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Atezolizumab Side Effects

In Summary

Commonly reported side effects of atezolizumab include: herpes simplex encephalitis, infection, mycobacterium infection, retroperitoneal hemorrhage, sepsis, severe infection, urinary tract infection, colitis, diarrhea, and increased thyroid stimulating hormone level. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to atezolizumab: intravenous solution

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:

More common

  • Bladder pain
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • bloody or cloudy urine
  • chills
  • constipation
  • cough
  • difficult, burning, or painful urination
  • fever
  • frequent urge to urinate
  • general feeling of tiredness and weakness
  • hoarseness
  • loss of appetite
  • lower back or side pain
  • nausea
  • pain
  • painful or difficult urination
  • rapid weight gain
  • stomach cramps
  • tenderness
  • tingling of the hands or feet
  • unusual weight gain or loss
  • vomiting
  • watery or bloody diarrhea

Less common

  • Burning, tingling, numbness or pain in the hands, arms, feet, or legs
  • chest pain
  • confusion
  • dark urine
  • depressed mood
  • difficulty with chewing, swallowing, or talking
  • dizziness
  • double vision
  • drooping eyelids
  • drowsiness
  • dry skin and hair
  • facial swelling
  • feeling cold
  • general feeling of discomfort or illness
  • hair loss
  • headache
  • inability to move the arms and legs
  • irritability
  • light-colored stools
  • muscle cramp, stiffness, or weakness
  • nervousness
  • seizures
  • sensation of pins and needles
  • sensitivity to heat
  • severe headache
  • severe tiredness
  • skin rash
  • slowed heartbeat
  • stabbing pain
  • stiff neck or back
  • sudden numbness and weakness in the arms and legs
  • sweating
  • thickening of bronchial secretions
  • trouble sleeping
  • troubled breathing
  • unusual tiredness or weakness
  • upper right abdominal or stomach pain
  • weakness
  • yellow eyes and skin

Rare

  • Bloating
  • darkening of the skin
  • diarrhea
  • fainting
  • fast heartbeat
  • hives, itching
  • indigestion
  • joint stiffness or swelling
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • redness of the skin
  • stiff neck
  • swelling of the eyelids, face, lips, hands, or feet
  • tightness in the chest

Incidence not known

  • Blurred vision
  • dry mouth
  • flushed, dry skin
  • fruit-like breath odor
  • increased hunger
  • increased thirst
  • increased urination
  • sweating

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:

More common

  • Back or neck pain
  • itching skin
  • pain in the joints

For Healthcare Professionals

Applies to atezolizumab: intravenous solution

Cardiovascular

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

General

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]

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]

References

1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. "Product Information. Tecentriq (atezolizumab)." Genentech, South San Francisco, CA.

Further information

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

Some side effects may not be reported. You may report them to the FDA.

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