Get emergency medical help if you have signs of an allergic reaction to Kymriah: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
A serious side effect of Kymriah is called cytokine release syndrome (CRS). Tell your caregivers right away if you have signs of this condition: fever, chills, trouble breathing, body aches, vomiting, diarrhea, or feeling light-headed. Your caregivers will have medication available to quickly treat CRS if it occurs.
Also tell your caregivers or seek emergency medical attention if you have signs of life-threatening nerve problems: problems with speech, problems with thinking or memory, confusion, or a seizure.
Also call your doctor at once if you have:
headaches, unusual tiredness;
tremors, anxiety, agitation;
unusual thoughts or behavior;
trouble speaking or understanding what is said to you; or
signs of infection - fever, chills, flu symptoms, mouth sores, skin sores, easy bruising or bleeding, cough, trouble breathing.
Common Kymriah side effects may include:
nausea, vomiting, diarrhea, loss of appetite;
fever;
headache, confusion, feeling tired;
bleeding; or
fast heartbeats.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
 Kymriah side effects (more detail)
Before taking this medicine
To make sure Kymriah is safe for you, tell your doctor if you have ever had:
hepatitis B or C;
HIV (human immunodeficiency virus); or
if you have received a vaccine in the past 2 weeks.
Women may need pregnancy testing before receiving this medicine. You may also need to use birth control to prevent pregnancy during and shortly after treatment with Kymriah and chemotherapy.
If you receive Kymriah during pregnancy, your baby's blood may need to be tested after it is born. This is to evaluate any effects the medicine may have had on the baby.
It may not be safe to breastfeed while using Kymriah . Ask your doctor about any risk.
How is Kymriah given?
Kymriah is available only at an authorized hospital or clinic, and must be given by specially trained healthcare professionals.
Kymriah is given after a procedure called leukapheresis (LOO-kuh-fuh-REE-sis).
During leukapheresis, some of your blood is collected through a small tube (catheter) placed into a vein. The catheter is connected to a machine that separates your white blood cells from other parts of the blood.
The cells are then sent to a laboratory where they are made into tisagenlecleucel. Because it will take time to process your blood cells into tisagenlecleucel, you will not receive the medicine on the same day your blood cells are drawn.
About 2 to 14 days before Kymriah is given, you will be pre-treated with chemotherapy to help prepare your body for tisagenlecleucel.
Just before you receive Kymriah, you will be given other medications to help prevent serious side effects or allergic reaction.
Once your body is ready to receive tisagenlecleucel, your care providers will inject the medicine into a vein through an IV.
For at least 4 weeks, plan to stay near the hospital or clinic where you received Kymriah. Avoid being so far away that it takes you longer than 2 hours to travel back to the hospital.
Serious and sometimes fatal infections may develop after the injection. Call your doctor right away if you have fever, chills, easy bruising, unusual bleeding, or other signs of infection.
This medicine can cause you to have a false positive screening test for HIV (human immunodeficiency virus). Tell any doctor who treats you that you are using Kymriah.
Using Kymriah may increase your risk of developing other types of cancer, or causing your leukemia to come back. Your doctor will need to check your progress for the rest of your life.
If you have ever had hepatitis B, Kymriah can cause this condition to come back or get worse. You will need frequent blood tests to check your liver function during treatment and for several months after you stop using this medicine.
