Why is this medication prescribed?

Pembrolizumab is a medication that belongs to a class of drugs known as immune checkpoint inhibitors. It is commonly prescribed for the treatment of certain types of cancer. Pembrolizumab works by blocking the activity of a protein called PD-1 (programmed cell death receptor-1) on the surface of certain immune cells. By inhibiting this protein, the drug helps the immune system recognize and attack cancer cells more effectively.

Indications for Pembrolizumab Injection:

• Melanoma: Pembrolizumab is used to treat advanced melanoma, a type of skin cancer.
• Non-Small Cell Lung Cancer (NSCLC): It is prescribed for the treatment of metastatic non-small cell lung cancer in patients whose tumors express PD-L1 and who have not received prior treatment.
• Head and Neck Squamous Cell Carcinoma: Pembrolizumab is indicated for the treatment of recurrent or metastatic head and neck squamous cell carcinoma.
• Classical Hodgkin Lymphoma: It is used for the treatment of classical Hodgkin lymphoma that has relapsed or progressed after other treatments.
• Urothelial Carcinoma: Pembrolizumab is prescribed for locally advanced or metastatic urothelial carcinoma, which includes cancers of the bladder, ureters, and renal pelvis.
• Microsatellite Instability-High (MSI-H) or Mismatch Repair Deficient (dMMR) Cancer: It is approved for the treatment of adult and pediatric patients with unresectable or metastatic MSI-H or dMMR solid tumors that have progressed following prior treatment.
• Gastric or Gastroesophageal Junction Adenocarcinoma: Pembrolizumab is used for the treatment of patients with recurrent locally advanced or metastatic gastric or gastroesophageal junction adenocarcinoma.

How should this medicine be used?

Here are general guidelines for the use of Pembrolizumab:

• Administration: Pembrolizumab is administered by intravenous (IV) infusion, which means it is delivered directly into the bloodstream through a vein.
• Dosage: The dosage and schedule of Pembrolizumab can vary depending on the type of cancer being treated and the specific circumstances of the patient. The drug is typically given every three weeks.
• Medical Supervision: Pembrolizumab should be administered under the supervision of a healthcare professional experienced in the use of cancer immunotherapy.
• Monitoring: Patients receiving Pembrolizumab may require regular monitoring for potential side effects, and adjustments to the treatment plan may be made based on the individual’s response and tolerability.

It’s important for patients to follow their healthcare provider’s instructions and attend scheduled appointments for monitoring and follow-up. Additionally, as with any medication, potential side effects and risks should be discussed with the treating physician.

Other uses for this medicine

Pembrolizumab is primarily used for the treatment of various cancers, as mentioned earlier. However, it’s important to note that the use of medications can evolve over time, and new indications may be approved. The information provided here is based on the known and approved uses of Pembrolizumab up to that date. It’s advisable to consult with a healthcare professional or check the latest medical literature for any updates or additional uses.

What special precautions should I follow?

As for special precautions when using Pembrolizumab, here are some key considerations:

• Immune-Related Adverse Reactions (irAEs): Pembrolizumab can lead to immune-related adverse reactions, where the immune system may attack normal cells and tissues. These reactions can affect various organs and systems, such as the skin, lungs, liver, intestines, and endocrine glands. Patients should be monitored for signs and symptoms of these reactions.
• Infections: Pembrolizumab may increase the risk of serious infections. Patients should be monitored for signs of infection, and appropriate measures should be taken if an infection is suspected.
• Infusion Reactions: Infusion-related reactions, including severe or life-threatening reactions, can occur during or after the administration of Pembrolizumab. Healthcare providers should closely monitor patients during the infusion and be prepared to manage reactions.
• Pregnancy and Breastfeeding: The safety of Pembrolizumab during pregnancy is not well established, and it may harm an unborn baby. Women of childbearing potential should use effective contraception during treatment and for some time after the last dose. It is not known whether Pembrolizumab passes into breast milk, and breastfeeding should be avoided during treatment and for some time after the last dose.
• Hepatitis B Virus Reactivation: Pembrolizumab can cause hepatitis B virus (HBV) reactivation in patients who are chronic carriers of the virus. Screening for HBV prior to starting treatment is recommended.
• Medical History: Before starting Pembrolizumab, patients should inform their healthcare provider about their complete medical history, including any existing medical conditions, allergies, and medications they are taking.

It’s crucial for patients to communicate openly with their healthcare team, report any symptoms or side effects promptly, attend regular follow-up appointments, and follow the prescribed treatment plan. Pembrolizumab and other immune checkpoint inhibitors have revolutionized cancer treatment, but they also come with unique challenges and potential side effects that require careful management. Individualized care and close monitoring are essential for optimizing the benefits of treatment while minimizing risks.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Pembrolizumab. However, maintaining a healthy and well-balanced diet is generally important for overall health, especially during cancer treatment. It’s advisable to consult with a healthcare professional or a registered dietitian for personalized dietary advice based on your individual health status and treatment plan.

What should I do if I forget a dose?

Pembrolizumab is typically administered in a healthcare setting by a trained professional, so the likelihood of patients forgetting a dose is low. However, if you miss an appointment for your infusion, it’s crucial to contact your healthcare provider promptly to reschedule. Consistent and timely administration of Pembrolizumab is important for the effectiveness of the treatment.

What side effects can this medication cause?

Pembrolizumab, like other immune checkpoint inhibitors, can cause a range of side effects. It’s important to note that not everyone will experience these side effects, and the severity can vary from person to person. Additionally, some side effects may be more common or more severe than others. If you are prescribed Pembrolizumab, your healthcare team will monitor you for potential side effects and provide appropriate management. Here are some common side effects associated with Pembrolizumab:

• Immune-Related Adverse Reactions (irAEs):
  • Skin reactions: Rash, itching
  • Gastrointestinal reactions: Diarrhea, colitis
  • Lung reactions: Pneumonitis
  • Liver reactions: Hepatitis
  • Endocrine reactions: Thyroid disorders, adrenal insufficiency
• Fatigue: Tiredness and lack of energy are common side effects.
• Nausea and Vomiting: Some individuals may experience nausea or vomiting.
• Decreased Appetite: A decrease in appetite may occur.
• Joint Pain (Arthralgia) and Muscle Pain (Myalgia): Pain in the joints and muscles can occur.
• Fever: Some patients may experience an elevated body temperature.
• Headache: Headaches are a possible side effect.
• Infusion Reactions: Reactions during or after the infusion may include fever, chills, or allergic-type reactions.
• Changes in Blood Cell Counts: Pembrolizumab can affect blood cell counts, leading to an increased risk of infections, anemia, and a decrease in platelet count.
• Hypothyroidism: Changes in thyroid function, leading to an underactive thyroid, may occur.
• Hyperthyroidism: In some cases, Pembrolizumab may cause an overactive thyroid.
• Pneumonitis: Inflammation of the lungs can occur, leading to symptoms such as cough and difficulty breathing.

It’s crucial to promptly report any symptoms or side effects to your healthcare provider. Some side effects may require medical intervention, dose adjustments, or the temporary or permanent discontinuation of Pembrolizumab. Early detection and management of side effects are important for optimizing the safety and effectiveness of the treatment.

This list is not exhaustive, and individual responses to Pembrolizumab can vary. Your healthcare provider will provide you with specific information about potential side effects and steps to take if you experience any symptoms during your treatment.

What should I know about storage and disposal of this medication?

Storage and Disposal of Pembrolizumab Injection:

• Storage: Pembrolizumab injections are typically stored by healthcare providers or facilities where the drug is administered. It’s important to follow specific storage instructions provided by the manufacturer or your healthcare team. Generally, the drug is stored in a controlled environment to maintain its stability.
• Disposal: Disposal of medical waste, including unused or expired Pembrolizumab, should be handled in accordance with local regulations and healthcare facility protocols. Patients receiving Pembrolizumab in a healthcare setting do not typically handle the disposal of the medication themselves.

In case of emergency/overdose

In the case of an emergency or overdose, it is important to seek immediate medical attention. The signs and symptoms of an overdose or severe adverse reaction to Pembrolizumab can vary, but they may include:

• Severe or persistent allergic reactions
• Severe infusion reactions
• Signs of immune-related adverse reactions affecting organs (such as severe diarrhea, colitis, pneumonitis, or hepatitis)

If you suspect an overdose or experience severe side effects, contact your healthcare provider or emergency services immediately. Do not attempt to manage a serious reaction at home without professional medical assistance.

What other information should I know?

• Regular Monitoring: Pembrolizumab treatment often involves regular monitoring for both efficacy and potential side effects. This may include blood tests, imaging studies, and clinical assessments.
• Follow-Up Appointments: Attend all scheduled follow-up appointments with your healthcare provider. These appointments are essential for monitoring your response to treatment, managing side effects, and adjusting the treatment plan as needed.
• Informing Healthcare Providers: Keep your healthcare team informed about all medications you are taking, including prescription drugs, over-the-counter medications, and any supplements. This information is important for assessing potential interactions and managing side effects.
• Patient Education: Educate yourself about the potential side effects of Pembrolizumab, and be vigilant for any unusual symptoms. Prompt reporting of symptoms to your healthcare provider is crucial for early intervention.
• Supportive Care: Your healthcare team may provide supportive care measures to manage specific side effects. This could include medications to alleviate symptoms or adjustments to the Pembrolizumab treatment plan.
• Patient Assistance Programs: If you are prescribed Pembrolizumab and have concerns about the cost of the medication, inquire about patient assistance programs or financial assistance options offered by the manufacturer or other organizations.

Always follow the guidance of your healthcare provider and the specific instructions provided with your medication. If you have questions or concerns about Pembrolizumab, discuss them with your healthcare team for personalized advice based on your medical history and treatment plan.