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Yervoy

ipilimumab
Used for Melanoma
Used for Melanoma

Yervoy (ipilimumab) is an immunotherapy medication that’s used to treat several different types of cancer, such as melanoma, non-small cell lung cancer, and renal cell cancer (a type of kidney cancer). It works by turning on your immune system to attack cancer cells. Yervoy (ipilimumab) is given as an injection into the vein (intravenously or IV) at an infusion center or provider’s office. It’s typically given together with another medication called Opdivo (nivolumab). Yervoy (ipilimumab) can cause immune-related side effects such as diarrhea, rash, and trouble breathing.

Reviewed by:
reviewer
Allison Baxley, PharmD, BCOP
reviewer
Cydnee Ng, PharmD
Last reviewed on September 20, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsAlternativesLatest newsReferencesPricesMedicare
basics-icon

What is Yervoy (ipilimumab)?

What is Yervoy (ipilimumab) used for?

How Yervoy (ipilimumab) works

Your immune system plays an important role in our body (for example, to fight bacterial infections). The immune system can also help attack and kill cancer cells that it recognizes as abnormal. Some cancer cells can hide from the immune system by using the CTLA-4 pathway. When a cancer cell uses the CTLA-4 pathway, it stops our immune cells from attacking the cancer cell. This allows the cancer to grow.

Yervoy (ipilimumab) is an immunotherapy medication that blocks the CTLA-4 pathway; it’s known as a CTLA-4 inhibitor. By blocking this pathway, the medication helps the immune system recognize and attack cancer cells. As a result, the immune system can kill the cancer cells and stop the cancer from growing.

Drug Facts

Common BrandsYervoy
Drug ClassCTLA-4 inhibitor
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

More on Yervoy (ipilimumab) essentials

Health: Immunotherapy: GettyImages 1329352527

What Are Opdivo and Yervoy — and Why Are They Taken Together?

Written by Sonja Jacobsen, PharmD, BCPS, BCOP
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What are the side effects of Yervoy (ipilimumab)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

When used by itself:
  • Tiredness (up to 51%)
  • Rash (up to 50%)
  • Diarrhea (up to 49%)
  • Higher liver enzyme levels (up to 46%)
  • Itching (up to 45%)
  • Anemia (up to 41%)
  • Muscle pain (up to 36%)
  • Headache (up to 33%)
  • Weight loss (up to 32%)
  • Nausea (up to 31%)
  • Lower white blood cells (up to 29%)
  • Changes in blood sugar levels (up to 26%)
  • Lower appetite (up to 24%)
  • Cough (up to 22%)

Other Side Effects

  • Vomiting
  • Fever
  • Joint pain
  • Trouble breathing

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Serious immune-related side effects: rash, diarrhea, trouble breathing, severe stomach pain, chest pain
  • Serious reaction during infusion: itching, trouble breathing, fast heart beat, feeling warm or hot

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Bloody, black, or tarry stools

diarrhea

fever

heartburn

indigestion

itching, skin rash

nausea

severe stomach pain, cramping, or burning

unusual tiredness or weakness

vomiting

vomiting of material that looks like coffee grounds, severe and continuing

watery or bloody diarrhea

Less common

Blistering, crusting, irritation, itching, or reddening of the skin

bloody or cloudy urine

blurred vision or other changes in vision

burning, dry, or itching eyes

burning, tingling, numbness or pain in the hands, arms, feet, or legs

chest pain

chills

clay-colored stools

cough

cracked, dry, or scaly skin

dark urine

darkening of the skin

decreased appetite

decreased frequency or amount of urine

difficulty with breathing, chewing, swallowing, or talking

dizziness

double vision

drooping eyelids

drowsiness

eye discharge or excessive tearing

eye pain or sensitivity to light

fainting

headache, possibly severe

hives or welts

loss of appetite

mental depression

muscle weakness

pain, itching, burning, swelling, bleeding, or a lump under the skin where the needle was placed

painful or difficult urination

redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid

sensation of pins and needles

severe tiredness

sore throat

sores, ulcers, or white spots on the lips or in the mouth

stabbing pain

stomach tenderness

swelling of the face, feet, or lower legs

swollen glands

unusual bleeding or bruising

unusual weight gain

yellow eyes or skin

Rare

Anxiety

bloating

blue or pale skin

chest pain, possibly moving to the left arm, neck, or shoulder

confusion

constipation

difficulty with moving

fast heartbeat

general feeling of discomfort or illness

increased thirst

lower back or side pain

muscle pain or stiffness

muscle weakness

pain or burning in the throat

pain, swelling, or redness in the joints

pains in the stomach or side, possibly radiating to the back

skin irritation or rash, including rash that looks like psoriasis

sores, welts, or blisters on the skin

stiff neck or back

Incidence not known

Back, leg, or stomach pains

blistering, peeling, or loosening of the skin

bleeding gums

general body swelling

inability to move the arms and legs

joint or muscle pain

nosebleeds

red irritated eyes

red skin lesions, often with a purple center

throbbing pain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Headache

trouble sleeping

weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Yervoy (ipilimumab)

thumbs-up

Pros

Less likely to cause side effects that are common with traditional chemotherapy (such as nausea or hair loss)

Given every 3 to 12 weeks so it doesn’t require frequent infusion appointments

First-choice treatment for some people with melanoma skin cancer

thumbs-down

Cons

Might cause immune-related side effects like diarrhea, rash, and liver problems

Might require breaks from treatment and a corticosteroid to manage side effects

Given through an IV, which requires using a needle

pharmacist-tips

Pharmacist tips for Yervoy (ipilimumab)

pharmacist

  • Yervoy (ipilimumab) can cause immune-related side effects that can happen anywhere in your body. They can be signs that the medication made your immune system too active. Contact your provider right away if you have any new symptoms such as rash, diarrhea, trouble breathing, or severe fatigue.

    • Ask your provider before using any over-the-counter medications to treat any side effects you might have from Yervoy (ipilimumab). Side effects caused by immunotherapy medications like Yervoy (ipilimumab) usually need to be quickly treated with a corticosteroid such as prednisone. Other medications you might otherwise use, such as diphenhydramine (Benadryl) for rash, won’t work as well.

      • If you need to take a steroid like prednisone for a few weeks to help with any side effects, don’t stop taking the steroid medication suddenly because this can cause uncomfortable symptoms. When it’s time to stop the steroid medication, your provider will give you a plan to do so slowly and safely.

        • Make sure to get your lab work done as your provider instructs you to during treatment with Yervoy (ipilimumab). Lab work helps your provider check for possible immune-related side effects that might not cause symptoms, such as kidney, liver, or thyroid problems. Your provider will contact you and make a treatment plan if they detect any changes in your lab test results.

          • Yervoy (ipilimumab) can harm an unborn baby. If you’re able to have children, use reliable birth control while you’re getting treated with Yervoy (ipilimumab) and for 3 months after your last dose. Let your provider know if you become pregnant during or after treatment.

            faqs

            Frequently asked questions about Yervoy (ipilimumab)

            What does it mean that Yervoy (ipilimumab) is an immunotherapy medication?
            Yervoy (ipilimumab) is an immunotherapy medication, which means it works by telling the immune system to turn on or activate. Sometimes, cancer cells can find ways to hide from the immune system, which allows them to keep growing. Yervoy (ipilimumab) works to make sure the immune system stays turned on so immune cells can find and attack cancer cells.
            Why is Yervoy (ipilimumab) usually given with Opdivo (nivolumab)?
            Cancer cells use many different methods to hide from the immune system so they can keep growing. For example, certain cancer cells can use the CTLA-4 and PD-1 pathways to avoid detection from the immune system. As a result, the immune system doesn’t attack and kill these cancer cells. While Yervoy (ipilimumab) blocks the cancer cells from using the CTLA-4 pathway, some cancer cells might also use the PD-1 pathway to dodge attacks from the immune system. So, using a second medication like Opdivo (nivolumab) together with Yervoy (ipilimumab) helps block both pathways at the same time. The two medications work together to help the immune system attack and kill cancer cells better.
            What should I do if I have diarrhea while I’m taking Yervoy (ipilimumab)?
            Contact your provider right away if you have diarrhea, especially if you have at least 4 bowel movements more than what’s usual for you in one day. Diarrhea is a sign that the medication caused your immune system to become too active. Treatment for immune-related diarrhea is different from treatment for other types of diarrhea. So, it’s important that you don’t try to manage it at home with over-the-counter medications until you speak with your provider. Usually, treatment involves taking a corticosteroid like prednisone and a break from Yervoy (ipilimumab). Remember to stay hydrated, eat bland foods like apples and bread, and avoid foods that might make any diarrhea worse (e.g., alcohol, caffeine, greasy foods). These dietary changes won’t treat diarrhea, but they can help prevent it from getting any worse.
            Will I lose my hair if I take Yervoy (ipilimumab)?
            Hair loss isn’t a common side effect of Yervoy (ipilimumab). So if you’re taking Yervoy (ipilimumab) by itself, you shouldn’t lose your hair. But sometimes, Yervoy (ipilimumab) might be given along with chemotherapy, such as when it’s used to treat non-small cell lung cancer. It’s possible that the other cancer medications you take with Yervoy (ipilimumab) might cause hair loss. If that’s the case, hair usually grows back after you stop treatment. Speak with your provider about ways to manage hair loss if you experience this side effect.
            Can I still take Yervoy (ipilimumab) if I have an immune-related side effect?
            It depends on how severe the immune-related side effect is. In most cases, you’ll need to pause Yervoy (ipilimumab) treatment and take a corticosteroid like prednisone if you have an immune-related side effect. This helps calm down your immune system. Then, if the side effect gets better, you might be able to restart Yervoy (ipilimumab). But in some cases, an immune-related side effect is serious enough that you’ll have to stop taking Yervoy (ipilimumab) altogether.
            How long should I take Yervoy (ipilimumab)?
            How long you take Yervoy (ipilimumab) depends on many factors, like what type of cancer you have, whether you’re taking it by itself or with other cancer medications, and whether you’re having any side effects from treatment. Sometimes (like for metastatic melanoma or advanced renal cell cancer), Yervoy (ipilimumab) is given for 4 doses only. Other times (like for malignant pleural mesothelioma), Yervoy (ipilimumab) is given every 6 weeks for as long as it’s working for you and as long as you don’t have severe side effects. Your provider will check your scan results to see how well treatment is working for you. Talk with your provider about how long you should take Yervoy (ipilimumab).
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            warings-icon

            What are the risks and warnings for Yervoy (ipilimumab)?

            Yervoy (ipilimumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

            risk-warning

            Immune-related side effects

            Side effects from immunotherapy are typically called immune-related adverse events (irAEs). They happen when the immune system becomes too active and attacks healthy cells along with cancer cells. These side effects can happen anywhere in your body. They can be mild, serious, or even life-threatening. And they can happen at any time during treatment.

            Some of these side effects, like changes in lab values that show how well your liver and kidneys are working, might not cause noticeable symptoms. You’ll need blood tests done often so your provider can monitor for those side effects closely. But you might notice certain other immune-related side effects, like diarrhea, skin rash, or shortness of breath. Call your provider right away if you experience any of these symptoms. You might need to pause or stop Yervoy (ipilimumab) and take a corticosteroid depending on how severe your symptoms are.

            risk-warning

            Infusion reactions

            Rarely, people taking Yervoy (ipilimumab) have had severe or life-threatening reactions during their infusion. Let your nurse know right away if you feel itchy or warm, have trouble breathing, feel nauseous, or suddenly have a fast heart rate while receiving Yervoy (ipilimumab). Most of the time, giving the infusion slower can help. But sometimes, having a serious reaction means that you shouldn’t take Yervoy (ipilimumab) again to avoid having another reaction in the future.

            risk-warning

            Stem cell transplant complications

            • Risk factors: People who’ve received a stem cell (bone marrow) transplant

              Some people who’ve taken immunotherapy medications like Yervoy (ipilimumab) and who’ve also had a stem cell transplant have experienced serious problems like graft-versus-host-disease. If you’ve taken an immunotherapy medication like Yervoy (ipilimumab) and have also had a stem cell transplant, your provider will follow up with you closely for signs and symptoms of these problems.

              risk-warning

              Harm to unborn baby

              Based on animal studies, Yervoy (ipilimumab) might harm an unborn baby or raise the risk for miscarriage (pregnancy loss) when taken during pregnancy. For this reason, if you’re able to get pregnant, your provider might require a negative pregnancy test before you start Yervoy (ipilimumab). You should use birth control while taking Yervoy (ipilimumab) and for 3 months after your last dose of medication. Let your provider know right away if you become pregnant while you’re taking Yervoy (ipilimumab).

              dosage

              Yervoy (ipilimumab) dosage forms

              Typical dosing for Yervoy (ipilimumab)

              Your provider will calculate your dose based on your body weight in kilograms. Your Yervoy (ipilimumab) dose will vary depending on the type of cancer that’s getting treated and the other medications in your treatment plan, such as Opdivo (nivolumab) or other chemotherapy.

              In general, Yervoy (ipilimumab) is given as an infusion through the vein (IV) at an infusion center or a provider’s office.

              • When Yervoy (ipilimumab) is used by itself: The typical dose is either 3 mg/kg given IV every 3 weeks for 4 doses only; or 10 mg/kg given IV every 3 weeks for the first 4 doses, then every 12 weeks for up to 3 years.

              • When Yervoy (ipilimumab) is given together with Opdivo (nivolumab): A common dose for Yervoy (ipilimumab) is 1 mg/kg given IV either every 3 or every 6 weeks. Another common dose is 3 mg/kg given IV every 3 weeks.

              interactions

              Interactions between Yervoy (ipilimumab) and other drugs

              Yervoy (ipilimumab) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Yervoy (ipilimumab). Please note that only the generic name of each medication is listed below.

              Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

              Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

              • Tofacitinib
              alternatives

              What are alternatives to Yervoy (ipilimumab)?

              There are a number of medications that your doctor can prescribe in place of Yervoy (ipilimumab). Compare a few possible alternatives below.
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              References

              Best studies we found

              American Cancer Society. (2020). What are infusion or immune reactions?

              American Cancer Society. (n.d.). Stem cell or bone marrow transplant.

              Buchbinder, E. I., et al. (2016). CTLA-4 and PD-1 pathways: Similarities, differences, and implications of their inhibition. American Journal of Clinical Oncology.

              View All References (21)

              Choi, J., et al. (2020). Clinical characteristics and treatment of immune-related adverse events of immune checkpoint inhibitors. Immune Network.

              Conroy, M., et al. (2022). Immune-related adverse events and the balancing act of immunotherapy. Nature Communications.

              E.R. Squibb & Sons, L.L.C. (2023). Yervoy- ipilimumab injection [package insert]. DailyMed.

              Gonzalez, H., et al. (2018). Roles of the immune system in cancer: From tumor initiation to metastatic progression. Genes & Development.

              Han, Y., et al. (2020). PD-1/PD-L1 pathway: Current researches in cancer. American Journal of Cancer Research.

              Hodgens, A., et al. (2023). Corticosteroids. StatPearls.

              InformedHealth.org. (2023). How does the immune system work? Institute for Quality and Efficiency in Health Care.

              MedlinePlus. (2022). PDL1 (immunotherapy) tests.

              MedlinePlus. (2023). Liver cancer - hepatocellular carcinoma.

              National Cancer Institute. (2020). Hair loss (alopecia) and cancer treatment.

              National Cancer Institute. (2023). Esophageal cancer treatment (PDQ®)–Patient version.

              National Cancer Institute. (2023). Non-small cell lung cancer treatment (PDQ®)–Patient version.

              National Cancer Institute. (2023). Renal cell cancer treatment (PDQ®)–Patient version.

              National Comprehensive Cancer Network. (2022). Immunotherapy side effects: Immune checkpoint inhibitors.

              National Comprehensive Cancer Network. (2022). Malignant pleural mesothelioma.

              National Comprehensive Cancer Network. (2022). Understanding immunotherapy side effects.

              National Comprehensive Cancer Network. (2023). Melanoma.

              National Comprehensive Cancer Network. (2023). Metastatic non-small cell lung cancer.

              National Comprehensive Cancer Network. (2024). Kidney cancer.

              National Marrow Donor Program. (n.d.). Graft-versus-host disease basics.

              National Marrow Donor Program. (n.d.). GVHD signs and symptoms.

              GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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