ipilimumab at a glance
Medicine class
CTLA-4 immune-checkpoint inhibitor
Administration
Intravenous infusion in a hospital or clinic
Important safety point
Immune-related inflammation can affect almost any organ and may begin after treatment stops
Monitoring
Blood tests and symptom checks are needed throughout treatment
What is ipilimumab used for?
Licensed uses for the selected product include:
Advanced melanoma in adults and adolescents aged 12 years and over, alone or with nivolumab
First-line treatment with nivolumab for intermediate- or poor-risk advanced renal cell carcinoma in adults
First-line treatment with nivolumab and platinum-based chemotherapy for metastatic non-small cell lung cancer without sensitising EGFR mutation or ALK translocation
First-line treatment with nivolumab for unresectable malignant pleural mesothelioma in adults
With nivolumab for unresectable or metastatic dMMR or MSI-H colorectal cancer, including after previous fluoropyrimidine-based combination chemotherapy
First-line treatment with nivolumab for specified unresectable advanced, recurrent or metastatic oesophageal squamous cell carcinoma
First-line treatment with nivolumab for unresectable or advanced hepatocellular carcinoma in adults
How does ipilimumab work?
CTLA-4 normally applies a brake to T-cell activation. Ipilimumab blocks this checkpoint, increasing antitumour T-cell activity and potentially reducing regulatory T-cell suppression within tumours. This immune activation can also inflame healthy tissues.
ipilimumab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 5 mg/mL
How to take ipilimumab
Ipilimumab is prepared and infused into a vein by trained staff in a hospital or clinic. It is not taken by mouth or given as an intravenous push. Attend planned blood tests and reviews, report new symptoms promptly and carry the supplied patient-alert card. Food does not affect an intravenous infusion.
Tell the team about autoimmune disease, previous lung inflammation, transplant history, infections and all medicines before treatment.
During combination therapy, the component medicines are prepared and infused separately.
Do not start remedies for suspected immune-related symptoms without checking with the cancer team.
ipilimumab side effects
Common or expected effects
- Tiredness or weakness
- Diarrhoea, nausea, vomiting, abdominal pain or reduced appetite
- Rash or itching
- Muscle or joint pain
- Headache
- Fever or swelling
- Cough or shortness of breath
- Changes in thyroid function or blood-test results
Get urgent medical advice
- Bowel inflammation, sometimes with bleeding or perforation
- Liver inflammation or failure
- Lung inflammation
- Kidney inflammation or dysfunction
- Hormone-gland inflammation, including thyroid, pituitary or adrenal problems and diabetes
- Severe skin reactions, including blistering or peeling
- Heart or muscle inflammation and marked muscle weakness
- Neurological or eye inflammation
- Severe infusion or allergic reactions
ipilimumab in pregnancy
Human pregnancy data are lacking, and placental transfer of this IgG1 antibody is expected. Ipilimumab is not recommended during pregnancy, or without effective contraception when pregnancy is possible, unless the specialist judges that the potential benefit outweighs the fetal risk. Tell the oncology team immediately about pregnancy or plans to conceive.
ipilimumab while breastfeeding
It is unknown whether ipilimumab enters human milk. Because adverse effects in a breastfed child cannot be excluded, the specialist and patient must decide whether to stop breastfeeding or stop ipilimumab, considering the importance of each.
ipilimumab interactions
Ipilimumab is not metabolised through cytochrome P450 pathways, but important interactions and treatment-sequence concerns remain.
Systemic corticosteroids or other immunosuppressants
Baseline use may interfere with antitumour immune activity. These medicines may nevertheless be required after treatment begins to manage immune-related toxicity.
Anticoagulants
They may add to the risk of gastrointestinal bleeding, requiring closer monitoring.
Vemurafenib
Concurrent use is not recommended because liver toxicity increased. Previous vemurafenib may also increase severe skin reactions.
Common questions about ipilimumab
Answers are fully visible for fast scanning and source review.
Is ipilimumab chemotherapy?
No. It is an immune-checkpoint inhibitor and monoclonal-antibody immunotherapy. It may be used alongside chemotherapy for some cancers.
Is ipilimumab the same as Yervoy?
Yervoy is the brand name of the selected ipilimumab product.
Is ipilimumab always given with nivolumab?
No. It is licensed alone or with nivolumab for advanced melanoma; its other selected indications use it in combination therapy.
How is ipilimumab given?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.