Brentuximab vedotin (Adcetris®)
About This Drug
Brentuximab is used to treat cancer. This drug is given in the vein (IV).
Possible Side Effects
- A decrease in the number of white blood cells and red blood cells. This may raise your risk of infection and make you feel more tired.
- Soreness of the mouth and throat. You may have red areas, white patches, or sores in your mouth that hurt.
- Nausea and vomiting (throwing up)
- Diarrhea (loose bowel movements)
- Constipation (unable to move bowels)
- Pain in your abdomen
- Weight loss
- Effects on the nerves are called peripheral neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped but it does not get better in all people.
- Upper respiratory infection
- Hair loss. Hair loss is often temporary, although with certain medicine, hair loss can sometimes be permanent. Hair loss may happen suddenly or gradually. If you lose hair, you may lose it from your head, face, armpits, pubic area, chest, and/or legs. You may also notice your hair getting thin.
Note: Each of the side effects above was reported in 20% or greater of patients treated with brentuximab. Not all possible side effects are included above.
Warnings and Precautions
- Fever in the setting of decreased white blood cells, which is a serious condition that can be life threatening.
- Severe infections, including viral, bacterial and fungal, which can be life-threatening. A specific virus called the JC virus can cause changes in your central nervous system, which can be life threatening. 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.
- Severe life threatening gastrointestinal complications may happen including severe nausea, vomiting and diarrhea, inflammation, perforation (hole) and bleeding.
- Tumor lysis syndrome: This drug may act on the cancer cells very quickly. This may affect how your kidneys work.
- Changes in your liver function which can cause liver failure and be life-threatening.
- Inflammation (swelling) of the lungs, which can be life-threatening. You may have a dry cough or trouble breathing.
- Severe allergic skin reaction, which may be life threatening. You may develop blisters on your skin that are filled with fluid or a severe red rash all over your body that may be painful.
- Allergic reactions, including anaphylaxis are rare but may happen in some patients. Signs of allergic reaction to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, do not take another dose of this drug. You should get urgent medical treatment.
- 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.
- 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).
- 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).
- Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or 1/2 teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
- If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat.
- 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 are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
- Ask your nurse or doctor about medicine that can lessen or stop your diarrhea and/or constipation.
- To help with weight loss, drink fluids that contribute calories (whole milk, juice, soft drinks, sweetened beverages, milkshakes, and nutritional supplements) instead of water.
- Include a source of protein at every meal and snack, such as meat, poultry, fish, dry beans, tofu, eggs, nuts, milk, yogurt, cheese, ice cream, pudding, and nutritional supplements.
- Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
- 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.
- 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.
- To help with hair loss, wash with a mild shampoo and avoid washing your hair every day.
- Avoid rubbing your scalp, pat your hair or scalp dry.
- Avoid coloring your hair.
- Limit your use of hair spray, electric curlers, blow dryers, and curling irons.
- If you are interested in getting a wig, talk to your nurse. You can also call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
Food and Drug Interactions
- Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with brentuximab. 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.
- Avoid the use of St. John’s Wort while taking brentuximab as this may lower the levels of the drug in your body, which can make it less effective.
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
- Confusion and/or agitation
- Trouble understanding or speaking
- Headache that does not go away
- Blurry vision or changes in your eyesight
- Numbness or lack of strength to your arms, legs, face, or body
- Tiredness that interferes with your daily activities
- Feeling dizzy or lightheaded
- Wheezing or trouble breathing
- Pain in your chest
- Dry cough
- Abdominal pain that does not go away
- Lasting loss of appetite or rapid weight loss of five pounds in a week
- Pain in your mouth or throat that makes it hard to eat or drink
- Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
- Throwing up more than 3 times a way
- Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
- No bowel movement in 3 days or when you feel uncomfortable
- Swelling of legs, ankles, or feet
- Weight gain of 5 pounds in one week (fluid retention)
- New rash and/or itching
- Rash that is not relieved by prescribed medicines
- Numbness, tingling, or pain your hands and feet
- Signs of tumor lysis: Confusion or agitation, decreased urine, nausea/vomiting, diarrhea, muscle cramping, numbness and/or tingling, seizures
- Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)
- 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 allergic reaction: swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way
- Decreased urine, or very dark urine
- 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 or may have impregnated your partner
- 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 6 months after treatment. Men with female partners of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 6 months after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
- Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should not breastfeed during treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
- Fertility warning: In men, 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 sperm banking.
Revised December 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.
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