This page tells you about the biological therapy drug temsirolimus and its side effects. There are sections about
Temsirolimus is pronounced tem-sir-oh-li-mus. It is also known by its brand name Torisel. Temsirolimus is a treatment for advanced kidney cancer and for mantle cell lymphoma.
Temsirolimus is a type of biological therapy drug treatment called an mTOR inhibitor. It blocks the effects of a particular protein called mTOR that is often over active in cancer cells and makes the cells divide and grow.
Temsirolimus also stops the cancer from making blood vessels, which the cells need to be able to grow. It is called an anti angiogenesis treatment. So temsirolimus helps to stop the cancer growing or may slow the growth.
Temsirolimus is a colourless or pale yellow liquid that you have into your bloodstream (intravenously). It takes between 30 and 60 minutes. You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.
You can read our information about having cancer drugs into a vein.
For kidney cancer you have temsirolimus once a week.
For mantle cell lymphoma you have the drug once a week for 3 weeks followed by weekly doses.
You have an anti histamine drug before each dose. You usually carry on having temsirolimus for as long as it works, unless the side effects get severe. If you take any other medicines you need to tell your doctor before starting temsirolimus treatment.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
We've listed the side effects associated with temsirolimus below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
The side effects may be different if you are having temsirolimus with other drugs.
Tell your doctor or nurse straight away if any of the side effects get severe.
More than 10 in every 100 people have one or more of the side effects listed below.
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae)
- Skin changes – about 4 out of 10 people (40%) have a rash or red, dry, itchy skin. Tell your doctor or nurse if you get a rash
- Feeling or being sick happens in about 4 out of every 10 people (40%). It is usually well controlled with anti sickness medicines
- Build up of fluid happens in just over a third of people (35%) and is usually mild but can be uncomfortable
- Shortness of breath occurs in 3 out of 10 people (30%)
- Poor appetite happens in about 3 out of 10 people (30%)
- A sore mouth or mouth ulcers occurs in about 3 out of 10 people (30%)
- Taste changes
- Diarrhoea affects 1 out of 4 people (25%) – drink plenty of fluids. Tell your doctor or nurse if it becomes severe or continues for more than 3 days
- A rise in blood sugar levels happens in 1 in 4 people (25%) – tell your doctor or nurse if you feel thirsty and need to pass urine often. If you have diabetes you should check your blood sugar levels more regularly than usual. You may need to increase the amount of tablets or insulin you take
- Abdominal pain affects 1 in 5 people (20%)
- General feeling of weakness
- Low levels of potassium in your blood (hypokalaemia) – let your doctor or nurse know if you feel faint or have muscle weakness and cramps, or tingling and numbness
- Pain in the joints, muscles and back occurs in about 1 in 5 people (20%)
- Difficulty sleeping occurs in just over 1 in 10 people (10%)
- Kidney changes, which are unlikely to cause any symptoms may occur. This will almost certainly go back to normal after the treatment ends
- Feeling weak, a high temperature and chills
- Cholesterol levels in your blood may go up
- Constipation – drink plenty of fluids. Let your doctor or nurse know if you are constipated for more than 3 days as you can have laxatives to help
- Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
Between 1 and 10 in every 100 people have one or more of these.
- Feeling anxious, agitated or depressed
- An allergic reaction – tell your doctor or nurse straight away if you have a swollen face, lips or tongue, and breathlessness
- Numbness and tingling
- Sore, red eyes or watery eyes – your doctor or nurse can give you eye drops to help
- A bloated tummy (abdomen)
- Blood clots – let your doctor or nurse know straight away if you have any pain, redness or swelling in an area that feels warm to the touch
- Liver changes that are usually mild and unlikely to cause symptoms. The liver will almost certainly go back to normal when treatment is finished. Let your doctor or nurse know straight away if you have itching, yellow eyes or skin, dark urine, and pain in the upper right area of your stomach
- Raised blood pressure – if your blood pressure goes up you may need to take tablets to control it
- Severe redness, scaling and peeling of the skin occurs in 1 in 20 people (5%) – let your doctor or nurse know if you have this
- A runny nose
- A sore throat
- Low levels of calcium in the blood. This can cause painful muscle spasms and cramps, muscle twitching, or numbness or tingling in your feet and hands or around your mouth. Let your doctor or nurse know if you have this
- Sleepiness – don't drive or operate machinery if you feel sleepy
- Difficulty swallowing – let your doctor or nurse know if you have this
- Nail changes
- Long term lung changes – let your doctor or nurse know if you develop a cough or breathing problems
- Muscle pain
Fewer than 1 in 100 people have these effects.
- A split in the wall of the bowel (bowel perforation) – this is extremely rare but is a serious side effect if it happens. Let your doctor or nurse know straight away if you have sudden abdominal pain, a high temperature, are sick and have blood in your stools
- Fluid build up around the heart (pericardial effusion) – let your doctor or nurse know straight away if you have sudden chest pain or breathlessness
- A hoarse voice, caused by swelling of the voice box
- Blood clots in the lung – tell your doctor or nurse straight away if you have breathlessness, wheezing, chest pain, a faster heart beat, feel sick, or cough up blood
- Bleeding in the brain – let your doctor or nurse know straight away if you feel confused, very tired, have difficulty speaking or swallowing and your pupils are different sizes
- Kidney failure – let your doctor or nurse know straight away if you have breathlessness, tiredness, and swelling of the body due to fluid build up
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Do not breastfeed during this treatment because the drug may come through in the breast milk.
Don't have grapefruit or grapefruit juice
Avoid eating grapefruit or drinking grapefruit juice while having temsirolimus treatment as it may increase the level of the drug in the blood.
Torisel contains alcohol and can be harmful to people who drink alcohol or are alcoholic.
Slow wound healing
Temsirolimus can slow wound healing. If you need to have an operation your doctor will normally advise you to stop taking temsirolimus beforehand. They will let you know when you can start taking it again.
You should not have immunisations with live vaccines while you are having treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your treatment. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it. Tell the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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