Atezolizumab Side Effects

Medically reviewed by Philip Thornton, DipPharm. Last updated on Oct 8, 2024.

Applies to atezolizumab: intravenous solution.

Precautions

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

Receiving this medicine while you are pregnant can harm your unborn baby. If you are female and able to get pregnant, your doctor may give you a pregnancy test before you start receiving this medicine to make sure you are not pregnant. Use an effective form of birth control to keep from getting pregnant during treatment with this medicine and for at least 5 months after the last dose. If you think you have become pregnant while receiving the medicine, tell your doctor right away.

Tell your doctor right away if you have a cough, chest tightness, or any type of breathing problem with this medicine. These could be symptoms of a serious lung problem (eg, pneumonitis, interstitial lung disease).

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, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

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

Adrenal, pituitary, or thyroid gland problems may occur while you are receiving this medicine. Tell your doctor if you have changes in mood or behavior, constipation, dry skin or hair, feeling cold, sensitivity to heat, sweating, trouble sleeping, or weight changes.

This medicine may affect blood sugar levels. Check with your doctor if you notice a change in the results of your blood or urine sugar tests or if you have any questions.

Check with your doctor if you have a headache, confusion, seizures, stiff neck, or vomiting while receiving this medicine. These may be symptoms of encephalitis.

Check with your doctor right away if you have a severe headache, drowsiness, confusion, general feeling of illness, or stiff neck or back while receiving this medicine. These may be symptoms of meningitis.

This medicine may cause inflammation of the heart muscle (myocardium) called myocarditis. Check with your doctor right away if you have chest pain or discomfort, fever, chills, a fast heartbeat, or trouble breathing.

Call your doctor right away if you have difficulty with breathing, swallowing, or talking, muscle weakness, severe tiredness, or sudden numbness and weakness in the arms or legs. These could be symptoms of a nervous system problem.

Tell your doctor right away if you have blurred vision, eye pain or redness, or other vision problems while you are receiving this medicine.

Pancreatitis (swelling of the pancreas) may occur while you are receiving this medicine. Tell your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.

Call your doctor right away if you start to have a cough that would not go away, weight loss, night sweats, fever, chills, painful or difficult urination, or flu-like symptoms, including runny or stuffy nose, headache, blurred vision, or feeling generally ill. These may be signs that you have an infection.

This medicine may cause a rare but serious type of allergic reaction called an infusion reaction, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you start to have a skin rash, dizziness, trouble breathing, chest tightness, swelling in your face or hands, fever, or chills while you are receiving this medicine.

This medicine may cause kidney problems (eg, nephritis). Check with your doctor right away if you have bloody or cloudy urine, difficulty in breathing, drowsiness, headache, nausea or vomiting, swelling of the face, feet, or lower legs, unusual tiredness or weakness, or unusual weight gain.

Serious skin reactions (eg, exfoliative dermatitis, Stevens-Johnson syndrome, drug rash with eosinophilia and systemic syndrome (DRESS), or toxic epidermal necrolysis) can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, chills, cough, diarrhea, itching, joint or muscle pain, red, irritated eyes, red skin lesions, often with a purple center, severe acne or a skin rash, sore throat, sores or ulcers on the skin, mouth, or lips, swollen glands, unusual bleeding or bruising, or unusual tiredness or weakness after receiving this medicine.

Call your doctor right away if you have fever, joint pain, muscle tenderness, weakness, pain, or cramps, skin rash, unusual tiredness or weakness, or weight loss. These could be symptoms of a muscle problem.

This medicine may increase your risk for possible organ transplant rejection. Talk to your doctor about this risk.

Talk with your doctor before receiving this medicine if you plan to have children. Some women who receive this medicine have become infertile (unable to have children).

Serious side effects of atezolizumab

Along with its needed effects, atezolizumab 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 while taking atezolizumab:

Other side effects of atezolizumab

Some side effects of atezolizumab 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:

For healthcare professionals

Applies to atezolizumab: intravenous solution.

General adverse events

The most common adverse reactions (greater than 20%) were fatigue, decreased appetite, nausea, urinary tract infection, pyrexia, and constipation. The most common Grade 3 to 4 adverse reactions (greater than 2%) were urinary tract infection, anemia, fatigue, dehydration, intestinal obstruction, urinary obstruction, hematuria, dyspnea, acute kidney injury, abdominal pain, venous thromboembolism, sepsis, and pneumonia.^[Ref]

Dermatologic

• Very common (10% or more): Rash (15%), pruritus (13%)^[Ref]

Endocrine

• Frequency not reported: Immune-related thyroid disorders (e.g., hyperthyroidism, hypothyroidism)^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (25%), constipation (21%), diarrhea (18%), abdominal pain (17%), vomiting (17%)
• Common (1% to 10%): Dehydration, intestinal obstruction^[Ref]

Cardiovascular

• Common (1% to 10%): Venous thromboembolism^[Ref]

Genitourinary

• Very common (10% or more): Urinary tract infection (22%)
• Common (1% to 10%): Urinary obstruction^[Ref]

Hematologic

• Common (1% to 10%): Anemia, lymphopenia, increased alkaline phosphatase, increased alkaline phosphatase^[Ref]

Hepatic

• Common (1% to 10%): Acute kidney injury, liver enzyme increase, increased ALT, increased AST

Immunologic

• Very common (10% or more): Immune related colitis (19.7%)
• Common (1% to 10%): Immune related pneumonitis, immune related hepatitis, sepsis
• Frequency not reported: Immune related endocrinopathies^[Ref]

Local

• Frequency not reported: Infusion related reactions^[Ref]

Metabolic

• Very common (10% or more): Decreased appetite (26%)
• Common (1% to 10%): Hyponatremia, hyperglycemia, hypoalbuminemia^[Ref]

Musculoskeletal

• Very common (10% or more): Back/neck pain (15%), arthralgia (14%)^[Ref]

Nervous system

• Frequency not reported: Meningoencephalitis, myasthenic syndrome/myasthenia gravis, Guillain-Barre^[Ref]

Ocular

• Frequency not reported: Ocular inflammatory toxicity^[Ref]

Other

• Very common (10% or more): Fatigue (52%), pyrexia (21%), peripheral edema (18%)
• Common (1% to 10%): Increased creatinine^[Ref]

Psychiatric

• Common (1% to 10%): Confusional state^[Ref]

Renal

• Common (1% to 10%): Hematuria^[Ref]

Respiratory

• Very common (10% or more): Dyspnea (16%), cough (14%)
• Common (1% to 10%): Dyspnea, pneumonia^[Ref]

See also:

Frequently asked questions

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Further information

Atezolizumab side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer