Atezolizumab

Other Names: Tecentriq ®

About this Drug:

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

Possible Side Effects

  • Decrease in red blood cells. This may make you feel more tired. 
  • Changes in your white blood cells that may raise your risk of infection. 
  • Nausea
  • Constipation (not able to move bowels)
  • Diarrhea (loose bowel movements)
  • Tiredness
  • Fever
  • Changes in your liver function
  • Urinary tract infection
  • Electrolyte changes
  • Decreased appetite (decreased hunger)
  • Changes in your kidney function
  • Cough
  • Trouble breathing

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 be life-threatening
  • Inflammation of the lungs which can be life-threatening. You may have a dry cough or trouble breathing.
  • Severe changes in your liver function, which can cause liver failure and be life-threatening.
  • Colitis which is swelling in the colon. The symptoms are diarrhea, stomach cramping, and 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. You could feel 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, and coma. If you start to have any of these symptoms let your doctor know right away.
  • This drug may affect your hormone glands (thyroid, adrenals, pituitary and pancreas). 
  • 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 infections, including viral, bacterial and fungal, which can be life-threatening 
  • 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, or chest pain. These reactions may happen after your infusion. If this happens, call 911 for emergency care

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

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

  • Manage tiredness by pacing your activities for the day. 
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease the risk of infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • To help with decreased appetite, eat high calorie 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 of 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. 
  • 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.
  • 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. 
  • If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids.
  • Infusion reactions may happen 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 prescription and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
  • 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. Do 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
  • Fatigue that interferes with your daily activities 
  • Feeling dizzy or lightheaded
  • Pain in your chest 
  • Dry cough 
  • Trouble breathing 
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • 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 
  • Diarrhea, 4 times in one day or diarrhea 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 
  • Numbness, tingling, or pain your hands and feet
  • Extreme weakness that interferes with normal activities 
  • A new rash or a rash that is not relieved by prescribed medicines
  • Signs of infusion reaction: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain.
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or 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 2018

This patient information was developed by Via Oncology, LLC © 2018. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.