Talimogene Laherparepvec (Injection)

Talimogene Laherparepvec is an Oncolytic Viral Therapy which is used to treat melanoma skin lesions which cannot be operated on.


Talimogene Laherparepvec solution for injection route is sold, distributed and prescribed under the brand name Imlygic. It is used to treat skin cancer (melanoma) lesions which cannot be operated on.

This medicine is made from a genetically engineered herpes virus, namely a weakened type of Herpes Simplex Virus Type 1, which is the medical name for the cold sore virus. It works by replicating itself within the actual cancer cells, which in turn causes them to burst.

This medicine is injected by a health professional directly into one or more lesion/s. It is often given for a time frame of at least six months.

This medicine should not be used on those with seriously weakened immune systems or pregnant/breastfeeding patients.

The medicine may cause a range of side effects but most notably chills and influenza-like symptoms.

Condition/s treated

  • Inoperable melanoma lesions from Skin Cancer

Type of medicine

  • Genetically Modified Oncolytic Viral Therapy

Side Effects

Along with its desired and needed effects, any medicine, including Talimogene Laherparepvec, may also cause one or more unwanted effects. Not all of these side effects can occur, but if one or more does occur then they may require medical attention.

Consult your doctor or nurse immediately should any of the following side effects occur:

More common side effects that require attention

  1. Chills
  2. Coughing
  3. Diarrhea
  4. Feverishness
  5. General feelings of discomfort and/or illness
  6. Headache
  7. Joint pain
  8. Loss of appetite
  9. Muscle aches and/or pains
  10. Nausea
  11. Pain at the site of an injection
  12. Runny nose
  13. Shivering
  14. Sore throat
  15. Sweatiness
  16. Trouble falling asleep or staying asleep
  17. Unusual tiredness, fatigue and/or weakness
  18. Vomiting

Incidence not known

  • A break in the skin, especially when associated with a blue-black discoloration, signs of swelling or a drainage of fluid
  • Burning or stinging of skin
  • Painful cold sores and/or blisters on or around the nose, lips, eyes or genitals

Some side effects that occur do not usually require medical attention. These side effects may go away during the course of your treatment as your body adjusts to the medicine. Furthermore, your health care professional might be able to advise you on ways to reduce or prevent some of these side effects. Check with your doctor, nurse or healthcare professional should any of the following side effects continue or if they become bothersome or you simply have any questions about them:

More common side effects that may not require attention

  1. Abdominal/stomach pain
  2. Difficulty making a bowel movement
  3. Difficulty moving
  4. Dizziness
  5. Muscle pain and/or stiffness
  6. Pain in arms and/or legs
  7. Weight loss

Further side effects which are not listed here can also occur in some patients. If you notice any additional side effects then check with your doctor, nurse or healthcare professional.

Always speak to your doctor first for proper medical advice regarding side effects. You may also wish to report side effects to the FDA at 1-800-FDA-1088.


This medicine comes in suspension of either one million PFU/ml or 100 million PFU/ml. The former is prescribed for the first visit and the latter for follow up visits.

Each treatment visit should not exceed a dosage of more than 4 ml.

Second treatments should occur three weeks after the first and subsequent visits should each be two weeks after the last.

This medicine will always be given in a hospital by a trained professional. It will be given as an intralesional injection, being injected directly into the lesion/s. Your doctor will know which lesions to prioritize and may leave some untreated if the maximum dosage has been reached already in that session. They will start with the largest lesions.


Drug Interactions

In some cases, drugs interact with other medicines in a way that reduces their desired effects. Always inform your doctor of all medicines that you are currently taking, including herbal remedies and over the counter medicines as well as prescriptions. Your doctor may choose to change one or more of your medicines or the doses you have been prescribed.

Other Interactions

Some medicines should not be used during or around the time of eating food or when eating certain types of food as it may cause unwanted interactions to occur. Using alcohol or tobacco along with certain medicines can also cause interactions to occur. Always discuss alcohol and tobaccos use with your healthcare professional and also discuss the times of day that you eat and anything signification about your diet that you think your doctor may need to know.

Other Medical Problems

The presence of other medical conditions and/or problems can affect both the effectiveness and the suitability of this medicine. Make sure you tell your doctor about any other medical problems, notably:

  • Autoimmune disease
  • Kidney problems (Glomerulonephritis)
  • Pneumonitis (inflammation of the lung tissue)
  • Psoriasis (skin problem)
  • Inflammation of the blood vessels (Vasculitis)
  • Vitiligo (use medicine with caution as the medicine may make these conditions worse)
  • Leukemia (or a history of)
  • Lymphoma (or a history of)
  • Weakened immune system (due to e.g. AIDS or HIV infection) or a history of. Medicine should not be used in patients with these conditions.
  • Multiple myeloma - Patients with this may have an increased risk of more serious side effects.


Using Talimogene Laherparepvec whilst pregnant could harm an unborn baby. Always use an effective method of birth control to prevent getting pregnant during the course of your treatment. If you have any concerns that you might have gotten pregnant during treatment, tell your doctor immediately.

Your doctor needs to check and analyze your progress very closely during the course of this treatment. This will allow them to assess whether the medicine is working as it's intended to and to make a decision as to whether you should continue to receive it. Blood tests may be a necessary course of action in order to check for the appearance of any unwanted effects.

Talimogene Laherparepvec can spread to other areas of the body and in some cases even to other people such as members of your household or caregivers.

Avoid spreading the medicine in the following ways:

  • Avoid any direct contact between your treatment sites, body fluids, dressings, or close contacts. Never scratch or touch the treatment sites.
  • Always wear gloves when putting on, applying or changing dressings.
  • Treatment sites should be covered with airtight AND watertight dressings for at least one week following each treatment.
  • If a dressing becomes loose or if it falls off, then use a new and clean dressing to replace it.
  • Place any used dressings and accessories or cleaning materials into a sealed plastic bag and dispose of them with your general waste.

Because of the nature of this medicine, it can cause herpes infections, including cold sores. Inform your doctor immediately should you experience any pain/burning/tingling or a blister around the mouth, genitals, fingers or ears. Also inform your doctor of any feelings of extreme drowsiness, confusion, eye pain, blurry vision, sensitivity to light or a feeling of weakness in the legs or arms.

Use of the medicine can cause delayed healing at the site of injection. This is more likely to happen if you have had previous radiation treatment at the same site or if there are lesions there. Tell your doctor straight away should you display signs of an infection or delayed healing at the site of injections.

Use of this medicine can trigger immune-mediated conditions. This can include pneumonitis, glomerulonephritis, vasculitis, psoriasis and/or vitiligo. Inform your doctor of any bloody or cloudy urine, of any swellings in the feet or in the lower legs, noticeable weight gain, feverishness and/or the appearance of any sores, blisters, welting or red, scaling or crusted skin.

Do not take other medicines before discussing this with your doctor. This includes both prescription and over the counter (non-prescription) medicines as well as herbal remedies or vitamin supplements.

Always inform your doctor should you have any unusual or allergic reactions to the medicine. Also inform your health care professional if you already have other types of allergies such as foods, preservatives, dyes or animals, including pets.


Talimogene Laherparepvec suspension for injection comes in single-use vials. These will never need to be stored by the patient themselves.

Long-term storage of Talimogene Laherparepvec should involve freezing the medicine. The medicine should be stored in an ultra-low freezer at a temperature of -90°C to -70°C.

It can be removed from the freezer for transportation if it is intended to be used within 96 hours and stored frozen during shipment in its shipment container.

The medicine shouldn't be thawed until just before administration. It also shouldn't be drawn into a syringe until the point of administration.


Talimogene Laherparepvec suspension for injection is an Oncolytic Viral Therapy made from a genetically modified and weakened herpes virus. It is used to treat skin lesions from skin cancer (melanoma) and is applied by injection directly into any lesions which cannot be operated on.

The medicine works by replicating within the actual cancer cells and causing those cells to burst.

This drug can only be administered in a hospital by a designated professional. The second treatment should be made for three weeks following the first and all subsequent sessions should be held two weeks after the last.

Pregnant and breastfeeding women, as well as those with serious immune-weakening conditions such as AIDS or HIV infection, will not normally be able to take this medicine.

Chills and other flu-like symptoms are the most common side effects in patients given Talimogene Laherparepvec, although side effects tend to affect patients much more in the first three months of therapy.

As with all medicines, it's important that your doctor knows about all other medicine you are taking, including non-prescription drugs, herbal remedies, and vitamin supplements. They will also need to know of any other medical conditions you may have, notably kidney problems, skin problems, leukemia or lymphoma or a history of either of these cancers.

Last Reviewed:
December 23, 2017
Last Updated:
April 26, 2018
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