Medically reviewed by Drugs.com. Last updated on Mar 10, 2022.
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) or that cannot be removed by surgery. It is also used to help prevent melanoma from coming back after it and lymph nodes that contain cancer have been removed by surgery.
Nivolumab injection is also used with medicines containing platinum and another cancer medicine before having surgery for early stage non-small cell lung cancer (NSCLC).
Nivolumab injection is also used with ipilimumab as first-line treatment for metastatic (cancer that has already spread) non-small cell lung cancer (NSCLC) in patients whose tumors express PD-L1 and do not have an abnormal EGFR or ALK gene. Your doctor will perform a test to check for the PD-L1 tumor before you receive nivolumab.
It is also used with ipilimumab and 2 cycles of medicines containing platinum as first-line treatment for non-small cell lung cancer that has come back or spread in patients whose tumors do not have an abnormal EGFR or ALK gene.
Nivolumab injection is also used to treat non-small cell lung cancer that has spread throughout the body and after other cancer medicines (eg, medicines containing platinum) have been tried but did not work well. It is given to patients whose tumors have an abnormal EGFR or ALK gene and have tried treatment for these tumors but did not work well.
Nivolumab injection is also used with ipilimumab as first-line treatment for malignant pleural mesothelioma (cancer that affects the inside lining of the lungs and chest wall) that cannot be removed by surgery.
Nivolumab injection is used alone to treat kidney cancer that has spread throughout the body in patients who have received other medicines. It is also used together with other medicines (eg, ipilimumab or cabozatinib) to treat kidney cancer that has spread throughout the body in patients who have not 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 (HSCT) and used brentuximab vedotin after stem cell transplant, or after you received at least 3 kinds of treatment including autologous HSCT.
Nivolumab is also used to treat squamous cell cancer of the head and neck (SCCHN) that has come back or spread throughout the body after receiving medicines containing platinum but did not work well.
Nivolumab injection is also used to treat urothelial carcinoma (bladder cancer) that has spread throughout the body (metastatic) or cannot be removed by surgery (locally advanced). Nivolumab is given to patients who have received other cancer medicines (eg, platinum) that did not work well or whose cancer has worsened within 12 months of treatment containing platinum, either before or after surgery to remove your cancer. It is also used to help prevent urothelial carcinoma from coming back after it has been removed by surgery.
Nivolumab injection is also used alone or together with other medicines (eg, ipilimumab) to treat microsatellite instability high (MSI-H) or mismatch repair deficient (dMMR) colorectal cancer (cancer of the colon or rectum) that has spread. It is given to patients who have received other cancer treatments (eg, fluoropyrimidine, oxaliplatin, irinotecan) that did not work well.
Nivolumab injection is also used together with other medicines (eg, ipilimumab) to treat hepatocellular cancer (liver cancer) in patients who have previously received treatment with sorafenib.
Nivolumab injection is also used to treat esophageal or gastroesophageal junction cancer in patients who have received combination of chemotherapy and radiation followed by surgery to remove the cancer. It is given to patients who still have some cancer cells in the removed tumor or lymph nodes.
Nivolumab injection is also used together with other medicines (eg, fluoropyrimidine and platinum, or ipilimumab) as first-line treatment for squamous cell carcinoma of the esophagus that has spread or cannot be removed by surgery. Nivolumab is also used to treat squamous cell carcinoma of the esophagus that has returned, spread, or cannot be removed by surgery in patients who have received other medicines (eg, fluoropyrimidine and platinum).
Nivolumab injection is also used together with other medicines (eg, fluoropyrimidine and platinum) to treat cancer of the stomach (gastric cancer), gastroesophageal junction, or esophagus (esophageal adenocarcinoma) that has spread or cannot be removed by surgery.
Nivolumab is a monoclonal antibody that affects the immune system and helps control the 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 performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of nivolumab injection to treat colon and rectum cancer in children 12 years of age and older. Safety and efficacy have not been established in children younger than 12 years of age to treat colon and rectum cancer or in children to treat other approved conditions.
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 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.
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
- Diabetes 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 receiving 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 in a medical facility. It is given through a needle placed into one of your veins. It must be given slowly, so the needle will have to remain in place for at least 30 minutes.
Nivolumab is usually given every 2, 3, or 4 weeks. Your doctor may adjust how often you will receive nivolumab or how long the infusion will take.
Your doctor will give you other medicines (eg, steroid medicine) before you receive nivolumab and during treatment to help prevent unwanted effects.
Nivolumab comes with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.
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.
Receiving nivolumab while you are pregnant can harm your unborn baby. If you are a woman who can bear children, your doctor may give you a pregnancy test before you start using nivolumab to make sure you are not pregnant. Use an effective form of birth control to keep from getting pregnant during treatment with nivolumab and for at least 5 months after the last dose. If you think you have become pregnant while receiving 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 (eg, pneumonitis).
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.
Serious problems with adrenal, pituitary, or thyroid gland may occur while you are receiving nivolumab. Tell your doctor if you have changes in mood or behavior (eg, being irritable or forgetful), constipation, dry skin or hair, feeling cold, sensitivity to heat, sweating, trouble sleeping, unusual or continuing headaches, or weight changes.
Nivolumab may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.
Tell your doctor right away if you have bloody or cloudy urine, decrease in the amount of urine, nausea, 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, or vomiting while receiving nivolumab. These may be symptoms of encephalitis.
Serious skin reactions, including Stevens-Johnson syndrome, drug rash with eosinophilia and systemic syndrome (DRESS), and toxic epidermal necrolysis can occur with nivolumab. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, chills, cough, diarrhea, itching, joint or muscle pain, red irritated eyes, red skin lesions, often with a purple center, severe acne or skin rash, sores or ulcers on the skin, mouth or lips, or swollen glands, unusual bleeding or bruising, or unusual tiredness or weakness with nivolumab.
Check with your doctor right away if blurred vision, difficulty with reading, eye pain, or any other change in vision occurs while you are receiving nivolumab. Your doctor may want your eyes be checked by an ophthalmologist (eye doctor).
Nivolumab may cause infusion-related reactions, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you start to have fever, chills or shaking, dizziness, trouble breathing, itching or rash, lightheadedness, or fainting after receiving nivolumab.
Nivolumab may increase your risk for transplant complications (eg, graft-versus-host-disease [GVHD]) in patients who have received a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic), which can be severe and life-threatening. Check with your doctor right away if you have skin rash, stomach pain, diarrhea, yellow skin or eyes, swelling in the legs or ankles, dark urine, pale stools, nausea, or vomiting.
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:
- Back pain
- blistering, peeling, or loosening of the skin
- blurred vision
- bone, joint, or muscle pain
- burning, numbness, tingling, or painful sensations
- change or loss of taste
- chest tightness
- depressed mood
- difficulty in moving
- dry skin and hair
- fast, slow, pounding, or irregular heartbeat or pulse
- feeling cold
- feeling of warmth
- hair loss
- hoarseness or husky voice
- loss of appetite
- muscle cramps and stiffness
- red, irritated eyes
- redness of the face, neck, arms, and occasionally, upper chest
- redness, swelling, pain of the skin
- scaling of the skin on the hands and feet
- sore throat
- sores, ulcers, or white spots in the mouth or on the lips
- tingling of the hands and feet
- trouble breathing
- ulceration of the skin
- unsteadiness or awkwardness
- unusual tiredness or weakness
- weight gain
- weakness in the arms, hands, legs, or feet
- 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
- change in vision
- darkening of the skin
- eye pain
- fruity breath odor
- increased hunger, thirst, and urination
- mental depression
- pains in the stomach, side, or abdomen, possibly radiating to the back
- redness of the eye
- sensitivity of the eyes to light
- skin rash
- swelling of the face, feet, or lower legs
Incidence not known
- Feeling of constant movement of self or surroundings
- sensation of spinning
- very deep pain in the eyes
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:
- Stuffy or runny nose
- swelling or inflammation of the mouth
Incidence not known
- Increase in blood flow to the whites of the eyes
- seeing flashes or sparks of light
- seeing floating spots before the eyes or a veil or curtain appearing across a part of vision
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.
Frequently asked questions
More about nivolumab
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- Drug class: anti-PD-1 monoclonal antibodies
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