Classification: Monoclonal Antibody
About Nivolumab (Opdivo®)
Nivolumab is an antibody that blocks a protein called PD-1 (programmed cell death 1), found on the surface of T-cells, which are part of the immune system. Cancer cells can produce another molecule that can bind to the T-cell, making it inactive. Nivolumab binds to PD-1, blocking the cancer cell’s ability to bind to the T-cell, allowing the T-cell to remain active and attack the cancer cells.
How to Take Nivolumab
Nivolumab is given by intravenous (into a vein) infusion. The infusion takes about an hour and is typically given every 2 weeks.
Possible Side Effects of Nivolumab
There are a number of things you can do to manage the side effects of Nivolumab. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:
Fatigue is very common during cancer treatment and is an overwhelming feeling of exhaustion that is not usually relieved by rest. While on cancer treatment, and for a period after, you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team for helpful tips on dealing with this side effect.
Nivolumab can cause rash or itchy skin (called pruritis). Report any rash to your healthcare team. Skin moisturizers can help with dry, itchy skin. Use an emollient, which are creams that soften and moisturize. Creams tend to be more effective than lotions. Avoid perfumed or scented lotions, as these can be irritating.
Auto-Immune Side Effects
Nivolumab is a medication that works with your immune system. It can cause your immune system to attack normal organs and tissues, affecting how they work. The following problems can become very serious and any signs of these should be reported to your oncology team.
- Pneumonitis (inflammation of the lung). Symptoms include: new or worsening cough, chest pain and shortness of breath.
- Colitis (inflammation of the bowel). This inflammation can lead to a tear or hole in the bowel. Symptoms include: diarrhea or more bowel movements than usual, blood in the stool or dark, tarry or sticky stools, severe stomach pain.
- Hepatitis (inflammation of the liver). Symptoms include: yellowing of the skin or whites of the eyes, nausea/vomiting, pain in the stomach, drowsiness, dark colored urine, bleeding or bruising more than normal, and loss of appetite.
- Kidney problems (kidney inflammation or failure). Symptoms include: decrease in the amount of urine, blood in the urine, swelling in your ankles or loss of appetite.
- Hormone gland problems (most often the thyroid and pituitary glands). Symptoms include: headaches, extreme fatigue, weight gain or loss, changes in mood or behavior, irritability, dizziness or fainting, hair loss, feeling cold, constipation, changes in your voice.
- Problems in other organs: Rash, changes in eyesight, severe or persistent muscle or joint pains, severe muscle weakness.
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Even if your menstrual cycle stops or you believe you are not producing sperm, effective birth control is necessary during treatment and up to 5 months after stopping treatment.