Ipilimumab (YERVOY ™)
Ipilimumab belongs to a group of cancer drugs known as monoclonal antibodies. It is used to treat advanced melanoma.
It is best to read this information along with our general information about advanced melanoma or other type of cancer.
Ipilimumab belongs to a group of cancer drugs known as monoclonal antibodies. Monoclonal antibodies are sometimes called targeted therapies because they ‘target’ specific proteins (receptors) on the surface of cancer cells.
Ipilimumab is also known as Yervoy ™. It is used to treat advanced melanoma. Melanoma is a type of skin cancer. It may also be used to treat other types of cancer as part of a research trial.
You'll see your doctor regularly while you have this treatment so they can monitor its effects. This information should help you discuss any queries about your treatment and its side effects with your doctor or specialist nurse.
Ipilimumab works by attaching itself to normal T-cells. T-cells are part of the immune system. They fight infection and diseases. In some people T-cells can recognise and destroy melanoma cells. But a protein on the surface of T-cells, called CTLA-4, stops this happening. Ipilimumab blocks the protein so the T-cells can destroy melanoma cells.
When ipilimumab is usedBack to top
Ipilimumab is used to treat people with melanoma that has:
- come back and cannot be removed with surgery, or
- spread to other parts of the body.
You have it after you have already had treatment with other anti-cancer drugs for melanoma.
It is also being tested in research trials as a possible treatment for other types of cancer.
Ipilimumab may only be available in some situations. Your cancer doctor can tell you if it's appropriate for you. Some people may be given it as part of a clinical trial. If a drug isn’t available on the NHS, there may be different ways you are still able to have it. Your cancer doctor can give you advice.
We have more information about what you can do if a treatment isn’t available.
How ipilimumab is givenBack to top
A nurse will give you ipilimumab usually as a drip into a vein (intravenous infusion) in your arm. You have it over about 90 minutes. You usually have ipilimumab every three weeks for up to four treatments. Your cancer doctor or specialist nurse will talk to you about how long the treatment will take.
Possible side effects of ipilimumabBack to top
We have included the most common likely side effects of ipilimumab here. We haven’t included all the less common and rarer side effects. You may get some of the side effects we mention, but you will not get them all.
If you have chemotherapy or radiotherapy along with ipilimumab, some side effects may be worse. You may also have side effects not listed here. We have more information about chemotherapy and radiotherapy.
Your doctor can prescribe drugs to help control some side effects. It is very important to take them exactly as your nurse or pharmacist has explained. This will help the drugs work as well as possible for you.
Your nurse will give you advice about managing side effects. Always tell your doctor or nurse about the side effects you have.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. You can call them if you feel unwell or need advice any time of day or night. Save these numbers in your phone or keep them somewhere safe.
More information about this drug
We’re not able to list every side effect for this treatment here, particularly the rarer ones. For more detailed information you can visit the electronic Medicines Compendium (eMC).
Serious and life-threatening side effects
Some side effects of ipilimumab begin during treatment but they can sometimes happen months after the last treatment. Because ipilimumab affects the immune system it may cause inflammation in parts of the body. This can sometimes cause severe side effects which may be life-threatening. Some people may need treatment in hospital. You may be given steroids to reduce inflammation. Doctors may delay or stop ipilimumab depending on the side effects.
It is important to follow the advice your cancer doctor or nurse give you. They will tell you how and when to contact them about certain side effects. This includes after you have stopped taking ipilimumab.
Ipilimumab can cause an itchy rash. This is a common side effect. You should always tell your doctor or nurse if it happens. If it is only on a small area of skin your doctor can prescribe creams to treat it. If the rash is on a lot of areas of skin, or covers more than half of your body, tell your doctor straight away. You usually need steroids creams or tablets to treat it. Your doctor may stop ipilumumab until the rash improves.
Less commonly some people have a severe skin reaction. The symptoms can include large blisters, peeling skin, or sores in your mouth. You may also have a fever (high temperature). If you have a severe reaction you need to contact the hospital straight away and will probably need treatment in hospital.
Here are some things you can do to look after your skin:
- Use tepid water and mild, non-scented soap for bathing and washing.
- Don't use skincare products with alcohol in them.
- Don’t use anti-acne products. They can dry your skin and make your symptoms worse.
- Moisturise your skin every day after a bath or shower. Your doctor or specialist nurse can tell you which moisturisers are best.
- Wear rubber gloves to protect your hands when you're using detergents.
- Protect your skin in the sun as sunlight can make skin symptoms worse.
During treatment and for a few months after you will be more sensitive to the sun. Your skin may burn more easily than usual. Wear a suncream with a high sun protection factor (SPF) and cover up with clothing and a hat.
It’s important to follow the advice your nurse or doctor gives you about diarrhoea. Contact the hospital if you have diarrhoea. They will give you advice on what to do and if you should be seen by a doctor. They may give you anti-diarrhoea tablets to take at home. Mild diarrhoea (up to four loose bowel motions a day) can usually be controlled with these. Drink plenty of fluids to stop you becoming too dry (dehydrated).
Let the hospital know immediately if you have pain in your tummy (abdomen), vomiting, blood or mucus in your bowel motion, or a fever. You may need to come into hospital to have a drip (infusion) and other treatments. If the bowel is inflamed (colitis) you may need steroids.
Feeling very tired (fatigue) is a common side effect. Try to pace yourself and get as much rest as you need. If you can, balance this with taking some gentle exercise, such as short walks. This can help reduce tiredness. If you feel sleepy, don’t drive or operate machinery.
Your doctor can prescribe anti-sickness drugs. You may be given these before you go home. Take them exactly as prescribed. If the sickness isn't controlled, or if it continues, tell your doctor. They can prescribe other anti-sickness drugs that may work better for you.
You may get constipated. This can usually be helped by drinking plenty of fluids, eating more fibre in your diet and doing some gentle exercise. You may need to take medicine (laxatives) to help. Your doctor can prescribe these or you can buy them from a pharmacy.
Risk of infection
This drug can reduce the number of white blood cells in your blood, which help to fight infection. If the number of white blood cells is low, you will be more likely to get infections. A low white blood cell count is called neutropenia. A severe infection can be very serious.
Contact the hospital straight away on the contact number you’ve been given if:
- your temperature goes over 37.5°C (99.5°F) or over 38°C (100.4°F), depending on the advice given by your hospital team
- you have symptoms of an infection – this can include feeling shaky, a sore throat, a cough or needing to pass urine often
- you suddenly feel unwell, even if your temperature is normal.
Anaemia (low number of red blood cells)
If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this.
Some people may get pain in the area of the cancer. Because of this you may be given pain killers to take at home. If the pain isn’t controlled let your doctor or nurse know.
You may get pain in your joints or muscles. Tell your doctor if this happens so they can prescribe painkillers. Let them know if the pain does not get better. They can increase or change your painkillers to help.
Changes in the way the liver works
Ipilimumab may cause changes in the way your liver works. This will return to normal when the treatment finishes. You have regular blood tests to check your liver is working properly.
Less commonly, ipilimumab may cause more severe inflammation of the liver (hepatitis). Signs and symptoms of hepatitis include yellowing of the whites of the eyes and the skin (jaundice), itchy skin, urine that is darker than usual, or pain on your right side.
If you have any of these symptoms it’s very important to contact the doctor straight away. They can do tests and, if necessary, give you treatment for liver inflammation.
Your hair may become thinner. It will grow back when treatment finishes.
Effects on the eyes
Ipilimumab can cause inflammation of the eyes. You may get blurred vision and pain in the eye. Always tell your doctor straight away if you have any changes to your eyesight or if your eyes become red or sore. They can prescribe treatment to reduce these symptoms.
Breathlessness or a cough
Some people may become breathless or have a cough. Let your doctor know if this happens. They can give you medicines to help. Tell your doctor if your breathing gets worse.
Less common side effects of ipilimumabBack to top
Effects on the nerves
Ipilimumab can cause inflammation of the nerves that can sometimes cause very serious problems.
If you have unusual weakness in your arms, legs or face, or have tingling in your hands or feet contact the hospital straight away.
Severe tummy pain
Rarely, ipilimumab can cause a hole (perforation) in the bowel, which can be very serious. Contact your doctor immediately if you have severe pain in the tummy or sickness and vomiting. It’s also very important to let them know if you have bleeding from the back passage, black stools, are vomiting up blood or have vomit that looks like coffee grounds.
Effects on hormone levels
Ipilimumab can cause inflammation of some glands that make hormones. Glands that may be affected include the pituitary gland, adrenal glands, and thyroid gland. If a gland is affected you may not have enough of the hormone that gland makes. Changes to hormone levels are often picked up with a blood test before you have symptoms.
Tell your doctor if you have any of the following:
- headaches that don’t go away
- extreme tiredness or sleepiness
- feeling cold
- weight gain
- feeling dizzy or faint
- changes in behaviour or mood, such as irritability or feeling confused.
Bruising and bleeding
This drug can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any bruising or bleeding you can’t explain. This includes nosebleeds, bleeding gums, blood spots or rashes on the skin.
Changes in the way the kidneys work
Ipilimumab can affect how your kidneys work. You will have blood tests before and during treatment to check how your kidneys are working. Your nurse will ask you to drink plenty of fluid. This helps protect your kidneys. Tell your nurse if there are any changes in how much urine you are passing.
It is important to tell your doctor or nurse straight away if you feel ill or have severe side effects. This includes any we don’t mention here.
Other information about ipilimumabBack to top
Ipilimumab may affect your ability to drive. Don't drive if you are dizzy, have blurred vision or feel very tired. Talk to your doctor if you have any concerns.
Some medicines, including those you can buy in a shop or chemist, can be harmful to take while you are having ipilimumab. Tell your doctor about any medicines you are taking, including ones you can buy for yourself, complementary therapies and herbal drugs.
Your doctor will advise you not to become pregnant or father a child while taking ipilimumab as not enough is known about its effect on the developing baby. It’s important to use effective contraception while having this drug. You can discuss this with your doctor or specialist nurse.
There is a potential risk that ipilimumab may be present in breast milk, so women are advised not to breastfeed during treatment with ipilimumab.
Doctors don’t yet know how ipilimumab may affect the fertility of men and women. If you are worried about this, talk to your doctor before treatment starts.
Medical or dental treatment
If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses that you are having ipilimumab or have had previous treatment with it. Tell them the name of your cancer doctor so they can ask for advice.
Always tell your dentist if you are having ipilimumab.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (eMC; medicines.org.uk). If you’d like further information on the sources we use, please feel free to contact us.
This information was reviewed by a medical professional.
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