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Side effects of brentuximab (Adcetris)

Find out about the side effects of the cancer treatment drug brentuximab. 

Tell your doctor or nurse if you have any side effects so they can help you manage them. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.

Contact your doctor or nurse immediately if any of your side effects get severe or if you have signs of infection, including a temperature above 37.5C.

The side effects may be different if you are having brentuximab with other cancer treatments.

Common side effects

Each of these effects happens in more than 1 in 10 people (10%). You might have one or more of them.

You may get pain in your muscles or back. Tell your doctor or nurse so they can give you painkillers and advice on what to do to help ease the pain.

Let your doctor or nurse know if you have headaches. They can give you painkillers such as paracetamol to help.

You might lose your appetite for various reasons when you are having cancer treatment. Sickness, taste changes or tiredness can all put you off food and drinks.

Tips

  • Eating several small meals and snacks throughout the day can be easier to manage.
  • Ask your doctor or nurse to recommend high calorie drinks to sip between treatments, if you are worried about losing weight.
  • You can make up calories between treatments for the days when you really don’t feel like eating.
  • Drink plenty of fluids even if you can't eat.
  • Don't fill your stomach with a large amount of liquid before eating.
  • Try to eat high calorie foods to keep your weight up.

Around 1 in 10 people (10%) will lose their appetite with this drug. 

You may feel short of breath or develop inflammation of the lungs (pneumonia).

Tell your doctor or nurse immediately if you have any difficulty breathing.

A small number of people have an allergic reaction while having this treatment. 

Tell your doctor or nurse immediately if you have any of these symptoms: 

  • a rash
  • shortness of breath
  • redness or swelling of the face
  • feeling hot
  • dizziness
  • a sudden need to pass urine

Signs of an infection include headaches, aching muscles, a cough, a sore throat, pain passing urine, or feeling cold and shivery.

Contact your treatment centre straight away if you have any of these signs or if your temperature goes above 37.5C. Severe infections can be life threatening.

Cancer drugs can reduce the number of white blood cells in the blood. This increases your risk of infections. White blood cells help fight infections.

Your white blood cell level begins to fall after each treatment. Then it gradually goes up again.

When the level is very low it is called neutropenia (pronounced new-troh-pee-nee-ah).

You have antibiotics if you develop an infection. You might have them as tablets or as injections into the bloodstream (intravenously). To have them into your bloodstream you need to go into hospital.

Constipation is easier to sort out if you treat it early. Drink plenty of fluids and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking.

Tell your doctor or nurse if you are constipated for more than 3 days. They can prescribe a laxative.

Constipation happens in just under 2 out of 10 people (20%) taking this drug. 

You might feel very tired during your treatment. It might take 6 months to a year for your energy levels to get back to normal after the treatment ends. A low red blood cell count will also make you feel tired.

You can do things to help yourself, including some gentle exercise. It’s important not to push yourself too hard. Try to eat a well balanced diet.

Talk to your doctor or nurse if you are finding the tiredness difficult to manage.

Fatigue affects 4 out of 10 people (40%) taking brentuximab. 

Feeling or being sick

You might feel sick or be sick. Anti sickness injections and tablets can control it. Tell your doctor or nurse if you feel sick. You might need to try different anti sickness medicines to find one that works.

Tips 

  • Avoid eating or preparing food when you feel sick.
  • Avoid hot fried foods, fatty foods or foods with a strong smell.
  • Eat several small meals and snacks each day.
  • Relaxation techniques help control sickness for some people.
  • Ginger can help – try it as crystallised stem ginger, ginger tea or ginger ale.
  • Try fizzy drinks.
  • Sip high calorie drinks if you can’t eat.

This happens in around 4 out of 10 people (40%) taking brentuximab. 

Tell your doctor or nurse if you have diarrhoea. They can prescribe medicine to help you. 

Drink at least 2.5 litres of fluid a day. This helps to keep you hydrated.

Ask your nurse about soothing creams to apply around your back passage (rectum). The skin in that area can get very sore and even break if you have severe diarrhoea.

Contact your doctor or nurse immediately if you have diarrhoea 4 or more times a day, or any diarrhoea at night.

Around 3 out of 10 people (30%) will have diarrhoea with this drug. 

You might get a high temperature and chills. 

Contact your doctor or nurse straight away if you feel unwell or have a temperature of 38C or more.

A rash can also be itchy. Tell your doctor or nurse if you have a skin rash. They can prescribe medicine to stop the itching and soothe your skin.

You may have a rash similar to acne on your face, neck and trunk.  A skin reaction happens in 1 out of 4 people (25%) taking brentuximab. 
 

Numbness or tingling in fingers and toes can make it difficult to do fiddly things such as doing up buttons. This starts within a few days or weeks and can last for a few months. Rarely, the numbness may be permanent.

Tips

  • Keep your hands and feet warm.
  • Wear well fitting, protective shoes.
  • Take care when using hot water as you may not be able to feel how hot it is and could burn yourself.
  • Use oven gloves when cooking and protective gloves when gardening.
  • Moisturise your skin at least a couple of times a day.
  • Take care when cutting your nails.

This happens in around 4 out of 10 people (40%) taking brentuximab. 

Occasional side effects

Each of these effects happens in more than 1 in 100 people (1%). You might have one or more of them.

Cancer treatment can cause the level of red blood cells to fall (anaemia). This makes you breathless and look pale.

Red blood cells contain haemoglobin, which carries oxygen around the body. When the level of red blood cells is low you have less oxygen going to your cells.

You can also feel tired and depressed when your blood count is low and feel better once it is back to normal. The levels can rise and fall during your treatment. So it can feel like you are on an emotional and physical roller coaster.

You have regular blood tests to check your red blood cell levels. You might need a blood transfusion if the level is very low. After a transfusion, you will be less breathless and less pale.

Tell your doctor or nurse if you feel breathless.

You might notice you:

  • bruise more easily
  • have nosebleeds
  • have bleeding gums when you brush your teeth

This is due to a drop in the number of platelets that help clot your blood.

If your platelets get very low you may have lots of tiny red spots or bruises on your arms or legs called petechiae.

Tell your doctor or nurse straight away if you have petechiae.

You'll have a platelet transfusion if your platelet count is very low. It is a drip of a clear fluid containing platelets. It takes about 15 to 30 minutes. The new platelets start to work right away. 

You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the levels of chemicals produced by the liver.

Your hair may thin. It usually begins falling out gradually within 2 to 3 weeks after treatment starts.

Your hair grows back once your treatment has finished. This can take several months and your hair is likely to be softer.

Tips

  • Use gentle hair products such as baby shampoos.
  • Don't use perms or hair colours on thinning hair.
  • Use a soft baby brush and comb thinning hair gently.
  • Pat your hair dry gently rather than rubbing.
  • Avoid using hair dryers, curling tongs and curlers.

You have regular blood and urine tests to check this. If you have diabetes you may need to check your blood sugar levels more often than usual. 

Don’t drive or operate machinery if you have this.

It is important to tell your doctor or nurse if you have a cough, or are breathless.

Tell your doctor or nurse if you notice this. It can also be painful. 

Rare side effects

Each of these effects happens in fewer than 1 in 100 people (1%). You might have one or more of them.

This is called Stevens-Johnson syndrome. Your skin may become very painful and red. This may spread. 

The top layer of your skin may peel off. Or you may have blisters. Most people who have this reaction need to stop the treatment permanently and go into hospital to control the symptoms.  

Contact your doctor or nurse straight away if you have this

High uric acid levels in the blood are due to the breakdown of tumour cells (tumour lysis syndrome). You will have regular blood tests to check your uric acid levels and may have a tablet called allopurinol to take. Drinking plenty of fluids helps to flush out the excess uric acid.

This viral infection can cause damage to areas of the brain. Symptoms include confusion, difficulty thinking, memory loss, eyesight changes, weakness, loss of control or sensation in an arm or leg, difficulty walking, or loss of balance. 

This condition can be very serious and even life threatening. Let your doctor or nurse know straight away if you have any of these changes.

Your family or carers should also look out for these changes. It is called progressive multifocal leukoencephalopathy (PML). 

About brentuximab

More information about this treatment

We haven't listed all the very rare side effects of this treatment. For further information see the electronic Medicines Compendium (eMC) website.

You can report any side effect you have that isn’t listed here to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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