Why is this medication prescribed?
Atezolizumab injection is used:
- to treat certain types of urothelial cancer (cancer of the lining of the bladder and other parts of the urinary tract) that has spread or cannot be removed by surgery in people unable to receive platinum-containing chemotherapy (carboplatin, cisplatin),
- alone or with other chemotherapy medications as a first treatment for certain types of non-small cell lung cancer (NSCLC) that has spread to other parts of the body,
- to treat a certain type of NSCLC that has spread to other parts of the body and that has worsened during or after treatment with other chemotherapy medications,
- together with other chemotherapy medications as a first treatment for a certain type of small cell lung cancer (SCLC) that has spread throughout the lung or to other parts of the body,
- together with other chemotherapy medications as a treatment for a certain type of breast cancer that has spread to other parts of the body or cannot be removed by surgery,
- in combination with bevacizumab (Avastin) to treat hepatocellular carcinoma (HCC) that has spread or cannot be removed by surgery in people who have not previously not received chemotherapy, and
- in combination with cobimetinib (Cotellic) and vemurafenib (Zelboraf) to treat certain types of melanoma (a type of skin cancer) that has spread or cannot be removed by surgery.
Atezolizumab injection is in a class of medications called monoclonal antibodies. It works by blocking the action of a certain protein in cancer cells. This helps the person's immune system to fight against the cancer cells, and helps to slow tumor growth.
How should this medicine be used?
Atezolizumab injection comes as liquid to be injected into a vein over 30 to 60 minutes by a doctor or nurse in a hospital or medical facility. When atezolizumab injection is used to treat urothelial cancer, NSCLC, SCLC, or hepatocellular carcinoma, it is usually injected once every 2, 3, or 4 weeks depending on your dosage for as long as your doctor recommends that you receive treatment. When atezolizumab injection is used to treat breast cancer it is usually injected on days 1 and 15 as part of a 28-day cycle. When atezolizumab injection is used to treat melanoma, it is usually injected every 2 weeks. The length of your treatment depends on how well your body responds to the medication and the side effects that you experience.
Atezolizumab injection may cause serious reactions during the infusion of the medication. A doctor or nurse will monitor you carefully while you are receiving the medication. If you experience any of the following symptoms, tell your doctor immediately: flushing, fever, chills, shaking, dizziness, feeling faint, shortness of breath, difficulty breathing, itching, rash, back or neck pain, or swelling of the face or lips.
Your doctor may need to slow down your infusion, delay or stop your treatment, or treat you with other medications if you experience certain side effects. Be sure to tell your doctor how you are feeling during your treatment with atezolizumab injection.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with atezolizumab injection and each time you receive the medication. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before receiving atezolizumab injection,
- tell your doctor and pharmacist if you are allergic to atezolizumab, any other medications, or any of the ingredients in atezolizumab injection. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you are being treated for an infection. Also tell your doctor if you have or have ever had an organ transplant; lung or breathing problems; disease that affects your nervous system such as myasthenia gravis (a disorder of the nervous system that causes muscle weakness) or Guillain-Barre syndrome (weakness, tingling, and possible paralysis due to sudden nerve damage); autoimmune disease (condition in which the immune system attacks a healthy part of the body) such as Crohn's disease (condition in which the immune system attacks the lining of the digestive tract causing pain, diarrhea, weight loss, and fever), ulcerative colitis (condition that causes swelling and sores in the lining of the colon [large intestine] and rectum) or lupus (condition in which the immune system attacks many tissues and organs including the skin, joints, blood, and kidneys); or liver disease.
- tell your doctor if you are pregnant, or plan to become pregnant. You should not become pregnant during your treatment and for 5 months after your last dose. Talk to your doctor about birth control methods that you can use during your treatment. If you become pregnant while receiving atezolizumab injection, call your doctor immediately.
- tell your doctor if you are breastfeeding. Your doctor will probably tell you not to breastfeed during your treatment and for 5 months after your last dose.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What side effects can this medication cause?
Atezolizumab injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- back, neck, or joint pain
- trouble falling asleep or staying asleep
- extreme tiredness
- pale skin
- feeling cold
- swelling of arms
- loss of appetite
- hair loss
- deepening of voice or hoarseness
- weight gain
Some side effects can be serious. If you experience any of these symptoms call your doctor immediately or get emergency medical treatment:
- diarrhea, stomach pain, blood or mucus in the stool, or black tarry, sticky, stools
- ongoing pain that begins in the upper left or middle of the stomach but may spread to the back, fever, nausea, vomiting
- constipation with stomach bloating or swelling
- fever, sore throat, cough, chills, flu-like symptoms, frequent, urgent, difficult, or painful urination, or other signs of infection
- pink, red, or dark brown urine
- decreased urination, swelling in your legs, ankles, or feet
- warm, red, swollen, or tender leg
- new or worsening cough which may be bloody, shortness of breath, or chest pain
- yellowing of the skin or eyes, extreme tiredness, bleeding or bruising easily, nausea or vomiting, stomach pain, dark colored urine, decreased appetite
- headaches that won't go away or unusual headaches, increased thirst or urination, vision changes, decreased sex drive
- fast heartbeat, increased appetite, sudden weight loss, feeling hot, mood changes
- muscle weakness, numbness or tingling in your hands, feet, arms, or legs, fever, confusion, changes in mood or behavior, sensitivity to light, neck stiffness
- blurry or double vision, or other vision problems, eye pain or redness
- dizziness or feeling faint
- feeling more hungry or thirsty than usual, increased urination, extreme tiredness, weakness, breath that smells fruity
- changes in mood or behavior (decreased sex drive, irritability, confusion, or forgetfulness)
- chest pain, shortness of breath, irregular heartbeat, swelling of ankles, not being able to exercise like you used to
Atezolizumab injection may cause other side effects. Call your doctor if you have any unusual problems while receiving this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests before and during your treatment with atezolizumab injection to check your body's response to the medication. For some conditions, your doctor will order a lab test before you begin your treatment to see whether your cancer can be treated with atezolizumab.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.