FDA-filed SPL labeling · retrieved through openFDA

Pembrolizumab Injection

Pembrolizumab (Keytruda) is an immunotherapy injection that helps your immune system find and fight many types of cancer.

Brand name Keytruda
Drug class Programmed Death Receptor-1 Blocking Antibody
Rx Form 1 Route Intravenous
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveJul 10, 2026
AvailabilityRx
Earliest approval/marketing year 2014
FDA-listed product records 8
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 21, 2026
Pembrolizumab Injection at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Pembrolizumab (Keytruda) is a powerful immunotherapy that unlocks your immune system to fight many types of cancer. It's generally well tolerated, but because it activates your immune system broadly, it can cause serious inflammation in almost any organ — so staying in close contact with your care team and reporting new symptoms quickly is essential. Women must not become pregnant or breastfeed while taking it.

📖 Pembrolizumab Injection: Patient Information Guide

A plain-language walkthrough of Pembrolizumab Injection — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Pembrolizumab treats a wide range of cancers, either alone or with other therapies. Main uses include:

  • Melanoma — advanced/unresectable disease, and as adjuvant (post-surgery) treatment for Stage IIB–III
  • Non-small cell lung cancer (NSCLC) — first-line and later-line treatment; also before and after surgery for resectable disease
  • Malignant pleural mesothelioma — advanced or metastatic, combined with chemotherapy
  • Head and neck squamous cell cancer (HNSCC) — locally advanced or metastatic
  • Bladder/urothelial cancer — advanced disease
  • Certain colorectal, gastric, esophageal, cervical, and liver cancers
  • Kidney cancer (RCC) — advanced or adjuvant after surgery
  • Endometrial carcinoma, ovarian cancer, triple-negative breast cancer (TNBC)
  • Blood cancers — classic Hodgkin lymphoma (cHL) and certain large B-cell lymphomas (PMBCL)
  • Tumors with specific markers — MSI-H/dMMR (certain DNA repair defects), TMB-H (high tumor mutation burden), PD-L1-expressing tumors
  • Merkel cell carcinoma (MCC) and cutaneous squamous cell carcinoma (cSCC)
⚙️How it works

Cancer cells can disguise themselves by activating a checkpoint called the PD-1 pathway — essentially putting up a "don't attack me" signal that quiets your immune system's T cells. Pembrolizumab is a monoclonal antibody (a precisely engineered protein) that locks onto the PD-1 receptor on T cells and blocks that signal. With the brake released, your T cells can recognize tumor cells as foreign and mount an attack against them.

In some cancer types, pembrolizumab is used alongside lenvatinib (another cancer drug). In lab models, that combination reduced certain immune-suppressing cells in tumors and boosted cancer-killing T cells more than either drug alone.

💊How it's taken

Pembrolizumab is given as a 30-minute IV infusion (drip through a vein) in a clinic or hospital infusion center — it is not a pill or home injection. It is typically administered every 3 weeks or every 6 weeks; your oncologist will determine the schedule that fits your treatment plan. For pediatric patients, dosing is based on body weight.

  • No food or fasting requirements are tied to the infusion
  • Your exact dose and schedule are set by your prescriber — follow that plan precisely
  • If you miss an appointment, contact your care team to reschedule as soon as possible
🤒Side effects — in detail

The most commonly reported side effects include:

  • Fatigue or weakness
  • Nausea, diarrhea, or constipation
  • Rash or itching
  • Cough or shortness of breath
  • Decreased appetite
  • Fever
  • Muscle and joint pain
  • Underactive thyroid (hypothyroidism)

More serious immune-related reactions can affect your lungs, liver, bowel, kidneys, skin, and hormone glands — these need prompt medical attention. If you notice anything new or worsening, call your doctor right away rather than waiting for your next appointment.

⚠️Warnings & precautions
  • Immune-mediated reactions: Because pembrolizumab activates your immune system, it can cause it to attack healthy organs — lungs (pneumonitis), bowel (colitis), liver (hepatitis), kidneys (nephritis), skin, thyroid, adrenal glands, and more. These can be severe or fatal and can occur at any time, even after treatment ends.
  • Infusion reactions: Symptoms during or right after the IV infusion — such as chills, flushing, dizziness, or breathing difficulty — should be reported immediately to the infusion team.
  • Stem cell transplant risks: Serious, potentially fatal complications can occur in patients who receive an allogeneic (donor) stem cell transplant before or after pembrolizumab treatment.
  • Multiple myeloma caution: Combining pembrolizumab with thalidomide-type drugs plus steroids for multiple myeloma is not recommended outside clinical trials.
  • Embryo-fetal toxicity: This drug can harm or cause loss of an unborn baby. Effective contraception is essential during treatment.
🔀What it interacts with

Pembrolizumab has a focused but serious interaction profile — always give your full medication list to your oncologist and pharmacist:

  • Thalidomide analogues (e.g., lenalidomide, pomalidomide) + dexamethasone: Combining these with pembrolizumab for multiple myeloma carries serious risks and is not recommended outside carefully controlled clinical trials.
  • Allogeneic stem cell transplant (HSCT): Having this type of bone marrow/stem cell transplant before or after pembrolizumab treatment raises the risk of severe, potentially fatal transplant complications — your team needs to know your full history.

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Pregnancy: Pembrolizumab can harm a developing baby and may increase the risk of miscarriage or stillbirth. Tell your doctor immediately if you are or could be pregnant.
  • Breastfeeding: Do not breastfeed during treatment or for 4 months after your last dose — the potential risk to the baby is unknown and considered serious.
  • Contraception: Women of childbearing potential must use effective birth control during treatment.
  • Autoimmune conditions: Tell your doctor if you have any autoimmune disease — activating the immune system could worsen these conditions.
  • Prior stem cell transplant: Report any history of allogeneic (donor) bone marrow or stem cell transplant before starting treatment.
  • Liver impairment: Severe liver impairment may affect how pembrolizumab behaves — discuss your liver health with your doctor.
  • Children: Approved for pediatric patients (age 12+) for melanoma; some indications allow younger children. Weight-based dosing is used.
  • Older adults: Age alone (up to 94 years studied) did not meaningfully change how the drug is processed in the body.
📡Pharmacodynamics — effects in the body

Pembrolizumab works by blocking the PD-1 checkpoint — a pathway cancer cells exploit to hide from immune attack. By releasing that inhibition, the drug restores the immune system's ability to detect and destroy tumor cells. Studies in adults with melanoma, Hodgkin lymphoma, and certain B-cell lymphomas have not identified a clear relationship between the amount of drug in the blood and either its effectiveness or its side effects across the doses studied.

🔬Pharmacokinetics — how your body processes it

Pembrolizumab is given directly into the bloodstream by IV, so there is no absorption step. It reaches stable, steady-state levels in the blood by about 16 weeks of regular dosing. The drug has a long half-life of approximately 22 days — meaning it stays active in your body for weeks after each dose. It is cleared slowly through normal protein breakdown pathways; age, sex, race, mild-to-moderate kidney impairment, and mild-to-moderate liver impairment do not significantly affect how the body handles it. Severe liver impairment has not been fully studied.

📦How to store it

Store vials under refrigeration at 2°C to 8°C (36°F to 46°F) in original carton to protect from light. Do not freeze.

📄 Written from Pembrolizumab Injection’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

1

Supplements & herbs that interact with Pembrolizumab Injection

1 supplement and herbal product has documented interactions with Pembrolizumab Injection in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Every supplement checked against Pembrolizumab Injection — ranked by severity The full interaction hub: 1 minor · every one linked to its full report. Check Pembrolizumab Injection against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Pembrolizumab Injection — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is pembrolizumab and how is it different from regular chemotherapy?
Great question — it's a very different approach. Chemo directly attacks fast-growing cells, including cancer cells. Pembrolizumab is immunotherapy: it doesn't target the cancer itself. Instead, it removes a kind of 'off switch' on your immune cells so your own body can recognize and attack the tumor. Think of it as lifting a disguise off cancer cells so your immune system can finally see them.
How often will I need to come in for infusions, and how long does each one take?
Each infusion takes about 30 minutes once it's running, though you'll spend extra time at the clinic for preparation and monitoring. Depending on your treatment plan, it's given every 3 weeks or every 6 weeks. Your oncologist decides the schedule — stick to it as closely as possible, and call them if you ever need to reschedule.
What side effects should I just manage at home versus which ones mean I need to call someone right away?
Mild fatigue, nausea, muscle aches, or a rash are common and often manageable — keep your team in the loop, but those usually don't need emergency care. What needs a call right away: new or worsening shortness of breath or cough, severe diarrhea or bloody stool, yellowing of your skin or eyes, unusual swelling, or anything that feels sudden and serious. Pembrolizumab can cause your immune system to inflame healthy organs, so don't wait to see if something gets better on its own.
Can I get pregnant or breastfeed while on this medication?
You should not get pregnant during treatment — pembrolizumab can cross the placenta and has the potential to cause pregnancy loss or harm to the baby. Women who could become pregnant need to use effective birth control while on treatment. Breastfeeding is also not safe during treatment or for 4 months after your last dose. If there's any chance you're pregnant, let your doctor know immediately before starting.
I've heard that immunotherapy can attack your own body — is that true? How will my doctors watch for that?
Yes, that's a real risk worth knowing about. Because pembrolizumab 'turns up' your immune system, it can sometimes turn too far and inflame healthy organs — like the lungs, liver, bowel, or thyroid. Your care team will run regular blood tests (liver enzymes, kidney function, thyroid levels) to catch problems early. Most immune-related reactions can be managed by pausing the drug or adding anti-inflammatory treatment. The key is reporting any new symptoms quickly — don't brush off things that feel off.
Does my tumor need to have a specific marker for this drug to work for me?
It depends on your cancer type. For some cancers — like certain lung cancers and head and neck cancers — your tumor needs to be tested for a protein called PD-L1 (or other markers like MSI-H or TMB-H) before pembrolizumab is approved for use. For others, like advanced melanoma, those tests aren't required. Your oncologist will have ordered or will order the right tests as part of your workup to make sure this is the right treatment for you.
Is Pembrolizumab Injection available over the counter?
Pembrolizumab Injection is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Pembrolizumab Injection first available?
Pembrolizumab Injection has been available in the United States since at least 2014, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Pembrolizumab Injection?
Pembrolizumab Injection is supplied by 3 manufacturers listed in the FDA NDC Directory, including Merck Sharp & Dohme LLC, MSD International GmbH (Singapore Branch), MSD Ireland (Carlow).

💬 Answers drafted from Pembrolizumab Injection’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Pembrolizumab Injection comes

Pembrolizumab Injection is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Injection

By injection · Into a vein
Brands Keytruda
Available strengths 1 strength
8 FDA-listed product records

📊 Pembrolizumab Injection across the U.S. market

How Pembrolizumab Injection appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

1
Dose forms
3
Manufacturers
1
Brand names
8
FDA-listed product records
2014
First marketed
Merck Sharp & Dohme LLC75%
MSD International GmbH (Singapore Branch)13%
MSD Ireland (Carlow)13%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Pembrolizumab Injection is used

A general measure of how commonly Pembrolizumab Injection is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Pembrolizumab Injection is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

51,156
Medicaid prescriptions filled (Q1–Q4 2025)
$583.4M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Pembrolizumab Injection prescribed? Of the 1,596 medications we measure, Pembrolizumab Injection ranks #632 by Medicaid prescriptions — more than 60% of them.

Where Pembrolizumab Injection ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Pembrolizumab Injection product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

4 ML pembrolizumab 25 MG/ML Injection

51,156 Medicaid prescriptions (Q1–Q4 2025) 100% of Pembrolizumab Injection prescriptions shown $583.4M gross reimbursement (before rebates) ≈ $11,404 per prescription (gross)

Summed across the 2 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1657750

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Pembrolizumab Injection, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 2 of 3 listed Pembrolizumab Injection NDCs with Medicaid activity.

🔍 Compare Pembrolizumab Injection products

A representative set of FDA-listed product records for Pembrolizumab Injection — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Strength Route Manufacturer / Labeler Category Details
💊Injection
25 mg/mL Intravenous Merck Sharp & Dohme LLC × 6 listings BLA View NDC →
25 mg/mL MSD International GmbH (Singapore Branch) DRUG FOR FURTHER PROCESSING View NDC →
25 mg/mL MSD Ireland (Carlow) DRUG FOR FURTHER PROCESSING View NDC →

Showing 8 of 8 products — FDA National Drug Code Directory. See every product, package size and price: browse all 8 Pembrolizumab Injection NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Pembrolizumab Injection RxCUI 1547545 1 dose form · 2 strengths
  1. Dose form (SCDF) Injection RxCUI 1657745 In current FDA listings
    Clinical drug / strength (SCD) 4 ML pembrolizumab 25 MG/ML RxCUI 1657750 50 MG RxCUI 1657746

Look up RxCUI 1547545 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Keytruda

🏭 Manufacturers & labelers

Merck Sharp & Dohme LLC 6 MSD International GmbH (Singapore Branch) 1 MSD Ireland (Carlow) 1

RxNorm drug class

Pembrolizumab Injection belongs to the Programmed Death Receptor-1 Blocking Antibody class.

Pharmacologic class Programmed Death Receptor-1 Blocking Antibody
Drug family (ATC) PD-1/PD-L1 (Programmed cell death protein 1/death ligand 1) inhibitors
How it works Programmed Death Receptor-1-directed Antibody Interactions

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Jul 10, 2026
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Pembrolizumab Injection.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Pembrolizumab Injection after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
1
NDC products indexed
8
Distinct labelers/manufacturers represented
3
Linked representative label
Merck Sharp & Dohme LLC
Linked label effective
Jul 10, 2026
Composite sections available
21
Linked SPL Set ID
9333c79b-d487-4538-a9f0-71b91a02b287
Linked SPL Document ID
228e1e3f-d207-481f-8e14-9fdcbd0470e9
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Merck Sharp & Dohme LLC is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.