Keytruda Injection (Pembrolizumab): Comprehensive Medicine Guide
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- New or worsening shortness of breath, cough, or chest pain
- Severe diarrhoea or blood in stool
- Yellowing of skin or eyes, dark urine, or severe abdominal pain
- Decreased urine output or swelling in legs
- Severe headache, vision changes, or confusion
- Rash with blistering or peeling of skin
- Chest pain, palpitations, or fainting
- Sudden weakness or difficulty breathing
If experiencing severe symptoms, call emergency services immediately.
What is keytruda injection used for?
This medicine is a prescription immunotherapy used to treat several types of advanced cancer by helping the immune system attack cancer cells. It is given as an intravenous infusion by a healthcare professional.
- Generic Name: Pembrolizumab (100mg)
- Manufacturer: MSD Pharmaceuticals Pvt Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 keytruda injection के बारे में (Hindi Summary)
उपयोग: यह दवा एक प्रिस्क्रिप्शन इंजेक्शन है जिसमें पेम्ब्रोलिज़ुमैब नामक सक्रिय तत्व होता है। यह कई प्रकार के उन्नत कैंसर के इलाज के लिए उपयोग की जाती है, जैसे मेलेनोमा, फेफड़ों का कैंसर, सिर और गर्दन का कैंसर, मूत्राशय का कैंसर, और हॉजकिन लिंफोमा। यह दवा शरीर की प्रतिरक्षा प्रणाली को कैंसर कोशिकाओं को पहचानने और नष्ट करने में मदद करती है। इसे डॉक्टर या नर्स द्वारा नस के माध्यम से दिया जाता है। यह दवा कैंसर को पूरी तरह से ठीक नहीं करती, लेकिन रोग को नियंत्रित करने और जीवनकाल को बढ़ाने में मदद कर सकती है।
साइड इफेक्ट्स: इस दवा के कई दुष्प्रभाव हो सकते हैं, क्योंकि यह प्रतिरक्षा प्रणाली को सक्रिय करती है। आम दुष्प्रभावों में थकान, दाने, खुजली, दस्त, मतली, भूख में कमी, और जोड़ों में दर्द शामिल हैं। कुछ रोगियों में गंभीर प्रतिरक्षा-संबंधी दुष्प्रभाव हो सकते हैं, जैसे फेफड़ों की सूजन, यकृत की सूजन, आंतों की सूजन, थायरॉइड की समस्या, और गुर्दे की सूजन। यदि आपको सांस लेने में कठिनाई, लगातार खांसी, गंभीर दस्त, पेट दर्द, या त्वचा पर गंभीर दाने हों, तो तुरंत डॉक्टर से संपर्क करें।
सुरक्षा सलाह: यह दवा केवल योग्य स्वास्थ्य पेशेवर द्वारा अस्पताल या कैंसर केंद्र में ही दी जानी चाहिए। इसे घर पर स्वयं न लें। उपचार से पहले अपने डॉक्टर को अपनी सभी चिकित्सीय स्थितियों के बारे में बताएं, विशेष रूप से यदि आपको ऑटोइम्यून बीमारी, अंग प्रत्यारोपण, या गर्भावस्था है। उपचार के दौरान नियमित रक्त परीक्षण करवाएं। कोई भी नया लक्षण जैसे लगातार खांसी, सांस लेने में कठिनाई, गंभीर दस्त, पीलिया, या असामान्य थकान होने पर तुरंत डॉक्टर को बताएं। इस दवा के दौरान जीवित टीके न लगवाएं। गर्भावस्था से बचने के लिए प्रभावी गर्भनिरोधक उपाय करें।
💊 keytruda injection Uses & Benefits
[{"condition":"Advanced melanoma","description":"Used for the treatment of unresectable or metastatic melanoma in adults and some pediatric patients.","evidence":"Well-established"},{"condition":"Non-small cell lung cancer (NSCLC)","description":"Used as first-line or later-line therapy for advanced NSCLC, often based on PD-L1 expression.","evidence":"Well-established"},{"condition":"Head and neck squamous cell carcinoma","description":"Indicated for recurrent or metastatic head and neck cancer that has progressed on prior therapy.","evidence":"Well-established"},{"condition":"Classical Hodgkin lymphoma","description":"Used for relapsed or refractory classical Hodgkin lymphoma in adults and children.","evidence":"Well-established"},{"condition":"Urothelial carcinoma","description":"Used for locally advanced or metastatic urothelial carcinoma that has progressed on platinum-containing chemotherapy.","evidence":"Well-established"},{"condition":"Gastric or gastroesophageal junction adenocarcinoma","description":"Used for recurrent locally advanced or metastatic gastric cancer expressing PD-L1.","evidence":"Well-established"},{"condition":"Cervical cancer","description":"Used for recurrent or metastatic cervical cancer with PD-L1 expression.","evidence":"Well-established"},{"condition":"Hepatocellular carcinoma","description":"Used for advanced hepatocellular carcinoma previously treated with sorafenib.","evidence":"Well-established"},{"condition":"Merkel cell carcinoma","description":"Used for recurrent locally advanced or metastatic Merkel cell carcinoma.","evidence":"Well-established"},{"condition":"Renal cell carcinoma","description":"Used in combination with other agents for advanced renal cell carcinoma.","evidence":"Well-established"},{"condition":"Endometrial carcinoma","description":"Used for advanced endometrial cancer with specific biomarkers.","evidence":"Well-established"},{"condition":"Esophageal cancer","description":"Used for advanced esophageal squamous cell carcinoma after prior therapy.","evidence":"Well-established"},{"condition":"Triple-negative breast cancer","description":"Used in combination with chemotherapy for PD-L1-positive advanced triple-negative breast cancer.","evidence":"Well-established"},{"condition":"Cutaneous squamous cell carcinoma","description":"Used for recurrent or metastatic cutaneous squamous cell carcinoma.","evidence":"Well-established"},{"condition":"Tumor mutational burden-high cancers","description":"Used for unresectable or metastatic solid tumors with high tumor mutational burden that have progressed on prior treatment.","evidence":"Well-established"},{"condition":"MSI-H/dMMR cancers","description":"Used for unresectable or metastatic solid tumors that are microsatellite instability-high or mismatch repair deficient.","evidence":"Well-established"}]
Off-label uses: [{"condition":"Thymic carcinoma","description":"Sometimes used off-label for advanced thymic carcinoma that has not responded to standard treatments.","evidence":"Limited"},{"condition":"Small cell lung cancer","description":"Occasionally used off-label in combination regimens for extensive-stage small cell lung cancer.","evidence":"Limited"},{"condition":"Glioblastoma","description":"Investigated off-label for recurrent glioblastoma, but evidence is not robust.","evidence":"Limited"},{"condition":"Basal cell carcinoma","description":"Rarely used off-label for advanced basal cell carcinoma when other treatments are not suitable.","evidence":"Limited"}]
Primary treatment for: Multiple advanced cancers including melanoma, lung cancer, head and neck cancer, and others.
Also treats: Hodgkin lymphoma, Urothelial carcinoma, Gastric cancer, Cervical cancer, Hepatocellular carcinoma, Merkel cell carcinoma, Renal cell carcinoma, Endometrial carcinoma, Esophageal cancer, Triple-negative breast cancer, Cutaneous squamous cell carcinoma
📋 Drug Information
| Generic Name(s) | Pembrolizumab (100mg) |
| Brand Name | keytruda injection |
| Manufacturer | MSD Pharmaceuticals Pvt Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | ANTI NEOPLASTICS |
| Action Class | Programmed Cell Death 1 (PD-1) Checkpoint Inhibitors |
| Route of Administration | Parenteral (intravenous infusion) |
| Storage | Store vials refrigerated at 2°C to 8°C (36°F to 46°F) in the original carton to protect from light. Do not freeze. Do not shake. Once reconstituted, the solution should be used immediately or stored refrigerated and used within a specified time as per institutional guidelines. |
| Shelf Life | Refer to the product label for the specific shelf life. Typically, unopened vials have a shelf life of 24 to 36 months when stored properly. |
| WHO Guideline | Not established from the available information. |
| ICMR Guideline | Not established from the available information. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine is a humanized monoclonal antibody that binds to the programmed death receptor-1 (PD-1) on T cells and other immune cells. By binding to PD-1, it blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2, which are often overexpressed on cancer cells. This blockade prevents the cancer cells from sending inhibitory signals to T cells, thereby restoring and enhancing the immune system's ability to detect and destroy cancer cells. The mechanism is part of a class of treatments known as immune checkpoint inhibitors.
Mechanism Steps
💡 How to Take keytruda injection
Strength: 100 mg per vial, lyophilized powder for solution for intravenous infusion.
Dosage Information
| Adult Dosage | The usual adult dose of this medicine is 200 mg administered as an intravenous infusion over 30 minutes every 3 weeks, or 400 mg every 6 weeks. The dose is the same for many indications, but some regimens may use weight-based dosing (2 mg/kg) in certain cases. Dose must be individualized by a qualified clinician based on indication, patient weight, renal and hepatic function, and concomitant therapies. Treatment is continued until disease progression or unacceptable toxicity. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatric oncologist for appropriate dosing in children. |
| Elderly Dosage | No overall differences in safety or efficacy have been observed between elderly patients (≥65 years) and younger patients. However, elderly patients may be more susceptible to certain side effects. Dose adjustments are not routinely required, but close monitoring is advised. |
| Renal Impairment | No dose adjustment is required for patients with mild to moderate renal impairment. Data are limited for severe renal impairment; use with caution and monitor closely. |
| Hepatic Impairment | No dose adjustment is required for patients with mild hepatic impairment. Data are limited for moderate to severe hepatic impairment; use with caution and monitor liver function closely. |
| Maximum Daily Dose | The maximum recommended dose is 400 mg every 6 weeks or 200 mg every 3 weeks. Doses above these are not recommended. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of keytruda injection
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Live vaccines | Major | |
| Immunosuppressants | Major | |
| Other checkpoint inhibitors | Major | |
| Warfarin | Moderate | |
| Antihypertensives | Moderate | |
| Thyroid hormone | Moderate | |
| Paracetamol | Minor | |
| Antihistamines | Minor |
🚨 Major Interactions
- Live vaccines
- Immunosuppressants (e.g., corticosteroids, tacrolimus, cyclosporine)
- Other immune checkpoint inhibitors (e.g., ipilimumab, nivolumab)
⚡ Moderate Interactions
- Warfarin
- Antihypertensives
- Thyroid hormone replacement
🍷 Alcohol Interaction
There is no direct interaction between alcohol and this medicine, but alcohol can worsen fatigue, nausea, and liver function. It is advisable to avoid or limit alcohol consumption during treatment, especially if you have liver problems.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Severe hypersensitivity to pembrolizumab or any component of the formulation","Active autoimmune disease requiring systemic immunosuppressive therapy","History of solid organ transplant (relative contraindication)","Pregnancy and breastfeeding","Live vaccine administration during treatment"]
⚠️ Warnings & Precautions
["Immune-related adverse events can occur in any organ system and may be severe or fatal.","Monitor for pneumonitis, colitis, hepatitis, nephritis, endocrinopathies, and skin reactions.","Infusion-related reactions may occur; monitor during and after infusion.","Use with caution in patients with a history of autoimmune disease.","May cause fetal harm; use effective contraception during treatment.","Avoid live vaccines during and after treatment.","Not recommended for use in patients with active infections.","May increase the risk of transplant rejection."]
🤱 Lactation Safety
It is not known whether this medicine is present in human milk. Because of the potential for serious adverse reactions in breastfed infants, women should not breastfeed during treatment and for at least four months after the last dose.
💊 Overdose Management
There is no specific antidote for overdose with this medicine. In case of overdose, patients should be monitored closely for any signs of adverse effects, and supportive care should be provided as needed. Hemodialysis is not expected to be effective because of the large molecular size of the antibody.
⏰ Missed Dose
If a dose of this medicine is missed, contact your healthcare provider as soon as possible to reschedule the infusion. Do not attempt to self-administer or double the dose. The dosing schedule should be adjusted to maintain the recommended interval.
Additional Safety Advice
This medicine must only be given by a qualified healthcare professional in a clinical setting equipped to manage severe reactions. Patients should not attempt to self-administer this medicine. Before starting treatment, inform your doctor about all your medical conditions, especially if you have an autoimmune disease, a history of organ transplant, liver or kidney problems, or if you are pregnant or planning to become pregnant. Also, tell your doctor about all other medicines, vitamins, and herbal supplements you are taking, as some may interact with this medicine. During treatment, you will need regular blood tests to monitor your liver, kidney, thyroid, and blood cell counts. Report any new symptoms such as persistent cough, shortness of breath, severe diarrhoea, blood in stool, yellowing of eyes or skin, severe abdominal pain, or unusual tiredness to your doctor without delay. These could be signs of immune-related side effects that need prompt treatment. Avoid receiving live vaccines while on this medicine, as they can cause serious infections. Use effective contraception during treatment and for at least four months after the last dose if you are of childbearing potential. If you miss an appointment for your infusion, contact your healthcare provider as soon as possible to reschedule. Do not stop treatment on your own; always consult your oncologist before making any changes.
👴 Special Considerations for Elderly
💡 For Patients Above 65
No overall differences in safety or efficacy have been observed between elderly patients (≥65 years) and younger patients. However, elderly patients may be more susceptible to certain side effects, such as fatigue and immune-related toxicities. Close monitoring is recommended.
🤰 Pregnancy Planning (TTC)
This medicine can cause fetal harm. Women of childbearing potential should use effective contraception during treatment and for at least four months after the last dose. If you are planning to become pregnant, discuss with your doctor before starting treatment. Men with female partners of childbearing potential should also use effective contraception during treatment and for at least four months after the last dose.
🏥 Post-Surgery Considerations
If you are scheduled for surgery, inform your surgeon and oncologist that you are receiving this medicine. There may be an increased risk of wound healing complications or infections. Your doctor may recommend temporarily stopping treatment before surgery.
🦷 Dental Procedures
Inform your dentist that you are receiving this medicine. There may be an increased risk of bleeding or infection. Your dentist may recommend postponing non-urgent dental procedures until your blood counts have recovered. Good oral hygiene is important during treatment.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
Exercise is generally encouraged, but you should avoid strenuous activities if you feel fatigued or unwell. Consult your doctor before starting any new exercise regimen. If you experience shortness of breath, chest pain, or dizziness during exercise, stop and seek medical attention.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine may cause fatigue, which can affect your ability to work or perform daily activities. You may need to adjust your work schedule or take time off for infusions and recovery. Avoid driving or operating heavy machinery if you feel tired or unwell. Discuss any work-related concerns with your healthcare team.
🛑 When to Stop This Medicine
Do not stop treatment on your own. Your doctor will decide when to stop based on your response to treatment, disease progression, or unacceptable side effects. If you experience severe side effects, contact your doctor immediately; they may temporarily or permanently discontinue the medicine.
📅 Long-Term Use Effects
Long-term use of this medicine may be associated with persistent immune-related side effects, such as thyroid dysfunction, which may require ongoing hormone replacement. Regular monitoring of organ function is necessary. Some patients may experience delayed immune-related adverse events even after stopping treatment. The benefits of continued treatment should be weighed against the risks of long-term immune activation.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Enrollment in clinical trials may offer access to new treatments.
Evidence: VariesOther targeted therapies may be options depending on the cancer type and mutations.
Evidence: Well-established for certain cancersTraditional chemotherapy may be used alone or in combination.
Evidence: Well-establishedMay be used for localized control of tumors.
Evidence: Well-established💉 Vaccination Considerations
💉 If You're Getting Vaccinated
Live vaccines should not be administered during treatment with this medicine and for at least four months after the last dose. Inactivated vaccines may be given, but their effectiveness may be reduced. Consult your doctor before receiving any vaccine.
📦 Storage Guide
✅ DO
Store vials refrigerated at 2°C to 8°C
❌ DON'T
Do not freeze
✅ DO
Keep in original carton to protect from light
❌ DON'T
Do not shake the vial
✅ DO
Use aseptic technique when preparing the infusion
❌ DON'T
Do not use if the solution is discolored or contains particles
✈️ Traveling with This Medicine
When traveling, carry this medicine in its original packaging with the prescription label. Keep it refrigerated at 2°C to 8°C using a portable cooler or arrange for refrigeration at your destination. Carry a copy of your prescription and a letter from your doctor explaining the need for the medicine. Check customs regulations for carrying prescription medicines across borders. Plan your infusions around your travel schedule and consult your healthcare provider for any adjustments.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: It may take several weeks to months to see the full effect of this medicine. Your doctor will monitor your response with regular scans.
A: Contact your healthcare provider as soon as possible to reschedule your infusion. Do not try to self-administer.
A: Live vaccines should be avoided during treatment and for at least four months after the last dose. Inactivated vaccines may be given, but consult your doctor first.
A: This medicine can harm the developing baby. Use effective contraception during treatment and for at least four months after the last dose.
🤔 Common Patient Concerns
🛑 Myths vs. Facts
- Myth: This medicine can cure all types of cancer.
Fact: This medicine is effective only for specific cancers and stages; it is not a universal cure. - Myth: This medicine has no side effects because it is immunotherapy.
Fact: This medicine can cause serious immune-related side effects that require monitoring and treatment. - Myth: You can take this medicine at home.
Fact: This medicine must be given by a healthcare professional in a clinical setting. - Myth: This medicine works immediately.
Fact: It may take weeks to months to see the full effect of this medicine.