Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Pembrolizumab

Immunotherapy (PD-1 checkpoint inhibitor)

Brand names: Keytruda

Oral health effects

  • Immune-related oral lichenoid reaction / xerostomia

    Oral lichenoid reactions, mucositis, and dry mouth are recognized immune-related effects.

    Clinical management: Topical management; coordinate with oncology for immune-related toxicity.

  • Taste change (dysgeusia)

    Dysgeusia is reported, e.g., 21% vs 9% in one combination-regimen table in the label, and is recognised as an oral immune-related adverse event.

    Clinical management: Ask about taste change at each visit; exclude candidiasis and dry mouth, keep the mouth clean, and inform the oncology team if it affects eating — symptom management is the mainstay.

Sources

  1. A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Wolff A, Joshi RK, Ekström J, et al. Drugs in R&D, 2017.
  2. A review and guide to drug-associated oral adverse effects-Oral mucosal and lichenoid reactions. Part 2. Teoh L, Moses G, McCullough MJ. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2019.
  3. Pembrolizumab (Keytruda) prescribing information (FDA label) Merck Sharp & Dohme LLC / DailyMed, 2026.
  4. MASCC/ISOO Clinical Practice Statement: management of oral complications of immunotherapy. Fregnani ER, Epstein JB, Blijlevens NMA, et al. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025.