nivolumab
Other Name: Opdivo®
solution mixed into larger bags of fluids
For treating many types of cancers such as melanoma (skin), lung, renal cell (kidney), colorectal, liver, head and neck, Hodgkin lymphoma, mesothelioma and others
Nivolumab is an immunotherapy drug. For more information on immunotherapy, click here.
Tell your doctor and pharmacist if you have or had any major medical conditions (such as diabetes) and especially if you have or had:
an organ or stem cell transplant
immune conditions (such as ulcerative colitis, Crohn's, rheumatoid arthritis or lupus)
problems with your hormone producing glands (such as thyroid, pituitary or adrenal glands)
diabetes
liver, kidney or lung problems
active infections or
any allergies
Tell your health care team if you are on a low salt diet.
Remember to:
- Tell your health care team about all of the other medications you are taking, especially if you are taking medications called corticosteroids (such as prednisone).
- Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
You will have a blood test to check for hepatitis B before starting treatment. See the Hepatitis B and Cancer Medications pamphlet for more information.
Talk to your health care team about:
How this medication may affect your sexual health.
How this medication may affect your ability to have a baby, if this applies to you.
This medication may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.
If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time until at least 5 months after your last dose. Talk to your health care team about which birth control options are best for you.
Do not breastfeed while on this medication and for at least 5 months after your last dose.
This drug is given through an IV (injected into a vein) . Talk to your health care team about your treatment schedule.
- If you missed your treatment appointment, talk to your health care team to find out what to do.
Will this medication interact with other medications or natural health products?
Although this medication is unlikely to interact with other medications, vitamins, foods and natural health products, tell your health care team about all of your:
prescription and over-the-counter (non-prescription) medications and all other drugs, such as cannabis/marijuana (medical or recreational)
natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements
Check with your health care team before starting or stopping any of them.
What should I do if I feel unwell, have pain, a headache or a fever?
Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).
Fever can be a sign of infection that may need treatment right away.
If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.
How to check for fever:
Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain).
- You have a fever if your temperature taken in your mouth (oral temperature) is:
- 38.3°C (100.9°F) or higher at any time
OR
- 38.0°C (100.4°F) or higher for at least one hour.
- 38.3°C (100.9°F) or higher at any time
If you do have a fever:- Try to contact your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
- Ask your health care team for the Fever pamphlet for more information.
If you do not have a fever but have mild symptoms such as headache or mild pain:
Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
Talk to your health care team before you start taking Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.
Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.
What to DO while on this medication:
DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.
DO tell your health care team about any serious infections that you have now or have had in the past.
What NOT to DO while on this medication:
DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
Nivolumab makes your immune system work harder. Your immune system is what fights infections and your cancer.
When your immune system is working harder, you may have side effects in your bowels, liver, lungs, skin, kidneys, hormones and other organs.
These side effects may be mild or may become serious or life-threatening in rare cases.
They may happen during your treatment or weeks to months after your treatment ends.
Some things to watch for are:
diarrhea
a new cough
problems with breathing
rash
any other new symptom
If you have side effects, you must talk to your health care team right away. You may need urgent treatment.
The following table lists side effects that you may have when getting nivolumab. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.
Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on nivolumab.
| Common Side Effects (25 to 49 or more out of 100 people) | |
| Side effects and what to do | When to contact health care team |
Fatigue What to look for?
What to do?
Ask your health care team for the Fatigue pamphlet for more information. | Talk to your health care team if it does not improve or if it is severe. |
Rash (May be severe) What to look for?
To prevent and treat dry skin:
If this happens, talk to your health care team or go to the emergency room right away. |
Talk to your health care team for advice.
Talk to your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away. |
| Less Common Side Effects (10 to 24 out of 100 people) | |
| Side effects and what to do | When to contact health care team |
Diarrhea (May be severe) What to look for?
What to do? If you have diarrhea:
Ask your health care team for the Diarrhea pamphlet for more information. In rare cases, your diarrhea may be severe due to inflammation of the intestines if:
If this happens, talk to your health care team or go to the emergency room right away |
Talk to your health care team for advice.
|
Too much or too little salt in your body What to look for?
What to do? Get emergency medical help right away for severe symptoms. | Get emergency medical help right away for severe symptoms. |
Nausea and vomiting (Generally mild) What to look for?
What to do? To help prevent nausea:
| Talk to your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if it is severe. |
Headache; mild joint, muscle pain or cramps What to look for?
What to do?
Ask your health care team for the Pain pamphlet for more information. | Talk to your health care team if it does not improve or if it is severe. |
Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:
- New cough, chest pain, trouble breathing, shortness of breath or coughing up blood
- Peeing more than normal and feeling very thirsty
- Signs of an allergy such as severe rash, swollen lips, face or tongue, chest and throat tightness, during or shortly after the drug is given
- Bleeding from your gums, unusual nosebleeds, bruising easily or more than normal, or blood in urine or stools. If you have bleeding that doesn’t stop, you must get emergency help.
- Rare immune problems after an organ or stem cell transplant (if this applies to you). Your health care team may discuss these with you.
Who do I contact if I have questions or need help?My cancer health care provider is: ______________________________________________ During the day I should contact:________________________________________________ Evenings, weekends and holidays:______________________________________________
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Other Notes:
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March 2023 Updated/Revised info sheet
For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.