When a patient is taking ipilimumab, what side effects do you tell the patients to watch for in particular and how do you prepare them?

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JeffreyWeberMDPhD (Physician - Oncology - Hematology/Oncology (Verified) ) - 07 / 01 / 2012

The key to management of side effects from ipilimumab is good communication between providers and patient. We tell patients to call for diarrhea more than one in a 24 hour period, for fevers of greater than 100.5 Fahrenheit, severe and profound fatigue, and any bloody bowel movements. We make clear what the spectrum of side effects is, starting with the rashes and itchiness that are most common, then describing the endocrine side effects generally presenting with fatigue, and finally the diarrhea and colitis, which are the most morbid side effects. All patients starting ipilimumab get a prescription for lomotil , and are told not to fill it until they speak with us on the phone if there is diarrhea. We also make it clear that any severe abdominal pain, nausea or vomiting or profound rash over 50% of the body or more merit a phone call.
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