Nivolumab
About Nivolumab
Nivolumab is a prescription immunotherapy medicine used to treat several types of advanced cancers, including melanoma, non-small cell lung cancer, kidney cancer, bladder cancer, head and neck cancer, and classical Hodgkin lymphoma. It works by helping your body's immune system recognise and attack cancer cells more effectively, slowing disease progression and improving treatment outcomes in eligible patients.
This medicine is administered as an intravenous (IV) infusion by a trained healthcare professional in a hospital or infusion centre. Depending on your condition and treatment plan, it is usually given every 2, 3, or 4 weeks. It is important to attend every scheduled appointment and complete your treatment as recommended by your doctor.
Your healthcare team will monitor you regularly throughout treatment with blood tests and clinical assessments. Unlike chemotherapy, Nivolumab stimulates the immune system, which can sometimes cause it to attack healthy organs. Contact your doctor immediately if you develop persistent diarrhoea, severe abdominal pain, a new or worsening cough, shortness of breath, yellowing of the skin or eyes, severe skin rash, vision changes, or unusual fatigue.
Before starting treatment, tell your doctor if you have an autoimmune disease, have received an organ transplant, or have lung, liver, kidney, or thyroid problems. Inform your healthcare provider about all medicines, herbal products, and dietary supplements you are taking before beginning treatment.
This medicine may harm an unborn baby. Women should use effective contraception during treatment and for at least 5 months after the last dose. Breastfeeding is not recommended during treatment and for at least 5 months after the final dose. Older adults generally tolerate this medicine similarly to younger adults but may require closer monitoring depending on their overall health.
Uses of Nivolumab
Medicinal Benefits
When used as prescribed, Nivolumab offers several important benefits in the treatment of advanced cancers.
- Helps the immune system fight cancer: Unlike traditional chemotherapy, Nivolumab works by strengthening your body's own immune response, allowing immune cells to recognise and attack cancer cells more effectively.
- Slows cancer progression: By improving the immune system's ability to control cancer growth, this medicine can slow the spread of the disease and help keep it under control for longer periods.
- Provides long-lasting responses in some patients: Some people experience durable responses that continue even after treatment has ended, making immunotherapy an effective option for selected cancers.
- Improves quality of life: By controlling tumour growth, Nivolumab may reduce cancer-related symptoms such as pain, breathing difficulties, or fatigue, helping many patients maintain their daily activities and overall well-being.
Directions for Use
- Follow your doctor's instructions on the dosage and timing of this medication.
- Nivolumab will be administered by a nurse or doctor.
- Do not self-administer.
Storage
Side Effects of Nivolumab
Common Side Effects (Usually mild)
- Fatigue or weakness
- Skin rash, itching, or dry skin
- Nausea
- Diarrhoea or constipation
- Decreased appetite
- Muscle, joint, or bone pain
- Cough
- Fever
Serious Side Effects
- New or worsening cough, chest pain, or difficulty breathing (possible lung inflammation)
- Severe diarrhoea, persistent abdominal pain, or blood in the stool (possible inflammation of the bowel)
- Yellowing of the skin or eyes, dark urine, or severe upper abdominal pain (possible liver inflammation)
- Severe skin rash, blistering, peeling skin, or painful mouth sores
- Severe headaches, confusion, vision changes, extreme tiredness, dizziness, excessive thirst, or unexplained weight changes (possible hormone gland disorders)
- Reduced urine output, swelling of the legs, or blood in the urine (possible kidney inflammation)
- Severe allergic or infusion-related reactions, including swelling of the face or throat, wheezing, difficulty breathing, or severe dizziness
Medicines Containing this Salt
View AllDrug Warnings
- Attend all scheduled blood tests: Regular monitoring helps your doctor detect immune-related side effects affecting the liver, kidneys, thyroid, lungs, and other organs before they become serious.
- Report new symptoms immediately: Tell your doctor promptly if you develop persistent diarrhoea, severe abdominal pain, a new or worsening cough, shortness of breath, yellowing of the skin or eyes, severe skin rash, or vision changes.
- Inform every healthcare provider that you are receiving immunotherapy: This is especially important before surgery, dental procedures, or starting any new medicines.
- Avoid self-medicating with corticosteroids or immunosuppressants: These medicines should only be used under your doctor's supervision, as they may affect your treatment or are sometimes needed to manage immune-related side effects.
- Avoid live vaccines during treatment: Consult your doctor before receiving any vaccination while you are being treated with Nivolumab.
- Pregnancy warning: Use effective contraception during treatment and for at least 5 months after your final dose. Do not breastfeed during treatment or for 5 months after your last dose.
- Do not ignore infusion reactions: Tell your nurse immediately if you experience fever, chills, flushing, itching, dizziness, chest tightness, or difficulty breathing during the infusion.
- When to seek urgent medical care: Seek immediate medical attention if you develop severe breathing difficulty, confusion, severe allergic reactions, chest pain, or any rapidly worsening symptoms.
Drug Interactions
- Immunosuppressants (such as high-dose corticosteroids): These medicines may reduce the effectiveness of nivolumab when used before or during treatment. However, your doctor may prescribe corticosteroids to manage serious immune-related side effects caused by nivolumab.
- Other anticancer medicines: When used together with chemotherapy, targeted therapy, or other immunotherapy medicines, the risk of side effects may increase. Your healthcare team will monitor you closely during combination treatment.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
consult your doctorIt is unknown whether Nivolumab interacts with alcohol. Consult your doctor for more information.
Pregnancy
unsafeNivolumab is not recommended for use in pregnancy as it may cause embryo-fetal toxicity and harm your foetus. Hence, if you are pregnant or planning pregnancy, inform your doctor before receiving Nivolumab. You should not become pregnant while you are receiving Nivolumab for at least five months from the last dose of Nivolumab. Using effective birth control methods while on treatment is suggested.
Breast Feeding
unsafeNivolumab should not be taken if you are breastfeeding as it passes into breast milk and may harm your infant. Avoid nursing your child while on treatment with this medicine and for at least five months from the last dose of medicine.
Driving
not applicableNivolumab will be administered to hospitalized patients.
Liver
cautionIf you have a pre-existing or a history of liver problems, tell your doctor before receiving this medicine. Inform your doctor if you experience severe nausea or vomiting, right-sided upper stomach pain, easy bruising or bleeding, dark urine, or jaundice (yellowing of the skin or eyes). Your doctor may suggest tests to monitor your liver function while on treatment with this medicine.
Kidney
cautionIf you have a pre-existing or a history of kidney diseases, inform your doctor before receiving Nivolumab. Tell your doctor if you have little or no urination, swelling in your feet or ankles, or blood in your urine. Your doctor may adjust the dose of this medicine or prescribe a suitable alternative based on your condition.
Children
safe if prescribedNivolumab is not recommended for children below 12 years. It is safe for use in children above 12 years for the treatment of microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer. It will be administered only if the benefits outweigh the risks.
Habit Forming
Diet & Lifestyle Advise
- Eat a balanced diet: Choose nutritious meals rich in fruits, vegetables, whole grains, and lean protein to help support your body's recovery during cancer treatment.
- Stay well-hydrated: Drink plenty of water unless your doctor advises otherwise. Good hydration helps support your overall health during treatment.
- Protect your skin: Use fragrance-free moisturisers and sunscreen when outdoors, as skin dryness and rashes are common with immunotherapy.
- Remain physically active: Gentle activities such as walking or stretching may help reduce fatigue and maintain strength. Adjust your activity level according to how you feel.
- Report new symptoms promptly: Because this medicine can affect many organs, tell your healthcare provider immediately if you notice persistent diarrhoea, cough, shortness of breath, skin rash, vision changes, or unusual fatigue.
- Keep all follow-up appointments: Regular blood tests and medical reviews help your doctor monitor for immune-related side effects and assess your response to treatment.
Special Advise
- Your doctor may suggest periodic liver function tests, kidney function tests, and lung function tests to monitor the function of the liver, kidney and lungs due to the use of Nivolumab.
- Using contraceptive pills while using Nivolumab to prevent pregnancy is advised.
- Thyroid function and adrenocorticotropic hormone levels will be monitored during treatment to avoid any life-threatening side effects.
Patients Concern
Disease/Condition Glossary
Renal Cell Carcinoma: It is the most common type of cancer in which cancer/ malignant cells grow uncontrollably in the kidney and form a tumor. Symptoms include red, orange, or pink-coloured urine due to the presence of blood in the urine. Nivolumab is used in combination with ipilimumab in adult patients who have already taken prior treatment and in combination with cabozantinib in patients who have not taken prior treatment.
Hepatocellular carcinoma: It occurs when the cancer/ malignant cells grow out of control. This infects the liver, destroys the liver cells and affects the ability of the liver to work properly. Symptoms may include abdominal pain, loss of appetite, weight loss, and pale bowel motions. Nivolumab is used in combination with ipilimumab in adult patients.
Colorectal cancer: It is a condition in which the cancerous/malignant cells grow out of control in the colon or rectum. Symptoms may include diarrhoea, constipation, bloody stools, change in bowel habits, abdominal discomfort, etc.
Metastatic Malignant Melanoma: Melanoma is a type of skin cancer in which the cancer cells grow in melanocytes. It is mainly caused by harmful UV radiation from the sun. Malignant melanoma is common in fair-skinned and freckled individuals. It results in mole formation, typically on the skin of the face. Nivolumab is used in combination with ipilimumab in adults and children above 12 years of age.
Malignant pleural mesothelioma: It is a type of cancer that develops in the mesothelium (a lining that covers the outer surface of organs), mainly caused by exposure to asbestos. Symptoms may include chest pain, shortness of breath, extreme tiredness, persistent cough, loss of appetite, unexplained weight loss, fever and sweating.
Non-Small Cell Lung Cancer (NSCLC): It is the most common form of lung cancer, which occurs when cells that form the lining of the lung start growing uncontrollably. It is mostly seen in persons who smoke. Symptoms may include chest pain, weight loss, hoarseness, and difficulty breathing. Nivolumab is used in combination with chemotherapy that contains platinum and another chemotherapy medicine.
Head and neck cancer: It is a type of cancer which causes abnormal growth of cancer cells in the tissues of the neck and head. This cancer generally starts in the cells known as squamous cells, which appear in the lining of the surface of moist mucosa in the head and neck (e.g., inside of the throat, nose, and mouth).
Bladder cancer: It is a cancer that begins in the bladder. It typically affects older adults. The most common symptom is blood in the urine..
Stomach Cancer (Gastric adenocarcinoma): It is a type of cancer that develops from the stomach lining. When the cancer cells spread to other organs of the body, it is called metastatic. This condition can occur mainly due to smoking, a highly processed or salty diet, and severe bacterial infection of H. pylori. Symptoms of stomach cancer include feeling bloated after eating, feeling full after eating small amounts of food, nausea, heartburn or indigestion.
Classical Hodgkin’s Disease: Hodgkin’s disease or lymphoma is a blood cancer of a certain type of cells called WBCs, specifically lymphocytes. Lymphocytes normally help control infection and maintain the body's normal immunity. However, in a cancerous state, there is an abnormal multiplication of these blood cells, causing many problems such as fatigue, fever, loss of appetite, itching, night sweats and lymph node swelling.
FAQs
Nivolumab is used to treat various cancers, including Metastatic Melanoma, metastatic non-small cell lung cancer, Renal Cell Carcinoma, Hepatocellular carcinoma, Colorectal Cancer, Malignant pleural mesothelioma, Stomach Cancer, Squamous cell carcinoma of head and neck, and Urothelia carcinoma.
Nivolumab contains Nivolumab, which works by inhibiting the action of a programmed death receptor-1 (PD-1) that causes the multiplication of cancerous cells.
Nivolumab is given as an intravenous (IV) infusion into a vein by a healthcare professional in a clinic or hospital. The process usually takes about 30 to 60 minutes. Talk to your doctor if you have questions about your schedule.
Most people can drive after their infusion, but you may feel unusually tired or weak after treatment. It is a good idea to have someone drive you to and from your first few appointments until you know how the medicine affects you. Talk to your doctor if you experience severe fatigue.
No, Nivolumab is not chemotherapy. It is an immunotherapy that helps your own immune system recognize and fight cancer cells, whereas chemotherapy directly targets and kills rapidly dividing cells. Talk to your doctor to learn more about how this treatment works.
Mild skin rashes can often be managed with fragrance-free moisturisers, but you must report any new or worsening skin reactions to your healthcare team immediately. Severe rashes can be a sign of a serious immune response. Talk to your doctor before applying any medicated creams.
You should avoid receiving live vaccines during your treatment, as they may cause serious infections. Non-live vaccines, like the annual flu shot, are generally safer, but you must always consult your healthcare team before getting any vaccination. Talk to your doctor for specific guidance.
There is no direct interaction between alcohol and Nivolumab, but alcohol can cause dehydration and worsen side effects like fatigue or nausea. It is best to limit alcohol intake during your treatment. Talk to your doctor or pharmacist for advice.
Early signs of lung inflammation include a new or worsening cough, chest pain, and shortness of breath. Because this can become serious quickly, you must report these symptoms to your doctor immediately. Talk to your doctor if you notice any changes in your breathing.
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