Tremelimumab - Intravenous

Tremelimumab is used together with other medicines to treat certain types of liver and lung cancer.

This medicine is used for individuals whose tumours cannot be removed by surgery or may have spread to other parts of the body.

Tremelimumab injection is to be given intravenously (into the vein) as an infusion. It is delivered directly into the bloodstream via the blood vessel.

Your doctor or nurse will administer the injection for you.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of treatment depending on the type and severity of your condition and your response to the medication.

Ensure that you keep all appointments with your doctor so that you do not miss any doses. Your doctor also needs to regularly monitor your response to Tremelimumab.

If you miss an appointment or miss an injection, alert your doctor or nurse. A replacement appointment or injection should be given as soon as possible.

Do not breastfeed while you are being treated with Tremelimumab and for 3 months after your last dose.

Inform your doctor if you have myasthenia gravis (muscle weakness disorder).

Let your doctor know if you are pregnant.

It is important that you do not get pregnant while being treated with Tremelimumab. Women of childbearing potential must use proven birth control methods during therapy and for 3 months after stopping the treatment. You may wish to discuss birth control methods with your doctor or pharmacist.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Pregnancy tests and hepatitis B screening must be done before treatment to know if this medicine is suited for you to use.
• Routine tests (e.g. liver, kidney and thyroid function, levels of a certain hormone) may be done while you are being treated with Tremelimumab. Your doctor will advise you about how often you need to have these tests.
• Regular monitoring for signs and symptoms of severe side effects may also be needed.

Tremelimumab may cause any of the following side effects: diarrhoea, nausea, stomach pain, decreased appetite, difficulty sleeping, night sweats, and muscle pain.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• signs and symptoms of lung inflammation e.g. new or worsening cough, shortness of breath, chest pain
• signs and symptoms of liver problem e.g. yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
• signs and symptoms of infusion-related reactions e.g. fever, chills, dizziness, skin itching or rash, flushing, shortness of breath or wheezing
• signs and symptoms of heart problem e.g. chest pain or pressure, shortness of breath, irregular or abnormal heartbeat, swelling in the arms or legs
• pass out bloody or black as tar stools, severe diarrhoea, severe stomach cramps
• pain or difficulty in passing urine, change in how much urine is passed, blood in the urine
• fast breathing, unusual hunger or thirst, feeling sleepy, passing urine more often, fruity-smelling breath
• rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
• headache, fever, fits or seizures, sensitivity of the eyes to light, stiff neck, confusion
• persistent muscle or joint pain, muscle weakness, tingling or numbness of arms or legs
• behavioural or mood changes, severe headache, feeling cold, excessive sweating, weight gain or loss, hair loss, unusual tiredness, decreased sex drive
• eye pain or redness, changes in eyesight, severe eye irritation

This medicine may cause the level of your red blood cells, white blood cells and platelets to drop.

Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.

White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, cough, or flu that does not go away.

Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• anti-inflammatory medicines
• medicines used in organ transplants or certain immune disorders

This list does not include all medicines that may interact with Tremelimumab.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Store in the refrigerator, between 2-8°C. Do not allow Tremelimumab to freeze. If frozen, this medicine will become ineffective and should not be used.

Protect from light.

Medicines must not be used past the expiry date.