Aldesleukin Side Effects
Some side effects of aldesleukin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to aldesleukin: intravenous powder for injection
Get emergency medical help if you have any of these signs of an allergic reaction while taking aldesleukin: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
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severe drowsiness, feeling like you might pass out;
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chest pain, fast or pounding heartbeats;
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runny or stuffy nose, cough, rapid breathing and heart rate, trouble breathing, swelling and pain in any part of your body;
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problems with vision, speech, balance, or coordination;
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mood or behavior changes, confusion, agitation, hallucinations;
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seizures (convulsions);
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swelling, rapid weight gain, little or no urinating;
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black, bloody, or tarry stools;
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a blistering skin rash;
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jaundice (yellowing of the skin or eyes); or
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signs of infection such as fever, chills, sore throat, flu symptoms, easy bruising or bleeding (nosebleeds, bleeding gums), nausea and vomiting, mouth sores, unusual weakness.
Common side effects may include:
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mild stomach pain, diarrhea, loss of appetite.
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tired feeling; or
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drowsiness, dizziness, anxiety.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
For Healthcare Professionals
Applies to aldesleukin: intravenous powder for injection
Cardiovascular
Cardiovascular side effects from aldesleukin have been reported. Many of the adverse cardiovascular events from aldesleukin result from a capillary or vascular leak syndrome. Shifting of fluid into the interstitial spaces results in hypotension, tachycardia, and sometimes congestive heart failure, or myocardial infarction. Besides the vascular leak syndrome and hypotension, direct effects on the myocardium have been noted. These effects include hemodynamic changes as well as myocardial injury with creatine phosphokinase (CPK) elevations and myocarditis secondary to lymphocyte infiltration.
Hypotension resulting from aldesleukin-induced capillary leak syndrome should be managed with careful fluid administration and institution of low-dose dopamine infusions.
Respiratory
Respiratory side effects including respiratory distress resulting from fluid weight gain attributed to the vascular leak syndrome has been reported. Other respiratory effects reported include dyspnea, pulmonary congestion with rales and rhonchi, unspecified pulmonary changes with infiltrates on X-ray, increased cough, and rhinitis.
Nervous system
Nervous system side effects including both acute and chronic neurologic and neuropsychiatric findings have been reported during aldesleukin administration. Patients receiving high-dose therapy have been reported to have become agitated, disoriented, and sometimes comatose. These effects have typically resolved upon discontinuation of the drug. Neuropsychiatric effects including a decrease in cognitive function and memory impairment have been reported in patients receiving continuous-infusion aldesleukin therapy.
Renal
Renal damage attributed to aldesleukin results from the decrease in vascular resistance. Low-dose dopamine helps maintain adequate renal perfusion during aldesleukin therapy and may decrease the incidence of renal failure.
Renal side effects including oliguria and anuria are the predominant adverse events that have been reported in the majority of patients. Acute kidney failure with an increase in creatinine has been reported in 1% of patients.
Hepatic
Hepatic side effects reported with aldesleukin therapy include bilirubinemia, SGOT increase, and alkaline phosphatase increase and hepatosplenomegaly.
Hematologic
Hematopoietic side effects which have been reported include anemia, thrombocytopenia, and leukopenia. Postmarketing reports have included lymphocytopenia.
Gastrointestinal
Antiemetics and antidiarrheals are helpful in treating the gastrointestinal side effects and H2-antagonists are often given for prophylaxis of gastrointestinal irritation and bleeding. Mucositis requires diligent oral care, including sodium bicarbonate mouthwashes and nystatin.
Gastrointestinal side effects have included nausea, vomiting, diarrhea, and mucositis. Colon dilatation, perforation, and ischemic necrosis have also been reported but are uncommon.
Dermatologic
Rashes have been treated with either hydroxyzine or diphenhydramine, which can be continued until resolution of the rash. Nonalcoholic-based creams and ointments as well as aloe vera gels may also be applied to skin conditions. Application may begin as early as 48 hours before treatment. Preparations containing steroids should be avoided.
Dermatologic side effects such as erythema, pruritus, and generalized erythroderma have been reported with aldesleukin therapy. In patients with preexisting dermatologic conditions such as psoriasis, exacerbation of the underlying condition has been reported.
General
Meperidine may be helpful for the chills and rigors associated with this flu-like syndrome. Scheduled nonsteroidal anti-inflammatory drugs like acetaminophen and indomethacin can substantially relieve the other symptoms.
General side effects including a flu-like syndrome have been reported in patients receiving aldesleukin. Symptoms include fever, chills, rigors, joint pain, myalgias, malaise, and anorexia.
Other
Other side effects including infection have been reported with aldesleukin treatment (which may be due to the initial drop in lymphocyte levels).
Endocrine
Endocrine side effects including hypothyroidism and hyperthyroidism have been reported with aldesleukin therapy.
Metabolic
Metabolic side effects seen with aldesleukin treatment have included acidosis, hypomagnesemia, hypocalcemia, and hyperuricemia.
Immunologic
Immunologic side effects have included the formation of anti-aldesleukin antibodies (up to 74%).
More aldesleukin resources
- aldesleukin Concise Consumer Information (Cerner Multum)
- aldesleukin MedFacts Consumer Leaflet (Wolters Kluwer)
- aldesleukin Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information
- Aldesleukin Professional Patient Advice (Wolters Kluwer)
- Aldesleukin Monograph (AHFS DI)
- Proleukin Prescribing Information (FDA)
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