Nivolumab / Relatlimab Side Effects
Medically reviewed by Drugs.com. Last updated on Sep 16, 2024.
Applies to nivolumab / relatlimab: intravenous solution.
Precautions
It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.
Receiving this medicine 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 this medicine to make sure you are not pregnant. Use an effective form of birth control to keep from getting pregnant during treatment with this medicine 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 this medicine. These could be symptoms of a serious lung problem (eg, pneumonitis).
Colitis (inflammation of the colon) may occur with this medicine. 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 this medicine. 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.
This medicine 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.
Serious skin reactions, including exfoliative dermatitis, Stevens-Johnson syndrome, drug rash with eosinophilia and systemic syndrome (DRESS), and toxic epidermal necrolysis can occur with this medicine. 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 this medicine.
This medicine may cause inflammation of the heart muscle (myocardium) called myocarditis. Check with your doctor right away if you have chest pain or discomfort, fever, chills, a fast heartbeat, or trouble breathing.
Check with your doctor if you have a headache, confusion, seizures, stiff neck, or vomiting while receiving this medicine. These may be symptoms of encephalitis (inflammation of the brain).
Check with your doctor right away if you are having severe muscle pain or cramps, unusual weakness of the arms or legs, or a burning, numbness, tingling, or painful sensation in the arms, hands, legs, or feet. These could be symptoms of a serious muscle or nerve problem.
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 this medicine. Your doctor may want your eyes be checked by an ophthalmologist (eye doctor).
This medicine 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 this medicine.
This medicine 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.
Serious side effects
Along with its needed effects, nivolumab/relatlimab 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 while taking nivolumab / relatlimab:
More common side effects
- back pain
- black, tarry stools
- blistering, peeling, or loosening of the skin
- chest pain or tightness
- chills
- constipation
- cough
- dark urine
- depressed mood
- diarrhea
- dry skin and hair
- feeling cold
- fever
- flushing
- hair loss
- headache
- hoarseness or husky voice
- itching
- joint or muscle pain
- light-colored stools
- muscle cramps and stiffness
- nausea and vomiting
- nervousness
- painful or difficult urination
- red irritated eyes
- red skin lesions, often with a purple center
- sensitivity to heat
- slowed heartbeat
- sore throat
- sores, ulcers, or white spots in the mouth or on the lips
- stomach cramps, pain, or tenderness
- sweating
- swollen glands
- trouble breathing
- trouble sleeping
- unusual bleeding or bruising
- unusual tiredness and weakness
- upper right abdominal or stomach pain
- watery or bloody diarrhea
- weight loss or gain
- yellow eyes and skin
Less common side effects
- bloody or cloudy urine
- chest discomfort
- darkening of the skin
- decrease in urine output or decrease in urine-concentrating ability
- dizziness
- fainting
- fast heartbeat
- loss of appetite
- mental depression
- muscle spasms
- pain or discomfort in the arms, jaw, back or neck
- pale skin
- seeing flashes or sparks of light
- seeing floating spots before the eyes, or a veil or curtain appearing across part of vision
- skin rash
- swelling of the face, feet, or lower legs
- swelling or redness in the joints
- thickening of bronchial secretions
Rare side effects
- anxiety
- back, leg, or stomach pains
- bleeding gums
- bloating
- blue or pale skin
- blurred vision
- burning, tingling, numbness or pain in the hands, arms, feet, or legs
- burning feeling in the chest or stomach
- chest pain, possibly moving to the left arm, neck, or shoulder
- confusion
- difficulty in breathing, chewing, swallowing, or talking
- double vision
- drooping eyelids
- drowsiness
- dry mouth
- eye pain
- fruit-like breath odor
- heavier menstrual periods
- inability to move the arms and legs
- increased hunger
- increased thirst
- increased urination
- indigestion
- irritability
- loss of consciousness
- muscle weakness
- nosebleeds
- pains in the stomach, side, or abdomen, possibly radiating to the back
- pinpoint red spots on the skin
- redness, soreness, or itching skin
- redness of the eye
- seizures
- sensation of pins and needles
- sensitivity of the eyes to light
- stabbing pain
- stiff neck or back
- stomach upset
- sudden numbness and weakness in the arms and legs
- swollen, painful, or tender lymph glands in the neck, armpit, or groin
- tearing
Other side effects
Some side effects of nivolumab / relatlimab 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 side effects
- decreased appetite
For healthcare professionals
Applies to nivolumab / relatlimab: intravenous solution.
General adverse events
The most frequent (greater than 1%) serious adverse events reported in clinical trials were adrenal insufficiency, anemia, colitis, pneumonia, acute myocardial infarction, back pain, diarrhea, myocarditis, and pneumonitis. The most common (greater than 20%) adverse reactions were musculoskeletal pain, fatigue, rash, pruritus, and diarrhea.[Ref]
Cardiovascular
- Frequency not reported: Myocarditis[Ref]
Dermatologic
Endocrine
- Very common (10% or more): Hypothyroidism (17%)
- Frequency not reported: Adrenal insufficiency
Gastrointestinal
- Very common (10% or more): Diarrhea (24%), nausea (17%)[Ref]
Hematologic
- Very common (10% or more): Decreased hemoglobin (37%), decreased lymphocytes (32%)[Ref]
Hepatic
- Very common (10% or more): Increased AST (30%), increased ALT (26%)
- Frequency not reported: Hepatitis[Ref]
Metabolic
- Very common (10% or more): Decreased appetite (15%), increased alkaline phosphatase (19%)[Ref]
Musculoskeletal
- Very common (10% or more): Musculoskeletal pain (45%)[Ref]
Nervous system
- Very common (10% or more): Headache (18%)[Ref]
Other
- Very common (10% or more): Fatigue (39%), decreased sodium (24%)[Ref]
Renal
- Very common (10% or more): Increased creatinine (19%)[Ref]
Respiratory
- Very common (10% or more): Cough (15%)
- Common (1% to 10%): Pneumonitis[Ref]
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References
1. (2023) "Product Information. Opdualag (nivolumab-relatlimab)." (Obsolete) Bristol-Myers Squibb Australia Pty Ltd, 2
2. (2022) "Product Information. Opdualag (nivolumab-relatlimab)." Bristol-Myers Squibb
More about nivolumab / relatlimab
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Further information
Nivolumab/relatlimab side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.