Lenalidomide
Severe
Database
Clinical effect not specified
Source: DDInter
Drug reference
Pembrolizumab
Anti-PD-1 immune checkpoint inhibitor (monoclonal antibody) · Antineoplastic
Also known as Keytruda
START
200 mg IV q3w (or 400 mg IV q6w)
TYPICAL MAX
400 mg IV every 6 weeks
STOP IF
Severe/grade 3–4 immune-related toxicity
WATCH
Thyroid/liver/glucose, pneumonitis/colitis symptoms, skin
CDSCO approvedSchedule HATC L01FF02
KDIGO 2024 + manufacturer label
- ONSET
- 6min · infusion start
- PEAK
- 30min · infusion Cmax
- t½
- 3.1w · t½ ~22 d
- DURATION
- 3w · q3w interval
EXCRETION
Catabolism; not excreted intact
route + CYP
INTERACTIONS
4 major
SEVERE in our sources
PREGNANCY
Can cause fetal harm — avoid; effective contraception during and 4 months after.
FDA category + note
Top interactionssee all 8 →
- LenalidomideSevereDatabaseDDInter
- Other Checkpoint InhibitorsSevereDatabaseKimi deep-research + Cla
- PomalidomideSevereDatabaseDDInter
- ThalidomideSevereDatabaseDDInter
Available in India
1 branded formulation. Look up specific brands in the Drugs workspace.
Mechanism
Humanised IgG4 monoclonal antibody that blocks PD-1 binding to PD-L1/PD-L2, releasing T-cell inhibition and restoring antitumour immune responses.
Indications
MelanomaNon-small-cell lung cancerHead and neck squamous carcinomaHodgkin lymphomaMSI-H/dMMR or TMB-high solid tumoursUrothelial, renal, oesophageal, cervical and other carcinomas
Dosing
- Adult
- 200 mg IV every 3 weeks OR 400 mg IV every 6 weeks (30-min infusion).
- Pediatric
- Classical Hodgkin/selected: 2 mg/kg (max 200 mg) IV every 3 weeks.
- Renal adjustment
- No dose adjustment required.
- Hepatic adjustment
- No adjustment for mild impairment; not studied in moderate–severe.
- Geriatric
- No dose adjustment.
- Max dose
- 400 mg IV every 6 weeks (or 200 mg q3w)
Pharmacokinetics
Onset
Tumour responses over weeks–months
Peak effect
End of infusion (serum); clinical weeks
Duration
Dosing interval 3–6 weeks
Half-life
~22 days
Bioavailability
IV 100%
Protein binding
Not applicable (antibody)
Metabolism
Catabolised to peptides/amino acids
Excretion
Catabolism (not renally/hepatically excreted intact)
Contraindications
- Severe hypersensitivity to pembrolizumab
- Caution with active autoimmune disease / prior solid-organ transplant / allogeneic HSCT
Side effects
Common
FatiguePruritus/rashDiarrhoeaNauseaArthralgiaDecreased appetite
Serious
- Immune-related pneumonitis
- Colitis
- Hepatitis
- Endocrinopathies (thyroid, hypophysitis, adrenal, diabetes)
- Nephritis
- Severe skin reactions
- Infusion reactions
- Allograft rejection
Pregnancy & lactation
Pregnancy
Can cause fetal harm — avoid; effective contraception during and 4 months after.
Lactation
Avoid breastfeeding during and 4 months after therapy.
Drug interactions
Other Checkpoint Inhibitors
Severe
Database
Additive immune activation
Intended combos only with strict monitoring
Source: Kimi deep-research + Cla
Pomalidomide
Severe
Database
Clinical effect not specified
Source: DDInter
Thalidomide
Severe
Database
Clinical effect not specified
Source: DDInter
Ipilimumab
Moderate
Textbook
Increased clinical responses (efficacy) in cancer treatment.
Caution must be used to ensure patient safety due to potential immune-related adverse events.
Source: G&G 14e · p764
Hepatotoxic Drugs
Moderate
Database
Additive hepatic injury
Monitor LFTs
Source: Kimi deep-research + Cla
Live Vaccines
Moderate
Database
Immune activation/uncertain safety
Avoid live vaccines during therapy
Source: Kimi deep-research + Cla
Systemic Corticosteroids
Moderate
Database
Blunted immune activation
Avoid baseline immunosuppression; OK to treat irAEs
Source: Kimi deep-research + Cla
4 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.
Related guidelines
Ask House about Pembrolizumab
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, Harrison 22e, Katzung, BNF·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20