Atezolizumab

Other Names: Tecentriq ®

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About this Drug:

Atezolizumab is used to treat cancer. It is given by the vein (IV).

Possible Side Effects

  • Tiredness
  • Decreased appetite (decreased hunger)
  • Nausea
  • Constipation (not able to move bowels)
  • Loose bowel movements (diarrhea)
  • Urinary tract infection. Symptoms may include:
    • Pain or burning when you pass urine.
    • Feeling like you have to pass urine often, but not much comes out when you do.
    • Tender or heavy feeling in your lower abdomen.
    • Cloudy urine and/or urine that smells bad.
    • Pain on one side of your back under your ribs. This is where your kidneys are.
    • Fever, chills, nausea and/or throwing up.
  • Fever
  • Cough and/or trouble breathing
  • Muscle, bone and joint pain

Note: Each of the side effects above was reported in 20% or greater of patients treated with atezolizumab. 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.

Warning symptoms can include:

  • Inflammation (swelling) of the lungs which can very rarely be fatal
  • Dry cough or trouble breathing.
  • Changes in your liver function. Your liver function will be checked as needed.
  • Colitis. This is swelling (inflammation) in the colon. Symptoms are:
    • Loose bowel movements (diarrhea)
    • Stomach cramping
    • Sometimes blood in the bowel movements
  • Changes in your central nervous system can happen. The central nervous system is made up of your brain and spinal cord. If you start to have any of these symptoms let your doctor know right away:
    • Extreme tiredness
    • Agitation
    • Confusion
    • Hallucinations (see or hear things that are not there)
    • Trouble understanding or speaking
    • Loss of control of your bowels or bladder
    • Eyesight changes
    • Numbness or lack of strength to your arms, legs, face, or body
    • Coma
  • Loss of control of your bowels or bladder
  • Changes of some 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.
  • Inflammation of your pancreas. Your doctor will check your pancreas function as needed.
  • Inflammation of your eyes and/or other changes in eyesight
  • Severe infections, including viral, bacterial and fungal, which can very rarely be fatal

While you are getting this drug in your vein (IV), you may have a reaction to the drug. Sometimes you may be given medication to stop or lessen these side effects. 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
  • Chest pain

These reactions may happen after your infusion. If this happens, call 911 for emergency care.

Important Information

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

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • To help with decreased appetite, eat small, frequent meals.
  • Eat high caloric food such as pudding, ice cream, yogurt and milkshakes.
  • Ask your doctor or nurse about medicine that is available to help stop or lessen the loose bowel movements, nausea and/or constipation.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • 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.
  • Manage tiredness by pacing your activities for the day. Be sure to include periods of rest between energy-draining activities.
  • If you’re diabetic, keep good control of your blood sugar level. Tell your nurse or your doctor if your glucose levels are higher or lower than normal.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • 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 atezolizumab with food.

This drug may interact with other medicines. 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 diets 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 diets without your cancer doctor's help.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Pain in your chest
  • Dry cough
  • Trouble breathing
  • Confusion and/or agitation
  • Hallucinations
  • Trouble understanding or speaking
  • Blurry vision or changes in your eyesight
  • Numbness or lack of strength to your arms, legs, face, or body
  • Blurred vision or other changes in eyesight
  • Loose bowel movements (diarrhea) 4 times or loose bowel movements with lack of strength or a feeling of being dizzy
  • Pain in your abdomen that does not go away
  • Blood in your stool
  • No bowel movement in 3 days or when you feel uncomfortable
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Pain or burning when you pass urine
  • Difficulty urinating
  • Feeling like you have to pass urine often, but not much comes out when you do
  • Tender or heavy feeling in your lower abdomen
  • Cloudy urine and/or urine that smells bad
  • Pain on one side of your back under your ribs. This is where your kidneys are.
  • Abnormal blood sugar
  • Unusual thirst, passing urine often, headache, sweating, shakiness, irritability
  • Pain that does not go away, or is not relieved by prescribed medicines
  • Fatigue that interferes with your daily activities
  • Signs of infusion reaction:
    • Fever or shaking chills
    • Flushing
    • Facial swelling
    • Feeling dizzy
    • Headache
    • Trouble breathing
    • Rash
    • Itching
    • Chest tightness
    • Chest pain
  • Signs of possible liver problems:
    • Dark urine
    • Pale bowel movements
    • Bad stomach pain
    • Feeling very tired and weak
    • Unusual itching
    • Yellowing of the eyes or skin
  • If you think you may be pregnant

Reproduction Warnings

  • Pregnancy warning: This drug can 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 5 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. For this reason, Women should not breast feed during treatment and for at least 5 months after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: In women, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on egg banking.

Revised September 2017