Polivy (polatuzumab vedotin-piiq) is a prescription biologic drug that treats certain types of B-cell lymphoma. Polivy can cause side effects that range from mild to serious. Examples include fatigue and nausea.

Specifically, Polivy is used in adults to treat:

  • Untreated moderate to high risk diffuse large B-cell lymphoma (DLBCL) that is not otherwise specified (NOS): For this use, Polivy is prescribed along with a rituximab product, cyclophosphamide, doxorubicin, and prednisone. (This combination with Polivy may be called R-CHP or pola-R-CHP.)
  • Untreated moderate to high risk high-grade B-cell lymphoma (HGBL): For this use, R-CHP or pola-R-CHP is prescribed.
  • Relapsed or refractory DLBCL that is NOS after two or more previous treatments: For this use, Polivy is prescribed along with bendamustine and a rituximab product. (“Relapsed” means the condition has returned. “Refractory” means the condition did not respond to treatment.)

Polivy is a biologic drug, and its active ingredient is polatuzumab vedotin-piiq. The drug comes as a powder. A healthcare professional mixes it with a liquid for intravenous (IV) infusion into a vein.

Keep reading to learn about the common, mild, and serious side effects that Polivy can cause. For a general overview of the drug, including details about its uses, see this article.

Below are just a few of the more common side effects reported by people who took Polivy in studies. These side effects can vary depending on what condition the drug is treating.

More common side effects in people using the R-CHP drug combination containing Polivy include:

  • low red blood cell, white blood cell, and platelet levels
  • nausea
  • peripheral neuropathy (nerve pain)
  • fatigue
  • constipation or diarrhea

More common side effects in people using Polivy with bendamustine and a rituximab product include:

  • peripheral neuropathy (nerve pain)
  • low red blood cell, white blood cell, and platelet levels
  • lack of appetite
  • fever
  • fatigue

The following sections include more side effects of Polivy. Each person’s experience with side effects may differ.

To learn more about peripheral neuropathy, see the “Side effects explained” section below.

Mild side effects have been reported with Polivy. These include:

  • fatigue
  • lack of appetite
  • nausea and vomiting
  • dizziness
  • muscle and joint pain
  • constipation or diarrhea
  • belly pain
  • swollen and painful lining of the mouth
  • fever
  • weight loss
  • hair loss
  • high blood levels of uric acid
  • low levels of albumin (blood protein)
  • rash
  • mild allergic reaction (This side effect is possible with Polivy but wasn’t reported in studies.)

In most cases, these side effects should be temporary. And some may be managed easily. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop using Polivy unless your doctor recommends it.

Polivy may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

To learn more about allergic reaction, see the “Side effects explained” section below.

Serious side effects have been reported with Polivy. These include:

If you develop serious side effects while using Polivy, call your doctor right away. If the side effects seem life threatening or you think you have a medical emergency, immediately call 911. Or call your local emergency number.

To learn more about the following side effects, see the “Side effects explained” section:

  • infusion reaction
  • peripheral neuropathy
  • allergic reaction

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Polivy, visit MedWatch.

Get answers to some frequently asked questions about Polivy’s side effects.

Are low white blood cell counts resulting from the use of Polivy treatable?

Low white blood cell counts occur commonly during Polivy treatment. Polivy is usually given with other medications, and all of them can lower white blood cell counts. White blood cells help protect against infections and certain cancers. Symptoms of low white blood cell counts include:

  • fatigue
  • frequent infection
  • dizziness
  • shortness of breath
  • sores in the mouth or throat
  • skin rash
  • sore throat
  • fever and chills

Doctors will often try to help prevent low white blood cell counts by prescribing a granulocyte colony-stimulating factor (G-CSF). This may help your body produce more white blood cells. For this, they may prescribe filgrastim to use as you begin Polivy treatment.

Some infections can occur when your white blood cell counts become low. To prevent them, doctors will prescribe other medications, including an:

  • Antibiotic: sulfamethoxazole with trimethoprim, to help prevent Pneumocystis jirovecii pneumonia (sometimes called Pneumocystis pneumonia)
  • Antiviral: valacyclovir, to prevent herpesvirus infection

While taking these medications, notify your doctor right away if you develop a high fever. This may indicate a different type of infection requiring immediate treatment.

Does Polivy cause long-term side effects?

It’s possible that Polivy can cause long-term side effects. These side effects may start at any time during treatment, even if you’ve used the drug for a long time. They also include side effects that may not go away, even after you stop the drug.

Examples of long-term side effects reported in Polivy’s studies include:

In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Talk with your doctor to learn more about possible side effects of Polivy and how long they may last.

Learn more about some of the side effects Polivy may cause.

Infusion reaction

Infusion reaction was a common side effect reported in studies of Polivy. This side effect can occur right away or anytime within 24 hours after an infusion. It may cause symptoms such as:

  • chills
  • flushing (temporary warmth, redness, or deepening of skin color)
  • fever
  • cough
  • skin rash or hives
  • nausea
  • low blood pressure
  • chest discomfort or pressure
  • shortness of breath
  • swelling of hands, legs, or feet
  • sudden swelling of lips, tongue, eyes, or face

Factors that can raise the risk of infusion reaction when using this drug include:

What might help

Your doctor can help prevent or lower your reaction to Polivy infusions. To do so, they’ll likely give you some medications 30–60 minutes before your infusion. These include an antihistamine and a pain reliever.

If you’ve ever had an infusion reaction to any medication, talk with your doctor. You can discuss your risk of another reaction if you have Polivy infusions.

Peripheral neuropathy

Peripheral neuropathy was a common side effect reported in studies of Polivy. Peripheral neuropathy is a type of nerve pain that can occur at any time during treatment. But, on average, it becomes noticeable about 2 months after starting Polivy.

If you already have peripheral neuropathy, using Polivy may worsen it.

Peripheral neuropathy may cause symptoms such as:

  • numbness in the feet or hands
  • stabbing, burning, or tingling pain in the feet or hands
  • muscle weakness, spasms, or cramps in the arms, hands, legs, or feet
  • reduced ability to sense hot or cold temperatures by touch

Factors that can increase the risk of peripheral neuropathy when using Polivy include:

  • low blood levels of vitamin B12
  • nerve injury from an accident or surgery
  • excessive alcohol use (if applicable) over a long term
  • smoking (if you smoke)
  • diabetes

What might help

If you have peripheral neuropathy during Polivy treatment, consider these options to help relieve your symptoms:

  • avoid smoking (if you smoke)
  • manage your blood sugar
  • reduce alcohol use (if you drink)
  • exercise or do physical therapy
  • eat a diet rich in antioxidants and fiber
  • check with your doctor about recommendations for vitamin supplements
  • seek alternative treatments, such as massage therapy, chiropractic care, or acupuncture

Always talk with your doctor before choosing treatment for peripheral neuropathy.

Allergic reaction

Like most drugs, Polivy can cause an allergic reaction in some people. But this side effect wasn’t reported in studies.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin (usually in your eyelids, lips, hands, or feet)
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an oral antihistamine, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

Your doctor can confirm whether you’ve had a mild allergic reaction to Polivy. If they do, they’ll determine whether you should continue using the drug.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 right away. Or call your local emergency number. These symptoms could be life threatening and require immediate medical care.

Your doctor can confirm whether you’ve had a serious allergic reaction to Polivy. If they confirm it, they may have you switch to a different treatment.

Keeping track of side effects

During your Polivy treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start a new drug or combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were using when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Polivy affects you. They can then use this information to adjust your treatment plan if needed.

Below is important information you should consider before using Polivy.

Warnings

Polivy can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether this drug is a good treatment option for you.

Talk with your doctor about your health history before you start Polivy. Be sure to tell them if any of the following factors apply to you:

  • liver problems
  • current infection
  • bone marrow problems or anemia
  • peripheral neuropathy (nerve pain)
  • you take other prescription medications, over-the-counter drugs, herbs, supplements, or vitamins
  • past infusion reaction
  • past allergic reaction to Polivy
  • you plan to have children
  • pregnancy
  • breastfeeding

Alcohol and Polivy

No interactions between alcohol and Polivy are known. But Polivy can increase levels of liver enzymes in the blood. And this can indicate that you have liver damage. If you do, drinking excessive amounts of alcohol during Polivy treatment could worsen it.

If you have questions about consuming alcohol during Polivy treatment, talk with your doctor or pharmacist.

Pregnancy and breastfeeding with Polivy

Before starting Polivy treatment, it’s important to talk with your doctor if you’re pregnant, breastfeeding, or planning either.

Pregnancy

Polivy is not safe to use during pregnancy and can cause harm to a fetus. If you’re pregnant or planning to become pregnant, talk with your doctor about your treatment options.

If you’re able to become pregnant, your doctor will do a pregnancy test before you start treatment.

Also, your doctor will likely recommend using a form of birth control during your Polivy treatment. You may need to use birth control for a certain amount of time before starting Polivy and throughout your treatment. You may also need to continue using it for 3 months after your Polivy treatment ends.

Males receiving Polivy should use effective contraception during treatment if they have female partners who can become pregnant. They also should use it for 5 months after their Polivy treatment ends. (In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.)

If you become pregnant during Polivy treatment, notify your doctor right away.

Breastfeeding

Polivy is not safe to use while breastfeeding. No studies have looked at the effects of Polivy and breastfeeding.

Polivy has a potential risk of severe adverse effects in children who are breastfed. Avoid breastfeeding during Polivy treatment and for an additional 2 months after your last dose.

If you’re breastfeeding or planning to do so, talk with your doctor about your options.

Like most drugs, Polivy can cause a number of side effects that range from mild to serious. But some are temporary and go away after a few days to weeks. If you have questions about side effects that Polivy can cause, talk with your doctor.

Examples of questions to help get you started include:

  • How can I manage the side effects of Polivy?
  • How will Polivy affect my quality of life during treatment?
  • Do side effects vary based on the combination of drugs used with Polivy?
  • Will the side effects of Polivy worsen over time?
  • Are the severe side effects of Polivy permanent?

To learn more about Polivy, see this “Polivy (polatuzumab vedotin-piiq)” article.

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.