nivolumab (Intravenous route)
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antineoplastic Agent
Pharmacologic Class: Monoclonal Antibody
Uses For nivolumab
Nivolumab injection is used alone or together with other medicines (eg, ipilimumab) to treat melanoma (skin cancer) that has spread throughout the body (metastatic) and cannot be removed by surgery. It is also used to treat non-small cell lung cancer that has spread throughout the body and after other cancer medicines have been tried. Nivolumab injection is also used to treat kidney cancer in patients who have received other medicines. It is also used to treat classical Hodgkin lymphoma (white blood cell cancer) that has come back or spread after autologous hematopoietic stem cell transplantation and used brentuximab vedotin after stem cell transplant. Nivolumab is a monoclonal antibody that changes the immune system and helps control growth of cancer cells.
nivolumab is to be given only by or under the supervision of your doctor.
Before Using nivolumab
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For nivolumab, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to nivolumab or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of nivolumab injection in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of nivolumab injection in the elderly.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving nivolumab, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using nivolumab with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Rubella Virus Vaccine, Live
- Varicella Virus Vaccine
Using nivolumab with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Adenovirus Vaccine
- Bacillus of Calmette and Guerin Vaccine, Live
- Cholera Vaccine, Live
- Influenza Virus Vaccine, Live
- Poliovirus Vaccine, Live
- Smallpox Vaccine
- Typhoid Vaccine
- Yellow Fever Vaccine
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of nivolumab. Make sure you tell your doctor if you have any other medical problems, especially:
- Crohn disease or
- Immune system problems or
- Kidney disease or
- Liver disease or
- Lung or breathing problems or
- Stomach or bowel problems or
- Systemic lupus erythematosus (lupus, SLE) or
- Thyroid problems or
- Ulcerative colitis—Use with caution. May make these conditions worse.
Proper Use of nivolumab
Medicines used to treat cancer are very strong and can have many side effects. Before using nivolumab, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
A nurse or other trained health professional will give you nivolumab. nivolumab is given through a needle placed in one of your veins. It must be given slowly, so the needle will remain in place for 60 minutes and the infusion will be given every 2 weeks (when used alone) or every 3 weeks (when given with ipilimumab).
nivolumab comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.
nivolumab needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.
Precautions While Using nivolumab
It is very important that your doctor check your progress at regular visits to make sure that nivolumab is working properly. Blood tests may be needed to check for unwanted effects.
Using nivolumab while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment and for at least 5 months after the last dose of nivolumab. If you think you have become pregnant while using the medicine, tell your doctor right away.
Tell your doctor right away if you have a cough, chest tightness, or any type of breathing problem with nivolumab. These could be symptoms of a serious lung problem.
Colitis (inflammation of the colon) may occur with nivolumab. Tell your doctor right away if you have stomach pain or tenderness, watery or bloody diarrhea, or a fever after receiving the medicine.
Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, a loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.
Adrenal, pituitary, or thyroid gland problems may occur while you are receiving nivolumab. Tell your doctor if you have changes in mood or behavior, constipation, dry skin or hair, feeling cold, sensitivity to heat, sweating, trouble sleeping, or weight changes.
Tell your doctor right away if you have bloody or cloudy urine, nausea or vomiting, trouble breathing, swelling of the face, feet, or lower legs, unusual tiredness or weakness, or unusual weight gain. These may be symptoms of a serious kidney problem.
Check with your doctor if you have a headache, confusion, seizures, stiff neck, vomiting while using nivolumab. These may be symptoms of encephalitis.
nivolumab may cause a rare but serious type of an allergic reaction called an infusion reaction. This can be life-threatening and requires immediate medical attention. Tell your doctor right away if you start to have a skin rash, dizziness, trouble breathing, chest tightness, swelling in your face or hands, fever or chills while you are receiving nivolumab.
nivolumab Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:More common
- Back pain
- blistering, peeling, or loosening of the skin
- chest tightness
- depressed mood
- dry skin and hair
- feeling cold
- hair loss
- hoarseness or husky voice
- joint or muscle pain
- muscle cramps and stiffness
- nausea and vomiting
- red, irritated eyes
- slowed heartbeat
- sore throat
- sores, ulcers, or white spots in the mouth or on the lips
- trouble breathing
- unusual tiredness or weakness
- weight gain
- Chest pain
- dark urine
- general feeling of discomfort or illness
- light-colored stools
- sensitivity to heat
- stomach cramps
- thickening of bronchial secretions
- trouble sleeping
- upper right abdominal or stomach pain
- watery or bloody diarrhea
- weight loss
- yellow eyes and skin
- bloody or cloudy urine
- blurred vision or other change in vision
- darkening of the skin
- eye pain
- fast heartbeat
- loss of appetite
- mental depression
- pains in the stomach, side, or abdomen, possibly radiating to the back
- redness of the eye
- sensitivity of the eye to light
- skin rash
- swelling of the face, feet, or lower legs
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Stuffy or runny nose
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
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