Home All Therapies Opdivo

Opdivo

nivolumab
PD-1 Inhibitor FDA Approved 2014 Bristol-Myers Squibb
1. Indications and Usage

Melanoma (adjuvant and unresectable/metastatic); Non-small cell lung cancer; Malignant pleural mesothelioma; Renal cell carcinoma; Classical Hodgkin lymphoma; Squamous cell carcinoma of the head and neck; Urothelial carcinoma; Microsatellite instability-high (MSI-H) or dMMR colorectal cancer; Hepatocellular carcinoma; Esophageal cancer; Gastric/GEJ/esophageal adenocarcinoma

2. Dosage and Administration

Single agent: 240 mg IV every 2 weeks or 480 mg IV every 4 weeks.
In combination with ipilimumab: Varies by indication — typically nivolumab 3 mg/kg IV followed by ipilimumab 1 mg/kg IV on the same day every 3 weeks for 4 doses, then nivolumab 240 mg or 480 mg maintenance.
Infusion time: Over 30 minutes.

3. Dosage Forms and Strengths

Injection: 10 mg/mL solution in 4 mL (40 mg), 10 mL (100 mg), and 24 mL (240 mg) single-dose vials

4. Contraindications

No absolute contraindications listed. Contraindicated in patients with a history of severe hypersensitivity reaction to nivolumab.

5. Warnings and Precautions
  • Immune-Mediated Adverse Reactions: Including pneumonitis, colitis, hepatitis, endocrinopathies, nephritis with renal dysfunction, dermatologic adverse reactions, encephalitis, and other organ-specific toxicities.
  • Infusion-Related Reactions: Discontinue for severe or life-threatening reactions.
  • Complications of Allogeneic HSCT after PD-1 Blockade: Increased risk of transplant-related complications.
  • Embryo-Fetal Toxicity: Can cause fetal harm.
6. Adverse Reactions
Most Common Adverse Reactions

Fatigue (46%), rash (28%), musculoskeletal pain (27%), diarrhea (25%), pruritus (21%), nausea (20%), decreased appetite (16%), cough (14%)

Fatigue
46%
Rash
28%
Musculoskeletal Pain
27%
Diarrhea
25%
Pruritus
21%
Nausea
20%
Decreased Appetite
16%
Cough
14%
Serious Adverse Reactions

Immune-mediated pneumonitis (3.6%), colitis (2.9%), hepatitis (1.8%), nephritis (1.2%), endocrinopathies (10% including thyroid disorders)

Consult the complete prescribing information for a comprehensive list of adverse reactions and their frequencies.

7. Drug Interactions

No formal drug interaction studies conducted. Avoid systemic corticosteroids and immunosuppressants before starting nivolumab.

8. Use in Specific Populations
Pregnancy

Consult the full prescribing information for pregnancy-related considerations.

Lactation

Refer to prescribing information for lactation guidance.

Pediatric Use

Pediatric safety and efficacy information is detailed in the full label.

Hepatic/Renal Impairment

Dose modifications for organ impairment are specified in the complete prescribing information.

12. Clinical Pharmacology
Mechanism of Action

Nivolumab is a human IgG4 monoclonal antibody that binds to the PD-1 receptor, blocking its interaction with PD-L1 and PD-L2 ligands, thereby releasing PD-1 pathway-mediated inhibition of the anti-tumor immune response.

Pharmacokinetics

Steady-state reached by 12 weeks. Terminal half-life: 26.7 days. Clearance: 9.5 mL/h. Volume of distribution at steady state: 8.0 L.

14. Clinical Studies

Clinical efficacy and safety data supporting the approval of Opdivo are available in the full prescribing information and from the clinical trials listed below.

Pivotal Clinical Trials
Additional Resources
FDA-Approved Tumor Types
External Resources
Important Notice: This page is intended as a navigational reference to the FDA-approved prescribing information for Opdivo. It does not replace the full prescribing information. Healthcare professionals should consult the complete package insert available at DailyMed before making prescribing decisions. Patient-specific factors should always guide clinical decision-making.