Ipilimumab

Other Name: Yervoy®

About This Drug

Ipilimumab is used to treat cancer. It is given in the vein (IV).

Possible Side Effects

  • Bone marrow suppression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding. 
  • Nausea and vomiting (throwing up) 
  • Diarrhea (loose bowel movements) 
  • Pain in your abdomen 
  • Colitis. This is swelling (inflammation) in the colon - symptoms are loose bowel movements (diarrhea) stomach cramping, and sometimes blood in the bowel movements 
  • Tiredness 
  • Fever
  • Changes in your liver function 
  • Electrolyte changes 
  • Decreased appetite (decreased hunger) 
  • Weight loss 
  • Muscle, bone and joint pain 
  • Headache 
  • Changes in your kidney function
  • Trouble sleeping
  • Cough
  • Trouble breathing
  • Rash and itching

Note: Each of the side effects above was reported in 5% or greater of patients treated with ipilimumab. 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. 
  • Severe allergic skin reaction which can 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. 
  • Colitis (swelling in the colon) which can be life-threatening. The symptoms are loose bowel movements (diarrhea) stomach cramping, and sometimes blood in the bowel movements.
  • Severe changes in your liver function which can cause liver failure and be life-threatening
  • This drug may affect some of your hormone glands (especially the thyroid, adrenals, pituitary and pancreas), which can be life-threatening
  • Effects on the nerves. 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. Very rarely, this can affect the nerves and muscles in your upper and lower body and cause paralysis. 
  • Severe inflammation (swelling) of the lungs, which can be life-threatening 
  • Severe changes in your kidney function which can cause kidney failure and be life-threatening 
  • 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, have 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, seizures or coma. If you start to have any of these symptoms let your doctor know right away.
  • 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.
  • Inflammation of your eye and/or other changes in eyesight

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 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. To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • 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. 
  • 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.
  • 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.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea. 
  • 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 are having trouble sleeping, talk to your nurse or doctor on tips to help you sleep better 
  • 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 occur after your infusion. If this happens, call 911 for emergency care.

Food and Drug Interactions

  • There are no known interactions of ipilimumab 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, flushing
  • Signs of a local infection such as pain, redness, tenderness, warmth and/or swelling 
  • Headache that does not go away
  • Blurred vision or other changes in eyesight
  • Extreme tiredness, agitation or confusion 
  • Changes in mood or behavior 
  • Seizures
  • Hallucinations
  • Trouble understanding or speaking 
  • Loss of control of bowels or bladder 
  • Numbness or lack of strength to your arms, legs, face, or body 
  • Have a seizure or coma 
  • Feeling dizzy or lightheaded 
  • Fatigue that interferes with your daily activities 
  • Feeling that your heart is beating fast or in a not normal way (palpitations) 
  • Wheezing or trouble breathing 
  • Easy bleeding or bruising
  • Nausea that stops you from eating or drinking or is not relieved by prescribed medicine 
  • Lasting loss of appetite or rapid weight loss of five pounds in a week 
  • Diarrhea (loose bowel movements) 4 times in one day 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
  • Decreased urine 
  • Weight gain of 5 pounds in one week (fluid retention) 
  • New rash and/or itching
  • Rash that is not relieved by prescribed medicines 
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin 
  • 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
  • Pain that does not go away, or is not relieved by prescribed medicines 
  • Numbness, tingling, pins and needles, or pain your arms, hands, legs or feet 
  • 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 3 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 3 months after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised August 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.