Sign Up

LOGIN / SIGNUP

Patient Handout: Nivolumab (Opdivo)

What is Nivolumab?

Nivolumab, sold under the brand name Opdivo, is a medication used to treat various types of cancer. It is an immune checkpoint inhibitor that works by helping the immune system recognize and attack cancer cells. Nivolumab is used for treating cancers such as:

  • Melanoma (skin cancer)
  • Non-small cell lung cancer (NSCLC)
  • Renal cell carcinoma (kidney cancer)
  • Classical Hodgkin lymphoma
  • Head and neck cancers
  • Bladder cancer
  • Colorectal cancer (with specific mutations)
  • Other cancers as determined by your doctor

Nivolumab is often used when other treatments have not been successful, or as part of a combination therapy with other cancer treatments.

How Does Nivolumab Work?

Nivolumab is an immune checkpoint inhibitor, which means it works by blocking a protein called PD-1. PD-1 is found on immune cells called T-cells, and it normally helps prevent T-cells from attacking normal cells in the body. Cancer cells can sometimes use this pathway to hide from the immune system. By blocking PD-1, nivolumab allows T-cells to recognize and attack cancer cells more effectively.

How is Nivolumab Given?

  • Administration: Nivolumab is given as an intravenous (IV) infusion in a healthcare setting.
  • Frequency: The dose and frequency of nivolumab depend on the type of cancer being treated and your individual treatment plan. It may be given every 2, 3, or 4 weeks.
  • Length of Infusion: The infusion typically lasts about 30 minutes to 1 hour.

You will be monitored during and after the infusion for any potential side effects.

Possible Side Effects

While nivolumab can be very effective in treating cancer, it can also cause side effects. These side effects can range from mild to severe and may occur during treatment or even after treatment has ended. Common side effects include:

Common Side Effects:

  • Fatigue: Feeling unusually tired or weak is common. Be sure to rest as needed, but talk to your doctor if fatigue affects your daily activities.
  • Skin reactions: You may experience rash, itching, or skin dryness. Let your doctor know if you develop any skin reactions.
  • Diarrhea: Nivolumab can cause diarrhea, sometimes severe. Drink plenty of fluids and contact your doctor if diarrhea becomes excessive or persistent.
  • Nausea: Some people experience nausea, which can sometimes lead to vomiting. Anti-nausea medication may be prescribed to help.
  • Loss of appetite: Some patients may experience reduced appetite. Eating smaller, more frequent meals may help manage this.

Serious Side Effects: Nivolumab can cause the immune system to attack healthy cells and tissues, leading to immune-related side effects. These can affect many organs in the body, including the lungs, liver, kidneys, intestines, skin, and endocrine system.

  • Pneumonitis: Inflammation of the lungs that can cause symptoms like coughing, shortness of breath, or chest pain. Seek medical help if you experience these symptoms.
  • Colitis: Inflammation of the colon, which can lead to symptoms like severe diarrhea, stomach pain, or blood in the stool.
  • Hepatitis: Inflammation of the liver, which can cause yellowing of the skin or eyes (jaundice), dark urine, or right upper abdominal pain.
  • Nephritis: Inflammation of the kidneys, which can cause swelling, decreased urine output, or changes in urination.
  • Endocrine problems: Nivolumab can cause thyroid problems, adrenal gland problems, or other hormone imbalances, leading to symptoms like weight changes, fatigue, mood swings, or dizziness.
  • Severe rash or itching: If you develop severe skin reactions, inform your doctor immediately.

Immune-related side effects may occur during treatment or even after treatment has ended.

Precautions Before Taking Nivolumab

Before starting nivolumab, inform your healthcare provider if you:

  • Have any autoimmune conditions (e.g., rheumatoid arthritis, lupus, etc.), as nivolumab may worsen these conditions.
  • Have lung or breathing problems, as nivolumab can cause lung inflammation.
  • Have liver or kidney problems, as nivolumab may affect these organs.
  • Are pregnant or planning to become pregnant, as nivolumab may harm an unborn baby. You should use effective contraception during treatment and for at least 5 months after treatment.
  • Are breastfeeding, as nivolumab may pass into breast milk and is not recommended during treatment. Speak to your doctor if you are breastfeeding or plan to breastfeed.

What to Avoid While Taking Nivolumab

  • Infections: Nivolumab may weaken your immune system, making it harder for your body to fight infections. Avoid contact with people who are sick, and wash your hands frequently.
  • Vaccines: Talk to your doctor before receiving any vaccines while on nivolumab. Live vaccines should generally be avoided during treatment.
  • Pregnancy: As mentioned, nivolumab can harm an unborn baby, so use effective birth control during and after treatment.

Regular Monitoring

Your doctor will monitor your health during treatment with nivolumab. This may include:

  • Blood tests: To check for any changes in your liver, kidney, and other organ functions.
  • Imaging tests: To assess how well the treatment is working and to monitor the size of the cancer.
  • Vital signs: Your healthcare provider will monitor your heart rate, blood pressure, and temperature during and after the infusion.

When to Contact Your Doctor

Call your healthcare provider immediately if you experience any of the following:

  • New or worsening cough, shortness of breath, or chest pain.
  • Severe diarrhea or blood in your stool.
  • Yellowing of your skin or eyes, dark urine, or right-sided abdominal pain (signs of liver problems).
  • Severe or persistent rash, blistering, or peeling of the skin.
  • Severe fatigue, dizziness, confusion, or weight loss.
  • Headache, vision changes, or dizziness, which could indicate a problem with your endocrine system.
  • Signs of infection, such as fever, chills, or sore throat.

Disclaimer:

This handout is for educational purposes only and should not be considered medical advice. Always follow the instructions provided by your healthcare provider regarding treatment and care. For personalized advice, consult your healthcare provider or pharmacist.