Opdivo (nivolumab)

Opdivo generic or biosimilar

Opdivo is available only as a brand-name medication. It’s not currently available in biosimilar form.

A biosimilar is a drug that’s similar to a brand-name biologic drug, referred to as the parent drug. Opdivo is a biologic medication, which is also called a biologic.

Biologic drugs are made from living cells. It’s not possible to copy these drugs exactly. A generic, on the other hand, refers to drugs made from chemicals. A generic contains exactly the same active ingredient in a brand-name medication. Biosimilars are considered to be just as safe and effective as their parent drug. And like generics, biosimilars tend to cost less than brand-name medications.

Opdivo side effects

Opdivo can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while using Opdivo. These lists do not include all possible side effects.

For more information on the possible side effects of Opdivo, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Opdivo and want to tell the FDA about it, visit MedWatch or call -800-FDA-1088 (800-332-1088).

More common side effects

The more common side effects of Opdivo can include:

• headache
• abdominal pain
• nausea or vomiting
• diarrhea
• constipation
• loss of appetite
• skin rash
• fatigue
• muscle, bone, back, or joint pain
• itchiness
• weakness
• cough
• shortness of breath
• upper respiratory infections, such as the common cold
• urinary tract infection (UTI)
• fever
• weight loss

For more information on some of these side effects, see the “Side effect details” section later in this article.

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Opdivo can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects can include the following:

• hepatitis (inflammation in your liver)
• hormonal problems, including changes in thyroid hormone and cortisol levels
• type 1 diabetes
• kidney damage
• severe skin reactions, including Stevens-Johnson syndrome
• encephalitis (swelling in your brain)
• infusion reactions (reactions that occur during or shortly after you receive a drug by intravenous [IV] infusion)
• immune system reaction (when your immune system attacks your organs)
• colitis (inflammation in your intestines)
• pneumonitis (inflammation in your lungs)

ALLERGIC REACTION

For some people, Opdvio can cause an allergic reaction.

In general, symptoms of an allergic reaction can be mild or serious.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Opdivo, your doctor may recommend a different medication instead.

Side effects in children

Side effects in children are expected to be similar to side effects in adults, when Opdivo is used to treat certain skin or colorectal cancers. These are the only conditions that Opdivo is approved to treat in children.

However, there haven’t been any clinical trials testing the safety of Opdivo or how often side effects occur in children using the drug. While clinical trials testing the safety of Opdivo for children is limited, data from existing trials permitted use in children for certain indications.

Opdivo for lung cancer

The Food and Drug Administration (FDA) approves prescription drugs such as Opdivo to treat certain conditions. Here you’ll find information on Opdivo for treating certain types of lung cancer. To learn more about Opdivo’s use for this condition, see this Opdivo for lung cancer article. And you can find more information about this condition in our lung cancer hub.

Opdivo for non-small cell lung cancer

Opdivo is FDA approved to treat certain types of non-small cell lung cancer (NSCLC), as described in the following text.

Opdivo for metastatic NSCLC

Doctors may prescribe Opdivo for NSCLC that’s metastatic (has spread from the lungs to other parts of the body).

It’s approved for use in adults whose NSCLC has gotten worse during or after treatment with platinum-based chemotherapy drugs. Examples include cisplatin and carboplatin.

Some people’s NSCLC has certain genetic changes, either EGFR mutations or ALK rearrangements. People with these genetic changes need to receive medication that’s FDA approved to treat that specific type of cancer before they use Opdivo. In addition, the cancer must have worsened during or after treatment with those drugs before they can receive Opdivo.

Opdivo is also approved for previously untreated NSCLC that is metastatic and has a high level of protein called PD-L1 on the surface. For this use, the cancer must not have EGFR or ALK genetic changes. To treat this type of cancer, doctors prescribe Opdivo in combination with ipilimumab (Yervoy).

The drug may also be used for previously untreated NSCLC that is metastatic or recurrent (comes back) in combination with ipilimumab and certain chemotherapy drugs, such as cisplatin and carboplatin. For this use, the cancer must not have EGFR or ALK genetic changes.

Opdivo for resectable NSCLC

Opdivo is FDA approved to treat NSCLC that’s resectable (can be removed by surgery) in adults. For this purpose, doctors prescribe the drug in combination with platinum-based chemotherapy drugs prior to surgery to help shrink tumors. Examples of such chemotherapy drugs include cisplatin and carboplatin.

In addition, Opdivo is approved to treat resectable NSCLC that has no EGFR or ALK genetic changes. For this purpose, it is used with platinum-based chemotherapy drugs prior to surgery. (Treatment prior to surgery is called neoadjuvant treatment.)

Opdivo is then used on its own after surgery to kill any cancer cells that remain. (Treatment after surgery is called adjuvant treatment.)

Effectiveness for non-small cell lung cancer

In clinical trials, Opdivo has been found effective in treating the types of NSCLC just described. For details about these trials, see Opdivo’s prescribing information.

Opdivo other uses

In addition to treating lung cancer (described in the section “Opdivo for lung cancer”), the Food and Drug Administration (FDA) has also approved Opdivo to treat other conditions. Opdivo may also be prescribed off-label for other conditions. Off-label use is when a drug that the FDA has approved to treat one condition is used to treat a different condition.

Effectiveness of Opdivo for certain cancers

Clinical trials have shown Opdivo to be effective for the cancers the FDA has approved the drug to treat. For more information, see the drug’s prescribing information.

Some of the uses for Opdivo described in the following text received accelerated approval from the FDA.

The FDA may grant accelerated approval to a drug that shows promise for treating certain conditions. This would be based on information from early studies. The FDA’s decision for full approval will be made after additional studies are completed.

Opdivo for liver cancer

Opdivo is FDA approved to treat hepatocellular (liver) cancer in adults when used in combination with ipilimumab (Yervoy). Doctors prescribe it for people who have taken the drug sorafenib (Nexavar) in the past to treat their liver cancer.

For this use, Opdivo received accelerated approval from the FDA.

To learn more about this condition, see our list of liver cancer articles.

Opdivo for kidney cancer

Opdivo is FDA approved to treat advanced renal cell (kidney) cancer in adults.

For this purpose, Opdivo is approved for use in people who have taken anti-angiogenesis drugs in the past for their kidney cancer. These drugs block the growth of blood vessels in and around cancer cells. This prevents the cancer cells from getting nutrients and oxygen, which they need to survive.

Examples of anti-angiogenesis drugs include axitinib (Inlyta) and lenalidomide (Revlimid). In this case, you would receive Opdivo on its own.

Opdivo is also FDA approved to treat advanced renal cell cancer in adults who haven’t previously received treatment for their cancer. In this case, you’ll receive Opdivo in combination with another drug. Which drug is prescribed depends on whether the kidney cancer is considered intermediate or poor risk.

Kidney cancer is considered intermediate or poor risk based on several factors. These factors include your hemoglobin levels and calcium levels.

For kidney cancer that is considered intermediate or poor risk, you would receive Opdivo with ipilimumab. Otherwise, you would receive Opdivo with cabozantinib (Cabometyx).

Opdivo for bladder cancer

Opdivo is FDA approved to treat urothelial cancer in adults. This type of cancer starts in the cells that line your bladder, ureters, and urethra. Urothelial cancer is often called bladder cancer.

Doctors prescribe Opdivo for previously untreated bladder cancer that is either unresectable (cannot be removed by surgery) or metastatic (has spread from the bladder to other areas in the body). For this purpose, you’ll receive Opdivo in combination with cisplatin and gemcitabine.

In addition, doctors may prescribe Opdivo for previously treated bladder cancer that is locally advanced (has spread to organs near the bladder) or metastatic. For this purpose, the bladder cancer has either:

• gotten worse during or after treatment with platinum-based chemotherapy drugs, such as cisplatin or carboplatin, or
• gotten worse within 12 months of receiving platinum-based chemotherapy drugs before or after surgery

The drug is also used to help prevent certain bladder cancers from returning after surgery when there is a high risk of the cancer coming back.

Opdivo for colorectal cancer

Opdivo is FDA approved to treat colorectal cancer (CRC). This type of cancer starts in your colon or rectum.

Opdivo is approved for use in adults and children ages 12 years and older with CRC that is all of the following:

• is metastatic (has spread from the colon or rectum to other parts of the body)
• has gotten worse after treatment with certain other cancer drugs, such as oxaliplatin, irinotecan (Camptosar), and a drug that contains fluoropyrimidine, such as capecitabine (Xeloda)
• has certain genetic changes called either microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR)

Opdivo may be used on its own or in combination with ipilimumab to treat colorectal cancer.

For this use, Opdivo received accelerated approval from the FDA.

To learn more about this condition, see our list of colorectal cancer articles.

Opdivo for head and neck cancer

Opdivo is FDA approved to treat squamous cell carcinoma of the head and neck (SCCHN) in adults. Squamous cell cancer starts in the squamous cells (flat cells) that make up the surface of your skin, eyes, and other internal organs.

Doctors prescribe Opdivo for SCCHN that is recurrent (has come back after improving with past treatments). It’s also prescribed to treat SCCHN that is metastatic (has spread beyond the head and neck).

The FDA has approved Opdivo to treat SCCHN that has worsened during or after treatment with platinum-based chemotherapy drugs. Examples of these drugs include cisplatin and carboplatin.

To learn more about this condition, see our list of head and neck cancer articles.

Opdivo for melanoma skin cancer

Opdivo is FDA approved to treat melanoma. Melanoma is a type of skin cancer that starts in cells that make melanin (the pigment that gives color to your skin). Melanoma can occur in your skin or in other parts of your body. For the types of melanoma Opdivo treats, doctors may prescribe the drug to adults and children ages 12 years and older.

To learn more about this condition, see our skin cancer hub.

Opdivo for unresectable or metastatic melanoma skin cancer

Opdivo is approved to treat melanoma that is unresectable (can’t be removed surgically). It’s also approved to treat melanoma that is metastatic (has spread from the area where it first started to other parts of your body).

For these conditions, Opdivo is approved for use on its own, or in combination with another cancer drug called ipilimumab.

Opdivo to prevent melanoma skin cancer from returning

Opdivo is also FDA approved as adjuvant treatment of melanoma. Adjuvant treatment is therapy you receive after surgery or use of other medication. The goal of adjuvant treatment is to reduce the risk of the cancer returning.

Opdivo is approved as adjuvant therapy for melanoma that is either still local but above a certain size, locally advanced, or metastatic. Opdivo is approved for this use after surgery to completely remove the cancer.

Opdivo for classical Hodgkin’s lymphoma

Opdivo is FDA approved to treat classical Hodgkin’s lymphoma (cHL) in adults. Doctors prescribe Opdivo to treat cHL that has returned or gotten worse after treatment with either:

• autologous hematopoietic stem cell transplant (HSCT) and a drug called brentuximab vedotin (Adcetris), or
• three or more cancer treatments in the past, where one of the treatments was HSCT

An autologous HSCT is a bone marrow transplant that’s done using stem cells that were harvested in the past from your own body. Stem cells work in your body to make new blood cells, which help you stay healthy as you fight off cancer.

For treating cHL, Opdivo received accelerated approval from the FDA.

Opdivo for malignant pleural mesothelioma

When used in combination with ipilimumab, Opdivo is FDA approved for previously untreated malignant pleural mesothelioma (cancer of the lining around the lungs) in adults. For this use, the cancer must be unresectable (cannot be removed by surgery).

Opdivo for esophageal cancer

Opdivo is FDA approved to treat certain types of esophageal cancer in adults. This is cancer that occurs in the esophagus, the tube that connects your throat and stomach.

Doctors prescribe Opdivo to treat esophageal cancer that remains after surgery in people who have received chemotherapy and radiation therapy.

The drug is also used to treat esophageal squamous cell carcinoma (ESCC) that is advanced (has spread to nearby areas) or metastatic (has spread from the area to other parts of the body). Squamous cells are flat cells that line parts of your body, including the inside of the esophagus.

For previously untreated advanced or metastatic ESCC that cannot be removed by surgery, Opdivo is used in combination with either:

• a fluoropyrimidine drug, such as capecitabine, and platinum-based chemotherapy drugs, such as cisplatin and carboplatin, or
• ipilimumab

Opdivo may be used on its own to treat ESCC that is all of the following:

• is either advanced, metastatic, or recurrent (comes back after treatment)
• was previously treated with a fluoropyrimidine drug and platinum-based chemotherapy drugs
• cannot be removed by surgery

Doctors may also prescribe Opdivo to treat esophageal adenocarcinoma, which is cancer in the glands of the esophagus. The adenocarcinoma must be advanced or metastatic. For treating this cancer, you ’ll receive Opdivo in combination with a fluoropyrimidine, such as capecitabine, and platinum-based chemotherapy drugs, such as cisplatin and carboplatin.

Opdivo for gastric cancer

Opdivo is FDA approved to treat gastric cancer (stomach cancer) as well as gastroesophageal junction cancer (cancer in the area where the esophagus joins the stomach). The cancer must be advanced (has spread to nearby areas) or metastatic (has spread from the area to other parts of the body).

For treating these cancers, Opdivo is used in combination with a fluoropyrimidine, such as capecitabine, and platinum-based chemotherapy drugs, such as cisplatin and carboplatin.

Opdivo for children

Opdivo is FDA approved for use in children ages 12 years and older with colorectal cancer that is all of the following:

• is metastatic (has spread from the colon or rectum to other parts of the body)
• has certain genetic changes, either microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR)
• became worse during or after treatment with other cancer drugs

See the “Opdivo for colorectal cancer” section for more details about this type of cancer.

Opdivo is also approved to treat the following types of melanoma in children ages 12 years and older:

• melanoma that can’t be removed surgically
• melanoma that is metastatic (has spread from the area where it first started to other parts of the body)

The drug may also be prescribed as adjuvant therapy (therapy you receive after surgery or use of other medication) for melanoma in children ages 12 years and older. For this purpose, the cancer must be either still local but above a certain size, locally advanced, or metastatic. Opdivo is approved for this use after surgery to completely remove the cancer.

See “Opdivo for unresectable or metastatic melanoma skin cancer” and “Opdivo to prevent melanoma skin cancer from returning” earlier in this article for more details about Opdivo for melanoma in children.

Effectiveness in children

The effectiveness of Opdivo to treat colorectal cancer and melanoma in children hasn’t been tested in children ages 12 through 18 years. However, the drug was approved for this use in children of these ages based on clinical trials of Opdivo’s effectiveness in adults with the same condition.

Also, the cancers Opdivo treats in children are expected to be similar to such cancers in adults.

Opdivo was also approved for these used based on how the body processes the drug. Opdivo is expected to be processed in children ages 12 years and older very similarly to how it’s processed in adults.

Opdivo use with other drugs

Opdivo is approved by the Food and Drug Administration (FDA) to be used in combination with ipilimumab (Yervoy) for certain types of cancer. This combination of treatment is approved to treat specific forms of the following cancers:

• skin cancer
• lung cancer
• kidney cancer
• colorectal cancer
• mesothelioma
• liver cancer
• esophageal cancer

Opdivo is also approved to be used in combination with a fluoropyrimidine drug, such as capecitabine (Xeloda), and platinum-based chemotherapy drugs, such as cisplatin and carboplatin, for specific types of esophageal cancer, gastric cancer, and colorectal cancer.

In addition, the drug is approved to be used in combination with cabozantinib (Cabometyx) for certain types of kidney cancer.

Alternatives to Opdivo

Other drugs are available that can treat your type of cancer. Some may be better suited for you than others. If you’re interested in finding an alternative to Opdivo, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that the FDA has approved to treat one condition is used to treat a different condition.

The table below describes alternatives to Opdivo based on condition.

Opdivo vs. Keytruda

You may wonder how Opdivo compares with other medications that are prescribed for similar uses. For example, find out how Opdivo compares to Keytruda.

Opdivo dosage

The Opdivo dosage your doctor prescribes will depend on several factors. These include:

• the condition you’re using Opdivo to treat
• your treatment schedule (how often you’re receiving Opdivo)
• whether you’re receiving Opdivo in combination with another drug, such as ipilimumab (Yervoy)
• your weight

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Opdivo contains the active ingredient nivolumab. It comes as a liquid solution inside vials. The vials contain 10 milligrams (mg) of drug in every milliliter (mL) of solution.

A healthcare professional will give Opdivo as an intravenous (IV) infusion.

Opdivo infusions typically last for 30 minutes. You’ll receive them at a healthcare professional’s office or clinic.

Dosage for non-small cell lung cancer

The usual dosage of Opdivo for non-small cell lung cancer (NSCLC) is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

Dosage for NSCLC when Opdivo is used with other drugs

The usual Opdivo dosage when it’s used in combination with certain chemotherapy drugs, ipilimumab, or both to treat NSCLC is 360 mg every 3 weeks.

Ipilimumab is given every 6 weeks. If your doctor prescribes chemotherapy with ipilimumab, you would receive the chemotherapy drugs for two cycles.

For treating NSCLC as part of neoadjuvant treatment (treatment before surgery), you would receive platinum-based chemotherapy drugs for three cycles.

If your doctor prescribes Opdivo as both neoadjuvant treatment and adjuvant treatment (treatment after surgery), you would receive platinum-based chemotherapy drugs for up to four cycles before surgery. After surgery, you would receive Opdivo alone at a dosage of 480 mg every 4 weeks.

Dosage for liver cancer

To treat liver cancer, you’ll receive Opdivo in combination with ipilimumab for the first four doses.

Your first four doses of Opdivo depend on your weight. The usual dosage is 1 mg of drug per kilogram (kg), or about 2.2 pounds (lb), of body weight, given every 3 weeks.

For example, if a person weighs 68 kg (about 150 lb), their dose would be 1 mg of drug multiplied by 68 kg. This equals 68 mg of Opdivo, which is given every 3 weeks for the first four doses.

After that, you’ll receive Opdivo alone. The usual dosage of Opdivo is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

Dosage for kidney cancer

The usual dosage of Opdivo for kidney cancer is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

Dosage for kidney cancer when Opdivo is used in combination with other drugs

To treat certain types of kidney cancer, you’ll receive Opdivo in combination with ipilimumab for the first four doses.

Your first four doses of Opdivo depend on your weight. The usual dosage is 3 mg of drug per kg (about 2.2 lb) of body weight, given every 3 weeks.

After your first four doses of these drugs, you’ll receive Opdivo alone. The usual dosage is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

If you’re receiving Opdivo in combination with cabozantinib (Cabometyx), you may take cabozantinib once daily for the duration of treatment. The Opdivo dosage is the same as just listed.

Dosage for bladder cancer

The usual dosage of Opdivo for bladder cancer is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

Dosage for bladder cancer when Opdivo is used in combination with other drugs

To treat certain types of bladder cancer, you’ll receive Opdivo in combination with certain chemotherapy drugs for the first six doses. Your first six doses of Opdivo will be 360 mg every 3 weeks.

After your first six doses of these drugs, you’ll receive Opdivo on its own. The usual dosage is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

Dosage for colorectal cancer

The usual Opdivo dosage for adults with colorectal cancer is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

The usual dosage for children ages 12 years and older is described in the “Pediatric dosage” section later in this article.

Dosage for colorectal cancer when Opdivo is used in combination with ipilimumab

To treat certain types of colorectal cancer, you’ll receive Opdivo in combination with ipilimumab for the first four doses.

Your first four doses of Opdivo depend on your weight. The usual dosage is 3 mg of drug per kg (about 2.2 lb) of body weight, given every 3 weeks.

After your first four doses of these drugs, you’ll receive Opdivo alone. The usual dosage is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

Dosage for head and neck cancer

The usual dosage of Opdivo for head and neck cancer is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

Dosage for melanoma skin cancer

The usual dosage of Opdivo for metastatic melanoma in adults is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

Doctors prescribe this dosage as treatment for metastatic melanoma and also as adjuvant treatment (treatment you receive after surgery or use of other medications) of melanoma.

The usual dosage for children ages 12 years and older is described in the “Pediatric dosage” section later in this article.

Dosage for melanoma skin cancer when Opdivo is used in combination with ipilimumab

To treat certain types of melanoma, you’ll receive Opdivo in combination with ipilimumab for the first four doses.

Your first four doses of Opdivo depend on your weight. The usual dosage is 1 mg of drug per kg (about 2.2 lb) of body weight, given every 3 weeks.

After your first four doses of these drugs, you’ll receive Opdivo alone. The usual dosage is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

Dosage for classical Hodgkin’s lymphoma

The usual dosage of Opdivo for classical Hodgkin’s lymphoma is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

Dosage for mesothelioma

To treat mesothelioma, you’ll receive Opdivo in combination with ipilimumab. The usual dosage for Opdivo is 360 mg every 3 weeks. Ipilimumab is given every 6 weeks.

Dosage for esophageal cancer

The usual dosage of Opdivo for esophageal cancer is either:

• 240 mg every 2 weeks, or
• 480 mg every 4 weeks

Dosage for esophageal cancer when Opdivo is used in combination with other drugs

To treat certain types of esophageal cancer, you’ll receive Opdivo in combination with ipilimumab. You’ll receive ipilimumab every 6 weeks. Depending on your doctor’s recommendation, your dosage of Opdivo may be 360 mg every 3 weeks. Or they may calculate your dosage based on your weight. The usual dosage is 3 mg of drug per kg (about 2.2 lb) of body weight, given every 2 weeks.

For esophageal cancer, Opdivo may also be used in combination with a fluoropyrimidine drug, such as capecitabine (Xeloda), and platinum-based chemotherapy drugs, such as cisplatin and carboplatin. The usual dosage for Opdivo is 240 mg every 2 weeks or 480 mg every 4 weeks, with the other drugs given on the same schedule.

To treat esophageal adenocarcinoma, Opdivo is also used in combination with a fluoropyrimidine and certain other chemotherapy drugs. The typical dosage of Opdivo for this use is 240 mg every 2 weeks or 360 mg every 3 weeks, with the other drugs given on the same schedule.

Dosage for gastric cancer

To treat gastric cancer, you’ll receive Opdivo in combination with a fluoropyrimidine, such as capecitabine, and platinum-based chemotherapy drugs, such as cisplatin and carboplatin. The typical dosage of Opdivo for this use is 240 mg every 2 weeks or 360 mg every 3 weeks, with the other drugs given on the same schedule.

Pediatric dosage

Opdivo is prescribed to treat colorectal cancer and melanoma in children ages 12 years and older.

Opdivo is given at a healthcare professional’s office. It’s administered as an IV infusion that lasts 30 minutes.

Opdivo dosage for colorectal cancer in children

The usual dosage of Opdivo for children with colorectal cancer who weigh 40 kg (about 88 lb) or more is the same as it is for adults. See “Dosage for colorectal cancer” earlier in this article for details.

The usual dosage for children who weigh less than 40 kg is based on their weight. Their dosage of Opdivo is 3 mg of drug per kg (about 2.2 lb) of body weight, given every 2 weeks.

For example, if a child weighs 45 kg (about 100 lb), their dose would be 3 mg of drug multiplied by 45 kg. This equals 135 mg of Opdivo, which is given every 2 weeks.

Dosage for colorectal cancer when Opdivo is used in combination with ipilimumab

To treat certain types of colorectal cancer in children, Opdivo is used in combination with ipilimumab for the first four doses.

The first four doses of Opdivo depend on a child’s weight. The usual dosage is 3 mg of drug per kg (about 2.2 lb) of body weight, given every 3 weeks.

After the first four doses of Opdivo and ipilimumab, children will receive Opdivo on its own. The usual dosage for children who weigh 40 kg (about 88 lb) or more is the same as it is for adults. See “Dosage for colorectal cancer” earlier in this article for details.

The usual dosage for children who weigh less than 40 kg is based on their weight. Their dosage of Opdivo is 3 mg of drug per kg (about 2.2 lb) of body weight, given every 2 weeks.

Opdivo dosage for melanoma skin cancer in children

The usual dosage of Opdivo for children with melanoma who weigh 40 kg (about 88 lb) or more is the same as it is for adults. See “Dosage for melanoma skin cancer” earlier in this article for details.

The usual dosage for children who weigh less than 40 kg is based on their weight. Their dosage of Opdivo is 3 mg of drug per kg (about 2.2 lb) of body weight, given every 2 weeks, or 6 mg per kg of body weight, given every 4 weeks.

Dosage for melanoma skin cancer when Opdivo is used in combination with ipilimumab

To treat certain types of melanoma in children, Opdivo is used in combination with ipilimumab for the first four doses.

The first four doses of Opdivo depend on a child’s weight. The usual dosage is 1 mg of drug per kg (about 2.2 lb) of body weight, given every 3 weeks.

After the first four doses of Opdivo and ipilimumab, children will receive Opdivo on its own. The usual dosage for children who weigh 40 kg (about 88 lb) or more is the same as it is for adults. See “Dosage for melanoma skin cancer” earlier in this article for details.

The usual dosage for children who weigh less than 40 kg is based on their weight. Their dosage of Opdivo is 3 mg of drug per kg (about 2.2 lb) of body weight, given every 2 weeks, or 6 mg per kg of body weight, given every 4 weeks.

How Opdivo is given

A healthcare professional will administer your Opdivo dose at a doctor’s office or clinic.

They’ll give you Opdivo as an intravenous (IV) infusion. Opdivo IV infusions last about 30 minutes.

If you’re using Opdivo in combination with other drugs, such as ipilimumab (Yervoy), your doctor will let you know your dosage schedule.

When it’s administered

When you’ll receive Opdivo infusions depends on what condition you’re using the drug to treat and whether you’ll receive it with other medications.

You and your doctor will determine the dosing schedule that’s best for you. To help make sure that you don’t miss an appointment for your dose, try setting a reminder on your phone.

What if I miss a dose?

Call your doctor’s office right away if you realize that you’ve missed an appointment for your Opdivo infusion. The office staff will reschedule the appointment for you.

To help make sure that you don’t miss a dose, try setting a reminder on your phone.

Will I need to use this drug long term?

Opdivo is meant to be used as a long-term treatment. If you and your doctor determine that Opdivo is safe and effective for you, you’ll likely use it long term.

Common questions about Opdivo

Here are answers to some frequently asked questions about Opdivo.

Does Opdivo cause hair loss?

Hair loss isn’t a common side effect of Opdivo. However, it could be a symptom of hormonal problems, which are a more serious side effect of Opdivo.

One hormonal problem that can occur with Opdivo use is hypothyroidism (low thyroid hormone levels). Your body needs normal thyroid hormone levels to maintain healthy hair growth. When your thyroid hormone levels are too low, hair loss can occur.

If you have hair loss while you’re receiving Opdivo, talk with your doctor. They will check to see whether your hair loss is related to hormonal problems. If needed, they can prescribe treatment to help regulate your hormone levels.

Is Opdivo a form of chemotherapy or immunotherapy?

Opdivo is not a form of chemotherapy, but it is a form of immunotherapy.

Doctors typically prescribe chemotherapy drugs to treat cancer. This type of treatment works by killing quickly multiplying cells. This includes not only cancer cells but also some healthy cells.

Immunotherapy drugs such as Opdivo work by helping your immune system fight certain diseases, including cancer. For treating cancer, these drugs boost the immune system so that it recognizes and attacks cancer cells.

To learn more about how Opdivo works to treat certain cancers, see the “How Opdivo works” section. Your doctor can also tell you more.

How long do people using Opdivo treatment live?

This is different for each person because it depends on many factors. Your life expectancy (the length of time you are expected to survive) depends on:

• the type of cancer you have
• the stage of your cancer
• your age
• other health conditions you may have

Your doctor can discuss with you how Opdivo treatment may affect life expectancy given your specific situation.

Do I need to follow a certain diet while I’m using Opdivo?

Your doctor may recommend that you follow a certain balanced diet while you’re receiving treatment with Opdivo. However, your doctor would take into account the type of cancer you have and your overall health when making diet recommendations. They would not make such recommendations based on how Opdivo works.

Talk with your doctor about ways to maintain a balanced, nutritious diet that reduces your risk of side effects and helps maintain your energy level during treatment.

Can I receive Opdivo before or after a stem cell transplant?

Yes, you might be able to. Doctors may prescribe Opdivo to treat classical Hodgkin’s lymphoma in people whose cancer has returned or worsened after they’ve had a stem cell transplant.

However, some people who took Opdivo before or after a stem cell transplant have had transplant complications. One complication is graft-versus-host disease. With this condition, the transplanted cells attack your healthy cells. This can cause side effects such as skin rash, diarrhea, and liver problems.

Other complications can include blockages in your veins and severe fevers.

Talk with your doctor about whether receiving Opdivo before or after a stem cell transplant is right for you.

Where will I get my Opdivo treatments?

You’ll receive Opdivo as an intravenous (IV) infusion at a healthcare facility. Opdivo infusions last about 30 minutes.

A healthcare professional will administer your infusion and monitor you for any side effects that may occur during your infusion.

Opdivo interactions

There aren’t any known drug interactions with Opdivo. However, before taking any drug, it’s always a good idea to talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Opdivo and herbs and supplements

There aren’t any herbs or supplements specifically reported to interact with Opdivo. However, you should still check with your doctor or pharmacist before using any of these products during Opdivo treatment.

Opdivo and alcohol

There aren’t any known interactions between Opdivo and alcohol.

If you drink alcohol, talk with your doctor if you’re concerned about whether drinking it is safe during your treatment.

Opdivo cost

As with all medications, the cost of Opdivo can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

For more information about Opdivo and cost, see this Opdivo cost article.

Financial and insurance assistance

If you need financial support to pay for Opdivo, or if you need help understanding your insurance coverage, help is available.

Bristol-Myers Squibb, the manufacturer of Opdivo, offers a program called BMS Access Support. For more information and to find out if you’re eligible for support, call 800-861-0048 or visit the program website.

How Opdivo works

Opdivo is a monoclonal antibody. This type of drug is made from immune system cells in a lab. Monoclonal antibodies work by blocking the action of certain substances in your body.

Opdivo belongs to a class of drugs called programmed death receptor-1 (PD-1) inhibitors. PD-1 receptors (attachment sites) are found on immune system cells in your body. When certain proteins bind to these receptors, the immune cells stop making other proteins that attack and kill cancer cells.

Some forms of cancer, like those that Opdivo is used to treat, have higher-than-usual amounts of proteins that bind to PD-1 receptors. This means the cancer is able to prevent your immune system from attacking cancer cells.

Opdivo blocks the activity of the PD-1 receptor. When Opdivo binds to the PD-1 receptor, it prevents other proteins from attaching to it. This allows your immune system to make and release more proteins that attack cancer cells.

Because there are greater numbers of proteins attacking the cancer cells, the cancer shrinks or even disappears, in some cases.

How long does it take to work?

It’s not known exactly how long Opdivo takes to work in your body. Your doctor will recommend that you come to their office every few weeks or months after you start using Opdivo. They’ll monitor your cancer at these appointments to see whether the drug is working for you.

Things to consider when receiving Opdivo

If you can become pregnant, consider the following information about pregnancy, fertility, birth control, and breastfeeding.

Opdivo and pregnancy

Opdivo isn’t safe to receive during pregnancy. Animal studies have shown harm to fetuses when the pregnant animal received Opdivo. The drug has also been shown to cause pregnancy loss and fetal death.

If you’re able to become pregnant, you’ll need to have a pregnancy test before you start Opdivo treatment. This will help make sure you’re not pregnant before you start the drug.

If you become pregnant while you’re using Opdivo, tell your doctor right away.

Opdivo and birth control

Opdivo isn’t safe to receive during pregnancy. If you’re sexually active and can become pregnant, you should use effective birth control during your Opdivo treatment. You should continue to use birth control for at least 5 months after your last dose of Opdivo.

Talk with your doctor about your birth control needs while you’re using Opdivo.

Opdivo and breastfeeding

There aren’t any studies to determine how safe Opdivo use is while you’re breastfeeding. It’s not known whether Opdivo passes into breast milk.

However, the side effects of Opdivo are severe, and if the drug does appear in breast milk, it may harm a child who consumes it. Because of this, you should not breastfeed during Opdivo treatment. You also should not breastfeed for at least 5 months after receiving your last dose of Opdivo.

Talk with your doctor about ways to safely feed your child while you’re receiving Opdivo.

Opdivo precautions

Before using Opdivo, talk with your doctor about your health history. Opdivo may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• Stem cell transplant: Opdivo can cause serious complications if you receive it before or after an allogenic hematopoietic stem cell transplant (transplant of blood-forming cells from someone who has a similar genetic makeup as you). If you’ve had a stem cell transplant or are planning to have one, talk with your doctor about whether Opdivo is right for you.
• Immune system or nervous system conditions: It’s possible for Opdivo to make your immune system overactive. This could cause side effects such as inflammation. Immune system conditions, including Crohn’s disease, or nervous system conditions, including myasthenia gravis, could worsen as a result. If you have an immune system or nervous system condition, tell your doctor before starting treatment with Opdivo. This will help them determine whether Opdivo is a good treatment option for you.
• Chest radiation treatment: Pneumonitis is a serious side effect of Opdivo. People who have had radiation treatment to the chest have an increased risk of developing this side effect. Tell your doctor if you’ve ever had chest radiation treatment. They can recommend whether Opdivo should be part of your treatment plan.
• Pregnancy: Opdivo can cause harm to a growing fetus. You should not receive Opdivo while pregnant. For more information, see the “Things to consider when receiving Opdvio” section.
• Breastfeeding: You should not breastfeed while you’re using Opdivo, or for at least 5 months after your last dose of Opdivo. For more information, see the “Things to consider when receiving Opdvio” section.

Note: For more information about the potential negative effects of Opdivo, see the “Opdivo side effects” section.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.