Pembrolizumab

KEYTRUDA

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Pronunciation: pem-broe-LIZ-yoo-mab (kee-TROO-da)

Pembrolizumab ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Pembrolizumab ballicule

Pembrolizumab KEYTRUDA mascot mnemonic cartoon — Visual mnemonic: Pembrolizumab mascot
**“Key Pimp bro”**

What it isPD-1 blocking antibody releasing T-cell inhibition; melanoma, lung cancer and many tumors with high PD-L1 or MSI.

Why this oneIt pioneered tumor-agnostic immunotherapy for MSI-high cancers and now carries an exceptionally broad oncology label.

What limits itImmune-related adverse events can hit any organ — thyroid, colon, liver, lung, pituitary — and are treated with steroids, not by stopping alone.

Pembrolizumab molecular structure (skeletal formula) — Molecular structure: Pembrolizumab

FDA label

Read the full label on DailyMed ↗

FDA dosing	Population	Start	Target	Max
Solid tumors and lymphomas (multiple approved indications)	adults	200 mg IV every 3 weeks or 400 mg IV every 6 weeks	200 mg Q3W or 400 mg Q6W	400 mg Q6W
Pediatric-approved indications (e.g., melanoma, cHL, PMBCL, MCC, MSI-H/dMMR, TMB-H)	pediatric	2 mg/kg (up to 200 mg) IV every 3 weeks	2 mg/kg (up to 200 mg) Q3W	200 mg per dose

Renal Undefined

Hepatic Undefined

Regimen and combination partners vary by indication (see full prescribing information).

Instructions

Administer as an IV infusion over 30 minutes after dilution.
Select patients per FDA-authorized tests where required (e.g., PD-L1 expression).
Withhold or permanently discontinue based on severity/type of immune-mediated reaction.

Available strengths

inj 25 mg/mL

Cautions

Severe and fatal immune-mediated adverse reactions (pneumonitis, colitis, hepatitis, endocrinopathies, nephritis, dermatologic reactions, solid organ transplant rejection)
Infusion-related reactions
Complications of allogeneic HSCT
Increased mortality with PD-1/PD-L1 blockade plus thalidomide analogue and dexamethasone in multiple myeloma
Embryo-fetal toxicity

Adverse reactions

Fatigue
Musculoskeletal pain
Rash
Diarrhea
Pyrexia
Cough
Decreased appetite
Pruritus
Dyspnea
Constipation
Nausea
Hypothyroidism

Pregnancy Can cause fetal harm based on mechanism of action; advise of risk to a fetus.

Lactation No data on presence in milk; do not breastfeed during treatment and for 4 months after the last dose.

Cost

Pembrolizumab (KEYTRUDA)

Strength		#/mo	generic $/unit	CostPlus
25 mg/mL	inj	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Pembrolizumab is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

NO BOXED WARNINGS

Principal riskImmune-related adverse events in any organ

Classes and tags

Clinical profile

Therapeutic safety burden4 / 4

Overdose danger2 / 4

Weight-gain liability1 / 4

Sedation liability1 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Defining liabilityPotentially fatal immune-mediated multiorgan injury

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