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COVID-19: Obtenez les dernières mises à jour ou faites une autoévaluation.

Les traitements par chimiothérapie et autres traitements systémiques pourraient être modifiés en raison de la COVID-19. Vous trouverez de plus amples renseignements à la page Traitements systémiques pendant la pandémie de la COVID-19.

Certaines de ces informations ou toutes, dans certains cas, n’apparaissent qu’en Anglais. Vous pouvez demander la version française

nivolumab

( nye-VOL-ue-mab )
Funding:
New Drug Funding Program
  • Nivolumab - Advanced Melanoma (Unresectable or Metastatic Melanoma)
  • Nivolumab - Advanced or Metastatic Non-Small Cell Lung Cancer
  • Nivolumab - Advanced or Metastatic Renal Cell Carcinoma and No Prior mTOR Inhibitor
  • Nivolumab - Advanced or Metastatic Renal Cell Carcinoma and Prior mTOR Inhibitor
  • Nivolumab - Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck which is Platinum Resistant or Refractory
  • Nivolumab plus Ipilimumab - Advanced Melanoma (Unresectable or Metastatic Melanoma)
  • Nivolumab plus Ipilimumab – Metastatic Renal Cell Carcinoma
  • Nivolumab - Adjuvant Treatment for Completely Resected Stage III or IV Melanoma
  • Nivolumab - Relapsed Classical Hodgkin Lymphoma (cHL) Post-Autologous Stem Cell Transplant (ASCT) or ASCT Ineligible
Other Name(s): Opdivo®
Apparence:  solution mixed into larger bags of fluids

Medication Information Sheet
nivolumab (nye-VOL-ue-mab)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Opdivo®

Appearance:

 solution mixed into larger bags of fluids

What is this medication for?
  • 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.

What should I do before I have this medication?
  • 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.
     
How will this medication affect sex, pregnancy and breastfeeding?

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.
     

How is this medication given?
  • 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.
     
What else do I need to know while on this medication?
  • 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.


    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.

What are the side effects of this medication?
  • 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?

  • Feeling of tiredness or low energy that lasts a long time and does not go away with rest or sleep.
     

What to do?

  • Be active. Aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days.
  • Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Ask family or friends to help you with things like housework, shopping, and child or pet care.
  • Eat well and drink at least 6 to 8 glasses of water or other liquids every day (unless your health care team has told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired.

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?

  • Your skin may look red or feel warm, like a sunburn.
  • Your skin may have bumps, itch, burn, sting or feel very tender when touched.


What to do?

To prevent and treat dry skin:

  • Use fragrance-free skin moisturizer.
  • Protect your skin from the sun and the cold.
  • Use sunscreen with UVA and UVB protection and a SPF of at least 30.
  • Avoid perfumed products and lotions that contain alcohol.
  • Drink 6 to 8 cups of non-alcoholic, non-caffeinated liquids each day, unless your health care team has told you to drink more or less.


In rare cases, rash may be severe if:

  • The rash covers more than a third of your skin (for example your whole trunk, or an arm AND a leg) or
  • The rash causes your skin to blister or peel.

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?

  • Loose watery, unformed stool (poo) that may happen days to weeks after you get your treatment.
     

What to do?

If you have diarrhea:

  • Take anti-diarrhea medication if your health care team prescribed it or told you to take it.
  • Do not eat foods or drinks with artificial sweetener (like chewing gum or “diet” drinks), coffee and alcohol.
  • Eat many small meals and snacks instead of 2 or 3 large meals.
  • Drink at least 6 to 8 cups of liquids each day, unless your health care team has told you to drink more or less.
  • Talk to your health care team if you can’t drink 6-8 cups of liquids each day when you have diarrhea. You may need to drink special liquids with salt and sugar, called Oral Rehydration Therapy.

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:

  • You have blood in your stool (poo) or
  • You have more than 4 bowel movements (going poo) a day (if that is not normal for you)

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.

Too much or too little salt in your body

What to look for?

  • Muscle spasms, cramping, weakness, twitching, or convulsions.
  • Irregular heartbeat, confusion or blood pressure changes.
     

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?

  • Nausea is feeling like you need to throw up. You may also feel light-headed.
  • You may feel nausea within hours to days after your treatment.
     

What to do?

To help prevent nausea:

  • It is easier to prevent nausea than to treat it once it happens.
  • If you were given anti-nausea medication(s), take them as prescribed, even if you do not feel like throwing up.
  • Drink clear liquids and have small meals. Get fresh air and rest.
  • Do not eat spicy, fried foods or foods with a strong smell.
  • Limit caffeine (like coffee, tea) and avoid alcohol.


If you have nausea or vomiting:

  • Take your rescue (as-needed) anti-nausea medication(s) as prescribed.
  • Ask your health care team for the Nausea & Vomiting pamphlet for more information.
  • Talk to your health care team if:
    • nausea lasts more than 48 hours
    • vomiting lasts more than 24 hours or if it is severe
       
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?

  • Mild headache
  • New pain in your muscles or joints, muscle cramps, or feeling achy.
     

What to do?

  • Take pain medication (acetaminophen or opioids such as codeine, morphine, hydromorphone, oxycodone) as prescribed.
  • Read the above section: "What should I do if I feel unwell, have pain, a headache or a fever?" before taking acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or Aspirin. These medications may hide an infection that needs treatment or they may increase your risk of bleeding.
  • Rest often and try light exercise (such as walking) as it may help.

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:______________________________________________

 

Other Notes:

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July 2021 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.