The recommended dose of Opdivo® is either 3 mg per kilogram of body weight every 2 weeks or 240 mg given every 2 weeks or 480 mg given every 4 weeks. It is administered through an IV infusion and takes about 30 minutes to get a full dose.

Nivolumab is a type of immunotherapy. It stimulates the body’s immune system to fight cancer cells.  Nivolumab targets and blocks a protein called PD-1 on the surface of certain immune cells called T-cells. Blocking PD-1 activates the T-cells to find and kill cancer cells.

Most common side effects:

• Nausea
• Diarrhea
• Skin rash, itching
• Fatigue or weakness
• Decreased appetite

These side effects are less common:

• Anemia
• Constipation
• Low potassium levels
• Low magnesium levels
• High or low calcium levels
• Vomiting
• High potassium levels
• Swelling
• Fever
• Abdominal pain
• Chest pain
• Weight loss
• Joint pain
• Pneumonia
• Pain

Contact your health care provider immediately if you should experience any of the following symptoms:

• Fever of 100.4° F (38° or higher, chills)
• Signs of an allergic reaction, like rash; hives; itching; red, peeling, or blistered, skin with or without fever; tightness in the chest or throat; wheezing; trouble breathing or talking; unusual hoarseness; or swelling of the lips, mouth, face, throat, or tongue.

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

• Vomiting more than 4-5 times in a 24 hour period
• Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness
• Sudden change in eyesight
• Sudden onset of shortness of breath, accompanied by cough and/or fever
• Skin or the whites of your eyes turn yellow
• Light colored stools, Blood in stools, Dark, tarry or sticky stools
• Urine turns dark or brown (tea color); Blood in the urine
• Big weight gain
• Unable to pass urine or change in the amount of urine passed
• Bleed or bruise more easily than normal
• Very bad muscle pain or weakness
• Very bad joint pain
• Swelling in the arms or legs
• Signs of trouble with your thyroid or pituitary gland (change in mood or the way you act, change in weight, constipation, dizziness, deeper voice, feeling cold, fainting, hair loss, feeling very tired, headache or loss of sex drive)

Discuss use of this medication with your healthcare professional if you have:

• Problems with your hormone producing glands (including the thyroid, pituitary, adrenal glands, and pancrea
• Diarrhea, stomach pain and mucus or blood in stool.
• Abnormal liver function tests
• Problems with your lungs such as breathing difficulties, or cough. 
• Abnormal kidney function tests or problems with your kidneys, such as decreased volume of urine or inflammation of the kidneys 
• Had an organ transplant (such as a kidney transplant).
• Take other medicines that make your immune system weak such as prednisone.
• An autoimmune disease (a condition where the body attacks its own cells);
• Melanoma of the eye
• Side effects with another drug, such as ipilimumab;
• You are on a low salt diet.

Drugs Interactions:

• No known drug interactions

Use during pregnancy: Do not use this medication if you are pregnant or plan to become pregnant. It can cause harm to fetus.  Effective birth control must be used while on nivolumab and for at least 5 months after. 

Use in breast-feeding. Nivolumab has been studied in breast-feeding women.  Use is not recommended as it may cause side effects in the infant. Discuss use with your physician.