Atezolizumab Side Effects

Medically reviewed by Philip Thornton, DipPharm. Last updated on Oct 9, 2023.

Applies to atezolizumab: intravenous solution.

Serious side effects of atezolizumab

Along with its needed effects, atezolizumab 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 while taking atezolizumab:

More common

• black, tarry stools
• bladder pain
• bloating or swelling of the face, arms, hands, lower legs, or feet
• bloody or cloudy urine
• blurred vision
• body aches or pain
• chest tightness
• chills
• constipation
• cough
• diarrhea
• difficult, burning, or painful urination
• difficulty in breathing
• dizziness
• ear congestion
• fever
• frequent urge to urinate
• general feeling of tiredness and weakness
• headache
• hoarseness
• loss of appetite
• loss of voice
• lower back or side pain
• muscle aches
• nausea
• nervousness
• nosebleed
• pain
• pale skin
• pounding in the ears
• rapid weight gain
• slow or fast heartbeat
• sneezing
• sore throat
• stomach cramps
• stuffy or runny nose
• tenderness
• tingling of the hands or feet
• ulcers, sores, or white spots in the mouth
• unusual bleeding or bruising
• unusual tiredness or weakness
• unusual weight gain or loss
• vomiting
• watery or bloody diarrhea

Less common

• anxiety
• burning, tingling, numbness or pain in the hands, arms, feet, or legs
• chest pain
• confusion
• dark urine
• decreased urine
• depressed mood
• difficulty with chewing, swallowing, or talking
• double vision
• drooping eyelids
• drowsiness
• dry skin and hair
• facial swelling
• feeling cold
• general feeling of discomfort or illness
• increased thirst
• inability to move the arms and legs
• irritability
• light-colored stools
• lightheadedness
• muscle cramp, stiffness, or weakness
• numbness in the hands, feet, or lips
• rapid, shallow breathing
• seizures
• sensation of pins and needles
• sensitivity to heat
• skin rash
• stabbing pain
• stiff neck or back
• sudden numbness and weakness in the arms and legs
• sweating
• swelling of the face, ankles, hands, or feet
• thickening of bronchial secretions
• trouble sleeping
• upper right abdominal or stomach pain
• yellow eyes and skin

Rare

• blistering, peeling, or loosening of the skin
• darkening of the skin
• fainting
• hives, itching
• indigestion
• joint pain, stiffness, or swelling
• muscle pain
• pains in the stomach, side, or abdomen, possibly radiating to the back
• red skin lesions, often with a purple center
• red, irritated eyes
• redness of the skin
• swelling of the eyelids or lips
• swollen glands

Incidence not known

• blue or pale skin
• chest pain, possibly moving to the left arm, neck, or shoulder
• flushed, dry skin
• fruit-like breath odor
• increased hunger
• increased urination
• trouble breathing

Other side effects of atezolizumab

Some side effects of atezolizumab 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

• back, neck, arm, or leg pain
• difficulty in moving
• loss of or change in taste
• thinning of the hair or hair loss
• unsteadiness or awkwardness
• weakness in the arms, hands, legs, or feet

For healthcare professionals

Applies to atezolizumab: intravenous solution.

General

The most common adverse reactions (greater than 20%) were fatigue, decreased appetite, nausea, urinary tract infection, pyrexia, and constipation. The most common Grade 3 to 4 adverse reactions (greater than 2%) were urinary tract infection, anemia, fatigue, dehydration, intestinal obstruction, urinary obstruction, hematuria, dyspnea, acute kidney injury, abdominal pain, venous thromboembolism, sepsis, and pneumonia.^[Ref]

Dermatologic

• Very common (10% or more): Rash (15%), pruritus (13%)^[Ref]

Endocrine

• Frequency not reported: Immune-related thyroid disorders (e.g., hyperthyroidism, hypothyroidism)^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (25%), constipation (21%), diarrhea (18%), abdominal pain (17%), vomiting (17%)
• Common (1% to 10%): Dehydration, intestinal obstruction^[Ref]

Cardiovascular

• Common (1% to 10%): Venous thromboembolism^[Ref]

Genitourinary

• Very common (10% or more): Urinary tract infection (22%)
• Common (1% to 10%): Urinary obstruction^[Ref]

Hematologic

• Common (1% to 10%): Anemia, lymphopenia, increased alkaline phosphatase, increased alkaline phosphatase^[Ref]

Hepatic

• Common (1% to 10%): Acute kidney injury, liver enzyme increase, increased ALT, increased AST

Immunologic

• Very common (10% or more): Immune related colitis (19.7%)
• Common (1% to 10%): Immune related pneumonitis, immune related hepatitis, sepsis
• Frequency not reported: Immune related endocrinopathies^[Ref]

Local

• Frequency not reported: Infusion related reactions^[Ref]

Metabolic

• Very common (10% or more): Decreased appetite (26%)
• Common (1% to 10%): Hyponatremia, hyperglycemia, hypoalbuminemia^[Ref]

Musculoskeletal

• Very common (10% or more): Back/neck pain (15%), arthralgia (14%)^[Ref]

Nervous system

• Frequency not reported: Meningoencephalitis, myasthenic syndrome/myasthenia gravis, Guillain-Barre^[Ref]

Ocular

• Frequency not reported: Ocular inflammatory toxicity^[Ref]

Other

• Very common (10% or more): Fatigue (52%), pyrexia (21%), peripheral edema (18%)
• Common (1% to 10%): Increased creatinine^[Ref]

Psychiatric

• Common (1% to 10%): Confusional state^[Ref]

Renal

• Common (1% to 10%): Hematuria^[Ref]

Respiratory

• Very common (10% or more): Dyspnea (16%), cough (14%)
• Common (1% to 10%): Dyspnea, pneumonia^[Ref]

Frequently asked questions

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Further information

Atezolizumab side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer