Side effects of Brentuximab (Adcetris)
Find out about the side effects of the biological therapy 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.
Common side effects
Each of these effects happens in more than 1 in 10 people (10%). You might have one or more of them.
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.
Sickness is most likely to start within 24 hours of the treatment. It is usually well controlled with anti sickness tablets and injections. Tell your doctor or nurse if you still have sickness as there are other medicines you can have.
This happens in around 4 out of 10 people (40%) taking brentuximab.
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.
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.
Around 3 out of 10 people (30%) will have diarrhoea with this drug.
You might get a high temperature and chills.
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.
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.
Signs of an infection include headaches, aching muscles, a cough, a sore throat, pain passing urine, or feeling cold and shivery.
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.
Some people can have a severe allergic reaction, with wheezing, an itchy rash and a drop in blood pressure.
Let your doctor or nurse know if you have headaches. They can give you painkillers such as paracetamol to help.
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.
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 loose their appetite with this drug.
Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Men
You may be able to store sperm before starting treatment.
It can take a few months or sometimes years for fertility to return to normal. You can have sperm counts to check your fertility when your treatment is over. Ask your doctor about it.
Women
This drug can cause an early menopause. This stops you from being able to become pregnant in the future. Talk to your doctor about this before your treatment. It’s sometimes possible to store eggs or embryos before treatment.
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.
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.
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 way your liver is working.
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.
This drug might make you feel dizzy. 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.
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.
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.
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.
