This information from UpToDate® Lexidrug™ explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.
Brand Names: US
Ziihera
- Diarrhea may happen with this drug. When used with certain chemo drugs, diarrhea may be severe and can be life-threatening or deadly. This risk may be higher when taken with another drug called tislelizumab-jsgr. The risk is also higher in patients who are 65 and older. If you are getting chemo drugs, your doctor will give you a drug to prevent diarrhea during the first cycle.
- You will need to take care not to become dehydrated. Be sure to drink plenty of fluids unless your doctor tells you otherwise. Follow what your doctor has told you to do about taking drugs to help with diarrhea. Tell your doctor right away if new or worse diarrhea happens.
- This drug may cause harm to an unborn baby. A pregnancy test will be done before you start this drug to show that you are NOT pregnant.
- If you may become pregnant, you must use birth control while taking this drug and for 4 months after the last dose. If you get pregnant, call your doctor right away.
What is this drug used for?
- It is used to treat biliary tract cancers (BTC).
- It is used to treat cancer of the stomach, esophagus, or the area where the esophagus meets the stomach.
- This drug may be taken with other drugs. Be sure you know about the warnings, benefits, and risks of these other drugs. Talk with the doctor if you have questions or concerns about any of the drugs.
What do I need to tell my doctor BEFORE I take this drug?
- If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
This drug may interact with other drugs or health problems.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
What are some things I need to know or do while I take this drug?
- Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
- Have your blood work and heart function checked as you have been told by your doctor.
- This drug may cause diarrhea. If you get diarrhea, talk with your doctor about ways to lower this effect. Do not stop taking this drug without talking with your doctor.
- If you are 65 or older, use this drug with care. You could have more side effects.
- Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby while you are taking this drug and for 4 months after your last dose.
What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of fluid and electrolyte problems like mood changes, confusion, muscle pain or weakness, fast or abnormal heartbeat, severe dizziness or passing out, increased thirst, seizures, feeling very tired or weak, decreased appetite, unable to pass urine or change in the amount of urine produced, dry mouth, dry eyes, or severe upset stomach or throwing up.
- Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
- A burning, numbness, or tingling feeling that is not normal.
- Redness or irritation of the palms of hands or soles of feet.
- Flushing.
- Fever or chills.
- Cough, shortness of breath, or other trouble breathing.
- Some patients have very bad side effects during the infusion. Tell your doctor if you have any bad effects during the infusion.
- Heart problems that may affect how well your heart pumps blood have happened with this drug. Call your doctor right away if you have an abnormal heartbeat, shortness of breath that is new or worse, swollen ankles, dizziness or passing out, sudden weight gain, or feeling very tired.
What are some other side effects of this drug?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Stomach pain.
- Upset stomach or throwing up.
- Decreased appetite.
- Feeling tired or weak.
- Skin irritation.
- Pimples (acne).
- Diarrhea is common with this drug and can be severe. Be sure you know what to do if you have diarrhea. Call your doctor right away if you have diarrhea that is new or worse.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.
You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.
How is this drug best taken?
Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
- It is given as an infusion into a vein over a period of time.
- Other drugs will be given with this drug to help avoid side effects.
What do I do if I miss a dose?
- Call your doctor to find out what to do.
How do I store and/or throw out this drug?
- If you need to store this drug at home, talk with your doctor, nurse, or pharmacist about how to store it.
General drug facts
- If your symptoms or health problems do not get better or if they become worse, call your doctor.
- Do not share your drugs with others and do not take anyone else’s drugs.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
- Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
- This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
- If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
Consumer Information Use and Disclaimer
This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.
Last Reviewed Date
2026-09-09
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