cough. This can improve comfort, daily functioning, and overall well-being during treatment.
Directions for Use
- It is advised to follow your doctor's instructions on the dosage and timing of Pembrolizumab for effective use.
- Pembrolizumab will be administered by the doctor or nurse.
- Do not self-administer.
Storage
Side Effects of Pembrolizumab
Common Side Effects (Usually mild):
- Feeling unusually tired or weak
- Mild skin rash, dry skin, or itching
- Nausea, loss of appetite, or mild diarrhoea
- Muscle, joint, or bone pain
- Mild cough or slight shortness of breath during exertion
Serious Side Effects (Consult your doctor right away):
- New or worsening cough, chest pain, or shortness of breath (signs of lung inflammation)
- Severe stomach pain, blood in your stool, or severe diarrhoea (signs of severe bowel problems)
- Yellowing of the skin or eyes, dark urine, or severe nausea and vomiting (signs of liver damage)
- Extreme fatigue, rapid weight changes, unexplained sweating, or mood changes (possible hormone gland problems)
- Changes in urine output, blood in the urine, or swelling in your ankles (signs of kidney problems)
- Fever, chills, dizziness, wheezing, or hives during the infusion (signs of a severe infusion reaction)
Medicines Containing this Salt
View AllDrug Warnings
- Verify the solution clarity: Ensure the medical staff inspects the vial before preparation; the liquid should be clear to slightly pearly, colourless to pale yellow, and free of visible particles.
- Report symptoms immediately: Do not wait for your next scheduled appointment to report new symptoms. Early treatment of immune-mediated side effects with steroids is vital.
- Carry an immunotherapy alert card: Always keep a medical alert card in your wallet stating that you are receiving it so that emergency medical staff are aware of your treatment.
- Avoid live vaccines: Do not receive any live vaccines (such as yellow fever or oral typhoid vaccines) while using this medicine, as they can cause serious complications.
- Check your blood sugar: If you have diabetes, monitor your blood sugar levels more frequently, as this medicine can affect your endocrine system and cause sudden glucose changes.
Drug Interactions
- Systemic corticosteroids (like prednisone or dexamethasone): Taking these immune-suppressing drugs before starting it can make your cancer treatment less effective. However, they may be prescribed after you start treatment to manage immune-related side effects.
- Immunosuppressive medications: Any drug that lowers your body's immune response can counteract the therapeutic action of this medicine.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
consult your doctorIt is unknown whether Pembrolizumab interacts with alcohol. Consult your doctor.
Pregnancy
unsafePembrolizumab is not recommended for use in pregnancy as it may cause embryo-fetal toxicity and harm your foetus. Hence, if you are pregnant or planning pregnancy, inform your doctor before receiving Pembrolizumab. You should not become pregnant while you are taking Pembrolizumab for at least 4 months from the last dose of Pembrolizumab. Using effective birth control methods while on treatment is suggested.
Breast Feeding
unsafePembrolizumab should not be taken if you are breastfeeding as it passes into breast milk and may harm your infant. Avoid nursing your child while on treatment with this medicine and at least for 4 months from the last dose of medicine.
Driving
cautionPembrolizumab will be administered in the hospital setting. Driving is not recommended.
Liver
cautionIf you have a pre-existing or a history of liver problems, tell your doctor before receiving this medicine. Hence, this medicine should be taken cautiously in patients with moderate liver impairment. Your doctor may suggest tests to monitor your liver function while on treatment with this medicine.
Kidney
cautionIf you have a pre-existing or a history of kidney diseases, inform your doctor before receiving Pembrolizumab. Your doctor may adjust the dose of this medicine or prescribe a suitable alternative based on your condition.
Children
safe if prescribedPembrolizumab is safe for use in children above two years of age when recommended by the physician. It will be administered only if the benefits outweigh risks.
Habit Forming
Diet & Lifestyle Advise
- Prioritise hydration: Drink plenty of water and clear fluids in the days surrounding your infusion. This helps protect your kidney function and keeps you hydrated if you experience diarrhoea.
- Protect your skin: This treatment can make your skin more sensitive. Apply a gentle, fragrance-free moisturiser daily and use a broad-spectrum sunscreen with SPF 30 or higher when outdoors.
- Eat small, nutrient-dense meals: If you experience nausea or a low appetite, eat 5 to 6 small meals throughout the day instead of 3 large ones. Focus on bland, high-protein foods to support your energy.
- Practice infection safety: Wash your hands frequently, avoid crowded areas, and stay away from individuals who are sick, as your body's immune system is highly active and adjusting.
- Balance rest with light activity: Fatigue is common. Listen to your body and rest when needed, but try to incorporate short, gentle walks into your daily routine to help maintain your strength.
Special Advise
- Your doctor may suggest periodic liver function tests, kidney function tests, lung function tests to monitor the function of the liver, kidney and lungs due to the use of Pembrolizumab.
- It is advised to use contraceptive pills while using Pembrolizumab to prevent pregnancy.
- Monitoring of thyroid function and adrenocorticotropic hormone levels will be done during the treatment to avoid any life-threatening side effects.
Patients Concern
Disease/Condition Glossary
Renal Cell Carcinoma: It is the most common type of cancer in which the cancer/ malignant cells grow uncontrollably in the kidney and form a tumour. Symptoms include red, orange, or pink-coloured urine due to the presence of blood in the urine. Pembrolizumab is used in combination with axitinib for the treatment of advanced renal cell carcinoma.
Hepatocellular carcinoma: It occurs when the cancer/ malignant cells grow out of control. This infects the liver, destroys the liver cells and affects the ability of the liver to work properly. Symptoms may include abdominal pain, loss of appetite, weight loss, and pale bowel motions. Pembrolizumab is used in treating liver cancer who are previously treated with sorafenib.
Metastatic Malignant Melanoma: Melanoma is a type of skin cancer in which the cancer cells grow in melanocytes. It is mainly caused by harmful UV radiation from the sun. Malignant melanoma is common in fair-skinned and freckled individuals. It results in mole formation, typically on the skin of the face.
Non-Small Cell Lung Cancer (NSCLC): It is the most common form of lung cancer which occurs when cells that form the lining of the lung start growing uncontrollably. It is mostly seen in persons who smoke. Symptoms may include chest pain, weight loss, hoarseness, and difficulty breathing. Pembrolizumab is used in combination with pemetrexed and platinum chemotherapy, as first-line treatment or in combination with carboplatin and either paclitaxel or paclitaxel protein-bound, as first-line treatment of patients with metastatic squamous NSCLC.
Head and neck cancer: It is a type of cancer which causes abnormal growth of cancer cells in the tissues of the neck and head. This cancer generally starts in the cells known as squamous cells which appear in the lining of the surface of moist mucosa in the head and neck (e.g., inside of the throat, nose, and mouth).
Bladder cancer: It is a cancer that begins in the bladder. It typically affects older adults. The most common symptom is blood in the urine.
Stomach Cancer (Gastric adenocarcinoma): It is a type of cancer that develops from the stomach lining. This condition can occur mainly due to smoking, a highly processed or salty diet, and severe bacterial infection of H. pylori. Symptoms of stomach cancer include feeling bloated after eating, feeling full after eating small amounts of food, nausea, heartburn or indigestion.
Hodgkin’s Disease: Hodgkin’s disease or lymphoma is a blood cancer of a certain type of cells called WBCs, specifically lymphocytes. Lymphocytes normally help control infection and maintain the body's normal immunity. However, in a cancerous state, there is an abnormal multiplication of these blood cells, causing many problems such as fatigue, fever, loss of appetite, itching, night sweats and lymph node swelling.
Endometrial cancer: It is a cancer which affects the endometrium (lining of the womb or uterus). Symptoms may include bleeding between periods, pelvic pain, and pain during sexual intercourse. This cancer is mostly occurred due to certain factors such as increasing age, obesity, never been pregnant, family history of cancer, and diabetes. It is usually seen in women above the age of 55 years. This condition is not life-threatening when it is diagnosed and treated in the early stages.
FAQs
Pembrolizumab is used to treat Renal Cell Carcinoma, Hepatocellular carcinoma, Metastatic Melanoma, non-small cell lung cancer, Malignant pleural mesothelioma, Stomach Cancer, Squamous cell carcinoma of the head and neck, Cervical cancer, and Urothelial carcinoma.
Pembrolizumab contains Pembrolizumab, which works by inhibiting the action of a PD-1 that causes the multiplication of cancerous cells.
It is given as an intravenous (IV) infusion into a vein by a trained healthcare provider in a clinic or hospital setting. The infusion typically takes about 30 minutes to complete. Talk to your doctor or pharmacist about your specific infusion schedule.
You should avoid receiving live vaccines during your treatment, as they can cause severe reactions. Inactivated vaccines are usually safe, but you must consult your healthcare provider before getting any vaccination. Talk to your doctor or pharmacist for personalised advice.
Early signs of lung inflammation include a new or worsening cough, shortness of breath, and chest pain. If you notice any of these changes, contact your medical team immediately. Talk to your doctor or pharmacist if you notice changes in your breathing.
No, it does not typically cause the widespread hair loss associated with traditional chemotherapy. Some patients may experience mild hair thinning, but complete hair loss is very rare. Talk to your doctor or pharmacist if you have concerns about skin or hair changes.
There is no direct chemical interaction between alcohol and this medicine. However, alcohol can contribute to dehydration, fatigue, and liver strain, which are important to avoid during cancer therapy. Talk to your doctor or pharmacist about safe lifestyle choices.
You should report any skin rash or itching to your healthcare team. Mild rashes can often be managed with gentle moisturisers or topical creams, but a severe or peeling rash requires urgent medical attention. Talk to your doctor or pharmacist about how to manage skin irritation.
Your doctor may test your tumour sample for markers such as PD-L1 expression, tumour mutational burden (TMB), or MSI-H/dMMR status. These tests help determine whether it is likely to work for your type of cancer and help your doctor choose the most appropriate treatment plan.
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