Nivolumab (Opdivo): A Comprehensive Medication Guide

Summary or Key Points

Nivolumab, known by its brand name Opdivo, is an immunotherapy medication used to treat several types of cancer. This guide provides comprehensive information about its pharmacological category, dosing, forms and strengths, administration instructions, and potential side effects. Remember, while this guide offers helpful information, always consult with your healthcare provider or schedule a telemedicine appointment with our team before adjusting your medication.

Names of Medication

US Brand Name: Opdivo
Generic Name: Nivolumab

The term ‘generic name’ refers to the official medical name for the active ingredient in the medication. In this case, Nivolumab is the generic name, and it is presented in parentheses.

Pharmacologic Category

Nivolumab falls under the category of monoclonal antibodies, specifically immune checkpoint inhibitors. Other medications in this category include pembrolizumab (Keytruda) and atezolizumab (Tecentriq).

Dosing

Nivolumab is used to treat the following conditions in adults. Remember, your dose may vary based on your individual health factors. Always consult your healthcare provider or book a telemedicine appointment with us before adjusting your medication.

• Melanoma: Typically, 240 mg every 2 weeks or 480 mg every 4 weeks, continuing until disease progression or unacceptable toxicity.
• Non-Small Cell Lung Cancer: The common dose is 360 mg every 3 weeks or 480 mg every 4 weeks, until disease progression or unacceptable toxicity.
• Renal Cell Carcinoma: Nivolumab is usually given at 240 mg every 2 weeks or 480 mg every 4 weeks, until disease progression or unacceptable toxicity.
• Hodgkin’s Lymphoma: The prescribed dose is commonly 240 mg every 2 weeks or 480 mg every 4 weeks, until disease progression or unacceptable toxicity.
• Head and Neck Cancer: Usual dosage is 240 mg every 2 weeks or 480 mg every 4 weeks, until disease progression or unacceptable toxicity.
• Urothelial Carcinoma: Patients typically receive 240 mg every 2 weeks or 480 mg every 4 weeks, until disease progression or unacceptable toxicity.
• Colorectal Cancer: Commonly, 240 mg every 2 weeks or 480 mg every 4 weeks, until disease progression or unacceptable toxicity.
• Hepatocellular Carcinoma: Nivolumab is typically prescribed at 240 mg every 2 weeks or 480 mg every 4 weeks, until disease progression or unacceptable toxicity.
• Esophageal Squamous Cell Carcinoma: The usual dose is 240 mg every 2 weeks or 480 mg every 4 weeks, until disease progression or unacceptable toxicity.

Dosage Forms and Strengths

Nivolumab (Opdivo) is available in the following forms and strengths:

• Injection: 40 mg/4 mL (10 mg/mL) in a single-dose vial.
• Injection:

  100 mg/10 mL (10 mg/mL) in a single-dose vial.

• Injection: 240 mg/24 mL (10 mg/mL) in a single-dose vial.

Administration Instructions

Adverse Reactions and Side Effects

Like all medications, Nivolumab can have side effects. While some patients may experience none or mild effects, others may experience more serious reactions. Always consult your healthcare provider or make a telemedicine appointment with our team if you experience any of the following:

• Common (may affect up to 1 in 10 people): Fatigue, decreased appetite, nausea, muscle, bone and joint pain, constipation, shortness of breath, cough, rash, itching, and fever.
• Less common (may affect up to 1 in 100 people): Severe skin reactions, severe stomach and bowel problems, severe lung problems, severe liver problems, kidney problems including kidney failure, hormonal gland problems, and infusion-related reactions.

Administration Instructions

Nivolumab is given as an infusion into a vein (intravenous or IV). This process usually takes about 60 minutes and is typically done in a healthcare facility by a healthcare professional. Dosage is based on your medical condition, weight, and response to treatment. Always consult your healthcare provider or schedule a telemedicine appointment with our team for personalized instructions and advice on your medication administration.

Adverse Reactions and Side Effects

Like all medications, Nivolumab can have side effects. While some patients may experience none or mild effects, others may experience more serious reactions. Always consult your healthcare provider or make a telemedicine appointment with our team if you experience any of the following:

• Common (may affect up to 1 in 10 people): Fatigue, decreased appetite, nausea, muscle, bone and joint pain, constipation, shortness of breath, cough, rash, itching, and fever.
• Less common (may affect up to 1 in 100 people): Severe skin reactions, severe stomach and bowel problems, severe lung problems, severe liver problems, kidney problems including kidney failure, hormonal gland problems, and infusion-related reactions.

If you notice any side effects not listed above, please consult your healthcare provider or arrange an immediate telemedicine appointment with our team.

Conclusion

Remember, while this guide provides helpful information on Nivolumab, it is not intended to replace professional medical advice. Every patient’s situation is unique, and your healthcare provider, who knows your full medical history, can best determine the appropriate treatment plan for you. We encourage you to schedule a telemedicine appointment with our primary care team for further discussion or any queries about your medication.

Contraindications

A contraindication refers to a situation in which a drug or procedure should not be used because it may be harmful to the person. Nivolumab is contraindicated in the following situations:

• Allergy: Patients who have had a severe allergic reaction to nivolumab or any of its components should not use it. An allergic reaction can cause serious complications.
• Autoimmune Disorders: Patients with certain autoimmune conditions may experience a flare of their condition with the use of Nivolumab, due to its action on the immune system.

Always consult with your healthcare provider or reach out to our team via telemedicine to understand if this medication is suitable for you.

Drug to Drug Interactions

At this time, significant drug-to-drug interactions with Nivolumab (Opdivo) have not been identified. However, always consult with your healthcare provider or schedule a telemedicine visit with our team before starting any new medications.

Nivolumab in Pregnancy

The effects of Nivolumab during pregnancy are unclear, as there are limited studies. It is recommended to avoid its use during pregnancy unless the benefits outweigh the potential risks. Discuss your options with your healthcare provider or arrange a telemedicine appointment with our team.

Nivolumab while Breastfeeding

It is unknown whether Nivolumab passes into breast milk. Due to potential risk to the infant, breastfeeding is not recommended while using this drug and for some time after the last dose. Consult your healthcare provider or our telemedicine team to discuss the best course of action.

Estimated Cost of Medication

Based on the GoodRX, the estimated cost of a 30-day supply of Nivolumab (Opdivo) without insurance is around $12,000 to $15,000. However, prices may vary by location and dosage. Always consult with your healthcare provider or contact our team via telemedicine to discuss options for medication affordability.

Possible Alternatives

For each of the following conditions, there are alternative treatments and lifestyle modifications that might help. Remember, it’s crucial to consult your healthcare provider or have a telemedicine appointment with us before making any changes to your treatment plan.

• Melanoma: Alternative treatments may include other immunotherapy drugs, targeted therapy, chemotherapy, radiation therapy, and surgery. Lifestyle changes such as regular skin checks and sun protection can aid in prevention.
• Non-Small Cell Lung Cancer: Alternatives could include chemotherapy, radiation therapy, targeted therapies, and surgical interventions. Smoking cessation is a key lifestyle change.
• Renal Cell Carcinoma: Alternatives include targeted therapies, immunotherapy, surgery, and radiation therapy. A healthy diet and regular exercise can support overall health.
• Hodgkin’s Lymphoma: Other treatments may include chemotherapy, radiation therapy, and stem cell transplant. Regular exercise and a balanced diet can support overall health and recovery.
• Head and Neck Cancer: Alternatives may include surgery, radiation therapy, chemotherapy, or targeted therapy. Avoiding tobacco and alcohol can reduce risk.
• Urothelial Carcinoma: Alternatives may include surgery, chemotherapy, radiation therapy, and immunotherapy. Drinking plenty of fluids can aid in prevention.
• Colorectal Cancer: Alternatives may include surgery, chemotherapy, radiation therapy, and targeted therapy. A diet high in fiber and regular exercise can support prevention.
• Hepatocellular Carcinoma: Alternatives may include surgery, radiation therapy, targeted therapy, and chemotherapy. Avoiding alcohol and maintaining a healthy weight can reduce risk.
• Esophageal Squamous Cell Carcinoma: Alternatives may include surgery, radiation therapy, chemotherapy, and targeted therapy. Avoiding tobacco and alcohol can reduce risk.

Recent Updates on Nivolumab Research

Research on Nivolumab continues to evolve. Recent studies have expanded its potential use for more types of cancer and in combination with other therapies. There are ongoing clinical trials exploring its efficacy in various stages of cancers and in combination with other medications. Always consult your healthcare provider or schedule a telemedicine visit with our team for the most up-to-date information.

Brief Legal Disclaimer: This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.