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Tips to Help With Your Treatment With KEYTRUDA® (pembrolizumab) and LENVIMA® (lenvatinib)

Tips to help with your treatment

Quick Tips to Help You Before and During Treatment With KEYTRUDA® (pembrolizumab) and LENVIMA® (lenvatinib)

Quick tips to help you before and during treatment

While everyone’s experience may differ, the tips below may be helpful. For more tips, talk to your health care team.

Before treatment: What to tell your doctor

Are you and your doctor considering KEYTRUDA + LENVIMA? As you talk through your treatment options, be sure to discuss the information below.

Before you receive KEYTRUDA, tell your doctor if you:

  • have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus
  • have received an organ transplant
  • have received or plan to receive a stem cell transplant that uses donor stem cells (allogeneic)
  • have received radiation treatment to your chest area
  • have a condition that affects your nervous system, such as myasthenia gravis or Guillain-Barré syndrome
  • are pregnant or plan to become pregnant
    • KEYTRUDA can harm your unborn baby.
    • Females who are able to become pregnant:

    • Your health care provider will give you a pregnancy test before you start treatment with KEYTRUDA.
    • You should use an effective method of birth control during and for at least 4 months after the final dose of KEYTRUDA. Talk to your health care provider about birth control methods that you can use during this time.
    • Tell your health care provider right away if you think you may be pregnant or if you become pregnant during treatment with KEYTRUDA.
  • are breastfeeding or plan to breastfeed.
    • It is not known if KEYTRUDA passes into your breast milk.
    • Do not breastfeed during treatment with KEYTRUDA and for 4 months after your final dose of KEYTRUDA.

Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Before you take LENVIMA, tell your health care provider about all of your medical conditions, including if you:

  • have high blood pressure
  • have heart problems
  • have a history of blood clots in your arteries (type of blood vessel), including stroke, heart attack, or change in vision
  • have or have had kidney or liver problems
  • have a history of a tear (perforation) in your stomach or intestine, or an abnormal connection between two parts of your gastrointestinal tract (fistula)
  • have headaches, seizures, or vision problems
  • have any bleeding problems
  • plan to have surgery, a dental procedure, or have had a recent surgery. You should stop taking LENVIMA at least 1 week before planned surgery. See the possible Side Effects of LENVIMA.
  • are pregnant or plan to become pregnant. LENVIMA can harm your unborn baby.

    Females who are able to become pregnant:

    • Your health care provider should do a pregnancy test before you start treatment with LENVIMA.
    • You should use an effective method of birth control during treatment with LENVIMA and for at least 30 days after the last dose of LENVIMA. Talk with your health care provider about birth control methods you can use during this time. Tell your health care provider right away if you become pregnant or think you are pregnant during treatment with LENVIMA.
  • are breastfeeding or plan to breastfeed. It is not known if LENVIMA passes into your breast milk. Do not breastfeed during treatment with LENVIMA and for at least 1 week after the last dose.

Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Especially tell your health care provider if you are taking, or have taken, an osteoporosis medicine.

Know the medicines you take. Keep a list of your medicines to show to your health care provider and pharmacist when you get a new medicine.

During treatment: Let your doctor know how you’re feeling

Communicate With Your Doctor

Communicate with your doctor

It’s important to always talk to your doctor about how you are feeling throughout treatment—even in between visits if you are feeling something out of the ordinary. The conversation can give them helpful insight on how your treatment is working.

Monitor Your Blood Pressure

Monitor your blood pressure

Some people taking KEYTRUDA + LENVIMA developed high blood pressure. It is important to regularly monitor your blood pressure. Talk to your doctor about how best to monitor your blood pressure. Tell your doctor immediately if your blood pressure levels are high.

These tips may help manage blood pressure:

  • Get your blood pressure checked regularly. Some people find it helpful to use a blood pressure monitor at home
  • Eat a healthy diet with plenty of whole grains, and try to limit sodium and alcohol
  • Exercise lightly
  • If you’re a smoker, consider quitting
Manage Diarrhea and Nausea

Manage diarrhea and nausea

If you experience diarrhea and/or nausea, tell your health care provider right away. Your doctor may recommend these tips:

For mild diarrhea:

  • Eat easy-to-digest foods like applesauce, bananas, toast, and rice
  • Avoid caffeine, alcohol, dairy, fat, fiber, orange juice, prune juice, and spicy foods
  • Drink lots of water and other clear liquids. Eat small, frequent meals
  • Always ask your health care team for more tips on what to do about diarrhea

For nausea:

  • Instead of 3 large meals a day, eat 6 to 8 snacks
  • Eat dry foods such as crackers or dry cereal
  • Avoid hot, spicy foods and stay away from foods that are overly sweet or greasy
  • Drink or sip clear liquids frequently
  • Ask your health care team about other ways you may be able to handle nausea

This is not a complete list of side effects you may experience while taking KEYTRUDA in combination with LENVIMA. Please see the side effects page of this website and the Patient Information for LENVIMA for more information.

Healthy tips: Take an active role in your health care

Eat Healthy Foods

Eat healthy foods

Nutrition is important for everyone. But if you are receiving treatment, there are even more reasons to eat regularly and make sure you are following a healthy diet. When you eat well, it may give you more strength. Your health care team may have more suggestions for how to eat healthier.

  • Eat at least 2 ½ cups of fruits and vegetables daily
  • Limit high-fat foods such as those from animal sources
  • Keep different types of protein-rich snacks on hand, such as low-fat yogurt or hearty soup
  • Avoid salty foods

Be sure to talk to your doctor first before making any dietary changes.

Try to Stay Active

Try to stay active

When you are receiving treatment, you may not always feel your best. However, exercise may help lessen some of your symptoms. Before you start a new exercise program, talk to your health care team.

  • Talk to your health care team about your goals
  • Start slowly with an activity such as walking, especially if you haven’t been active for a while
  • Try short periods of exercise. Rest often and drink lots of water
  • Have fun by doing the things you enjoy
  • Speak with your health care team about trying something different. And always remember to speak with your health care team before making any additions or changes to your exercise routine
Get Proper Rest

Get proper rest

Getting a good night’s sleep is important during treatment. Additionally, if you’re able to take short naps during the day, the extra rest may help.

Potential Adjustments to Your Treatment Dose

About your treatment dose

For LENVIMA:

Based on your conversations with your health care team, your doctor may need to adjust your medication, stop treatment for some time, or completely stop treatment with LENVIMA if you have side effects. Do not make any changes to your dose or medication without talking to your doctor first.

For KEYTRUDA:

Always talk to your doctor if you are feeling something new or different so he/she can make any potential changes to your treatment plan.

FDA-Approved Indication

KEYTRUDA and LENVIMA are prescription medicines used together to treat a kind of uterine cancer called endometrial carcinoma:

  • when your tumor is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR), and
  • you have received anti-cancer treatment, and it is no longer working, and
  • your cancer cannot be cured by surgery or radiation (advanced endometrial carcinoma).

It is not known if LENVIMA is safe and effective in children.

Important Safety Information for KEYTRUDA® (pembrolizumab)

KEYTRUDA is a medicine that may treat certain cancers by working with your immune system. KEYTRUDA can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These problems can sometimes become severe or life-threatening and can lead to death. You can have more than one of these problems at the same time. These problems may happen any time during treatment or even after your treatment has ended.

Call or see your health care provider right away if you develop any signs or symptoms of the following problems or if they get worse. These are not all of the signs and symptoms of immune system problems that can happen with KEYTRUDA:

Lung problems: cough, shortness of breath, or chest pain.

Intestinal problems: diarrhea (loose stools) or more frequent bowel movements than usual; stools that are black, tarry, sticky, or have blood or mucus; or severe stomach-area (abdomen) pain or tenderness.

Liver problems: yellowing of your skin or the whites of your eyes; severe nausea or vomiting; pain on the right side of your stomach area (abdomen); dark urine (tea colored); or bleeding or bruising more easily than normal.

Hormone gland problems: headaches that will not go away or unusual headaches; eye sensitivity to light; eye problems; rapid heartbeat; increased sweating; extreme tiredness; weight gain or weight loss; feeling more hungry or thirsty than usual; urinating more often than usual; hair loss; feeling cold; constipation; your voice gets deeper; dizziness or fainting; changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness.

Kidney problems: decrease in the amount of your urine; blood in your urine; swelling of your ankles; loss of appetite.

Skin problems: rash; itching; skin blistering or peeling; painful sores or ulcers in your mouth or in your nose, throat, or genital area; fever or flu-like symptoms; swollen lymph nodes.

Problems can also happen in other organs and tissues. Signs and symptoms of these problems may include: chest pain; irregular heartbeat; shortness of breath; swelling of ankles; confusion; sleepiness; memory problems; changes in mood or behavior; stiff neck; balance problems; tingling or numbness of the arms or legs; double vision; blurry vision; sensitivity to light; eye pain; changes in eyesight; persistent or severe muscle pain or weakness; muscle cramps; low red blood cells; bruising.

Infusion reactions that can sometimes be severe or life-threatening. Signs and symptoms of infusion reactions may include chills or shaking, itching or rash, flushing, shortness of breath or wheezing, dizziness, feeling like passing out, fever, and back pain.

Rejection of a transplanted organ. Your health care provider should tell you what signs and symptoms you should report and they will monitor you, depending on the type of organ transplant that you have had.

Complications, including graft-versus-host disease (GVHD), in people who have received a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic). These complications can be serious and can lead to death. These complications may happen if you underwent transplantation either before or after being treated with KEYTRUDA. Your health care provider will monitor you for these complications.

Getting medical treatment right away may help keep these problems from becoming more serious. Your health care provider will check you for these problems during treatment with KEYTRUDA. They may treat you with corticosteroid or hormone replacement medicines. They may also need to delay or completely stop treatment with KEYTRUDA if you have severe side effects.

Before you receive KEYTRUDA, tell your health care provider if you have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus; have had an organ transplant or have had or plan to have a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic); have had radiation treatment in your chest area; have a condition that affects your nervous system, such as myasthenia gravis or Guillain-Barré syndrome.

If you are pregnant or plan to become pregnant, tell your health care provider. KEYTRUDA can harm your unborn baby. If you are able to become pregnant, you will be given a pregnancy test before you start treatment. Use effective birth control during treatment and for at least 4 months after your final dose of KEYTRUDA. Tell them right away if you think you may be pregnant or you become pregnant during treatment with KEYTRUDA.

Tell your health care provider if you are breastfeeding or plan to breastfeed. It is not known if KEYTRUDA passes into your breast milk. Do not breastfeed during treatment with KEYTRUDA and for 4 months after your final dose of KEYTRUDA.

Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Common side effects of KEYTRUDA when given with LENVIMA include low levels of thyroid hormone; high blood pressure; feeling tired; diarrhea; joint and muscle pain; nausea; decreased appetite; vomiting; mouth sores; weight loss; stomach-area (abdominal) pain; urinary tract infection; protein in your urine; constipation; headache; bleeding; blisters or rash on the palms of your hands and soles of your feet; hoarseness; rash; liver problems; and kidney problems.

These are not all the possible side effects of KEYTRUDA. Talk to your health care provider for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please read the accompanying Medication Guide for KEYTRUDA and discuss it with your doctor. The physician Prescribing Information also is available.

Important Safety Information for LENVIMA® (lenvatinib)

LENVIMA may cause serious side effects, including:

High blood pressure (hypertension): High blood pressure is a common side effect of LENVIMA and can be serious. Your blood pressure should be well controlled before you start taking LENVIMA. Your healthcare provider should check your blood pressure regularly during treatment with LENVIMA. If you develop blood pressure problems, your healthcare provider may prescribe medicine to treat your high blood pressure.

Heart problems: LENVIMA can cause serious heart problems that may lead to death. Call your healthcare provider right away if you get symptoms of heart problems, such as shortness of breath or swelling of your ankles.

Problem with blood clots in your blood vessels (arteries): Get emergency medical help right away if you get any of the following symptoms: severe chest pain or pressure; pain in your arms, back, neck, or jaw; shortness of breath; numbness or weakness on one side of your body; trouble talking; sudden severe headache; sudden vision changes.

Liver problems: LENVIMA may cause liver problems that may lead to liver failure and death. Your healthcare provider will check your liver function before and during treatment with LENVIMA. Tell your healthcare provider right away if you have any of the following symptoms: your skin or the white part of your eyes turns yellow (jaundice); dark “tea-colored” urine; light-colored bowel movements (stools); feeling drowsy, confused or loss of consciousness.

Kidney problems: Kidney failure, which can lead to death, has happened with LENVIMA treatment. Your healthcare provider should do regular blood tests to check your kidneys.

Increased protein in your urine (proteinuria): Proteinuria is a common side effect of LENVIMA and can be serious. Your healthcare provider should check your urine for protein before and during your treatment with LENVIMA.

Diarrhea: Diarrhea is a common side effect of LENVIMA and can be serious. If you get diarrhea, ask your healthcare provider about what medicines you can take to treat your diarrhea. It is important to drink more water when you get diarrhea. Tell your healthcare provider or go to the emergency room, if you are unable to drink enough liquids and your diarrhea is not able to be controlled.

An opening in the wall of your stomach or intestines (perforation) or an abnormal connection between two or more body parts (fistula): Get emergency medical help right away if you have severe stomach (abdomen) pain.

Changes in the electrical activity of your heart called QT prolongation: QT prolongation can cause irregular heartbeats that can be life threatening. Your healthcare provider will do blood tests before and during your treatment with LENVIMA to check the levels of potassium, magnesium, and calcium in your blood, and may check the electrical activity of your heart with an ECG.

Low levels of blood calcium (hypocalcemia): Your healthcare provider will check your blood calcium levels during treatment with LENVIMA and may tell you to take a calcium supplement if your calcium levels are low.

A condition called Reversible Posterior Leukoencephalopathy Syndrome (RPLS): Call your healthcare provider right away if you get severe headache, seizures, weakness, confusion, or blindness or change in vision.

Bleeding: LENVIMA may cause serious bleeding problems that may lead to death. Tell your healthcare provider if you have any signs or symptoms of bleeding during treatment with LENVIMA, including severe and persistent nose bleeds; vomiting blood; red or black (looks like tar) stools; blood in your urine; coughing up blood or blood clots; heavy or new onset vaginal bleeding.

Change in thyroid hormone levels: Your healthcare provider should check your thyroid hormone levels before starting and every month during treatment with LENVIMA.

Wound healing problems: Wound healing problems have happened in some people who take LENVIMA. Tell your healthcare provider if you plan to have any surgery before or during treatment with LENVIMA.

  • You should stop taking LENVIMA at least 1 week before planned surgery.
  • Your healthcare provider should tell you when you may start taking LENVIMA again after surgery.

Severe jaw bone problems (osteonecrosis): Severe jaw bone problems have happened in some people who take LENVIMA. Certain risk factors such as taking a bisphosphonate medicine or the medicine denosumab, having dental disease, or an invasive dental procedure may increase your risk of getting jaw bone problems. Your healthcare provider should examine your mouth before you start and during treatment with LENVIMA. Tell your dentist that you are taking LENVIMA. It is important for you to practice good mouth care during treatment with LENVIMA. Tell your healthcare provider right away if you have any signs or symptoms of jaw bone problems during treatment with LENVIMA, including jaw pain, toothache, or sores on your gums, and if you plan to have any dental procedures before or during treatment with LENVIMA.

  • You should stop taking LENVIMA at least 1 week before planned dental surgery or invasive dental procedures.
  • Your healthcare provider should tell you when you may start taking LENVIMA again after dental procedures.

The most common side effects of LENVIMA when given with KEYTRUDA include decrease in thyroid hormone levels, increased blood pressure, tiredness, diarrhea, joint and muscle pain, nausea, decreased appetite, vomiting, mouth sores, weight loss, stomach-area (abdomen) pain, urinary tract infection, protein in your urine, constipation, headache, bleeding, rash, redness, itching, or peeling of your skin on your hands and feet, hoarseness, and rash.

LENVIMA may cause fertility problems in males and females and can harm your unborn baby. Tell your healthcare provider if you are:

  • pregnant or plan to become pregnant. For females who are able to become pregnant, your healthcare provider should do a pregnancy test before you start treatment with LENVIMA. Use an effective method of birth control during treatment with LENVIMA and for at least 30 days after the last dose of LENVIMA
  • breastfeeding or plan to breastfeed. It is not known if LENVIMA passes into your breast milk. Do not breastfeed during treatment with LENVIMA and for at least 1 week after the last dose

Your healthcare provider may need to reduce your dose of LENVIMA, or delay or completely stop treatment if you have certain side effects.

These are not all the possible side effects of LENVIMA. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please read the accompanying Patient Information for LENVIMA and discuss it with your doctor. The physician Prescribing Information also is available.