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Ipilimumab (Intravenous)

ip-i-LIM-ue-mab

Intravenous route(Solution)

Ipilimumab can result in severe and fatal immune-mediated adverse reactions. Reactions may involve any organ system and manifest during treatment or weeks to months after discontinuation. The most common severe reactions are enterocolitis, hepatitis, dermatitis (including toxic epidermal necrolysis), neuropathy, and endocrinopathy. Assess patients for signs and symptoms of severe reactions and evaluate clinical chemistries (eg, liver function tests, adrenocorticotropic hormone levels, thyroid function tests) at baseline and before each dose. Permanently discontinue ipilimumab and initiate systemic high-dose corticosteroid therapy for severe immune-mediated reactions .

Medically reviewed on Oct 4, 2018

Commonly used brand name(s)

See also: Xeloda

In the U.S.

  • Yervoy

Available Dosage Forms:

  • Solution

Therapeutic Class: Antineoplastic Agent

Pharmacologic Class: Monoclonal Antibody

Uses For ipilimumab

Ipilimumab injection is used to treat melanoma (a type of skin cancer) that has spread or cannot be removed by surgery. It is a monoclonal antibody that changes the immune system to help control the growth of cancer cells in the skin.

Ipilimumab injection is also used to help prevent melanoma from coming back after surgical removal.

Ipilimumab injection is also used in combination with other medicines (eg, nivolumab) to treat patients with previously untreated kidney cancer that has spread throughout the body.

Ipilimumab injection is also used with nivolumab to treat microsatellite instability high (MSI-H) or mismatch repair deficient (dMMR) colorectal cancer (cancer of the colon or rectum) that has spread. It is given to patients who have received other cancer treatments (eg, fluoropyrimidine, oxaliplatin, irinotecan) but did not work well.

Ipilimumab is to be given only by or under the immediate supervision of your doctor.

Before Using ipilimumab

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ipilimumab, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ipilimumab or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of ipilimumab injection in children 12 years of age and older. Safety and efficacy have not been established in children younger than 12 years of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ipilimumab injection in the elderly.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving ipilimumab, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ipilimumab with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Tofacitinib

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of ipilimumab. Make sure you tell your doctor if you have any other medical problems, especially:

  • Adrenal gland problem or
  • Allergic skin reactions (eg, dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis), severe or
  • Colitis (inflammation of the bowel) or
  • Eye or vision problems (eg, episcleritis, iritis, uveitis) or
  • Guillain-Barré syndrome or
  • Hemolytic anemia (blood disorder) or
  • Hepatitis (inflammation of the liver) or
  • Hyperthyroidism (overactive thyroid) or
  • Hypopituitarism (low levels of pituitary hormone) or
  • Hypothyroidism (underactive thyroid) or
  • Intestinal or bowel perforation (a hole in the bowel) or
  • Meningitis (inflammation of the brain) or
  • Myasthenia gravis (severe muscle weakness) or
  • Nephritis (inflammation of the kidney) or
  • Pancreatitis (inflammation of the pancreas) or
  • Pericarditis (inflammation of the heart) or
  • Peripheral neuropathy (nerve problem in the arms and legs) or
  • Pneumonitis (inflammation of the lungs)—Use with caution. May make these conditions worse.

Proper Use of ipilimumab

Medicines used to treat cancer are very strong and can have many side effects. Before receiving ipilimumab, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.

A nurse or other trained health professional will give you ipilimumab in a medical facility. It is given through a needle placed into one of your veins. It must be given slowly, so the needle will have to remain in place for at least 30 to 90 minutes.

Ipilimumab is usually given every 3 weeks for a total of 4 doses. Your doctor may adjust how often you will receive ipilimumab or how long the infusion will take.

Ipilimumab comes with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Missed Dose

Ipilimumab needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.

Precautions While Using ipilimumab

It is very important that your doctor check your progress at regular visits to make sure that ipilimumab is working properly. Blood tests may be needed to check for unwanted effects.

Receiving ipilimumab while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment and for 3 months after your last dose. If you think you have become pregnant while receiving the medicine, tell your doctor right away.

Colitis (inflammation of the colon) may occur with ipilimumab. Tell your doctor right away if you have stomach pain or tenderness, watery or bloody diarrhea, or a fever after receiving the medicine.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, a loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Serious skin reactions can occur with ipilimumab. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are receiving ipilimumab.

Check with your doctor right away if you are having unusual weakness of the arms or legs, or a burning, numbness, tingling, or painful sensation in the arms, hands, legs, or feet. These could be symptoms of a serious nerve problem that can lead to paralysis.

Serious problems with the adrenal, pituitary, or thyroid glands (hormone glands) may occur while you are receiving ipilimumab. Tell your doctor if you start having continuing or unusual headaches, changes in mood or behavior (eg, being irritable or forgetful), lightheadedness, dizziness, or fainting, unusual sluggishness, or an increase in weight.

Check with your doctor right away if blurred vision, difficulty with reading, eye pain, or any other change in vision occurs while you are receiving ipilimumab. Your doctor may want your eyes be checked by an ophthalmologist (eye doctor).

Ipilimumab may increase the risk for other problems caused by the immune system, including pneumonitis (swelling of the lungs), nephritis (kidney problem), or encephalitis (swelling of the brain). Check with your doctor if you have the following problems: chest pain, thickening of bronchial secretions, troubled breathing, bloody or cloudy urine, unusual tiredness or weakness, nausea, vomiting, unusual weight gain, swelling of the face, feet, or lower legs, confusion, irritability, headache, seizures, or stiff neck.

Ipilimumab may cause infusion-related reactions, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you start to have a fever, chills or shaking, dizziness, trouble breathing, itching or rash, lightheadedness or fainting after receiving ipilimumab.

Ipilimumab Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

  • Bloody, black, or tarry stools
  • diarrhea
  • fever
  • heartburn
  • indigestion
  • itching, skin rash
  • nausea
  • severe stomach pain, cramping, or burning
  • unusual tiredness or weakness
  • vomiting
  • vomiting of material that looks like coffee grounds, severe and continuing
  • watery or bloody diarrhea

Less common

  • Blistering, crusting, irritation, itching, or reddening of the skin
  • bloody or cloudy urine
  • blurred vision or other changes in vision
  • burning, dry, or itching eyes
  • burning, tingling, numbness or pain in the hands, arms, feet, or legs
  • chest pain
  • chills
  • clay-colored stools
  • cough
  • cracked, dry, or scaly skin
  • dark urine
  • darkening of the skin
  • decreased appetite
  • decreased frequency or amount of urine
  • difficulty with breathing, chewing, swallowing, or talking
  • dizziness
  • double vision
  • drooping eyelids
  • drowsiness
  • eye discharge or excessive tearing
  • eye pain or sensitivity to light
  • fainting
  • headache, possibly severe
  • hives or welts
  • loss of appetite
  • mental depression
  • muscle weakness
  • pain, itching, burning, swelling, bleeding, or a lump under the skin where the needle was placed
  • painful or difficult urination
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • sensation of pins and needles
  • severe tiredness
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stabbing pain
  • stomach tenderness
  • swelling of the face, feet, or lower legs
  • swollen glands
  • unusual bleeding or bruising
  • unusual weight gain
  • yellow eyes or skin

Rare

  • Anxiety
  • bloating
  • blue or pale skin
  • chest pain, possibly moving to the left arm, neck, or shoulder
  • confusion
  • constipation
  • difficulty with moving
  • fast heartbeat
  • general feeling of discomfort or illness
  • increased thirst
  • lower back or side pain
  • muscle pain or stiffness
  • muscle weakness
  • pain or burning in the throat
  • pain, swelling, or redness in the joints
  • pains in the stomach or side, possibly radiating to the back
  • skin irritation or rash, including rash that looks like psoriasis
  • sores, welts, or blisters on the skin
  • stiff neck or back

Incidence not known

  • Back, leg, or stomach pains
  • bleeding gums
  • general body swelling
  • inability to move the arms and legs
  • nosebleeds
  • throbbing pain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Headache
  • trouble sleeping
  • weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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