Nivolumab is a monoclonal antibody and a PD-1 inhibitor (programmed death receptor inhibitor) which is prescribed for cancer treatment.

It is mainly used for treating progression or relapse of classical Hodgkin lymphoma (a type of blood cancer), and melanoma (a skin cancer) which has spread to other parts of the body and which cannot be removed by surgery.

It is also used as a second-line treatment for non-small cell lung cancer and renal cell carcinoma (kidney cancer) which worsens during or after treatment with other chemotherapy medications.

The mode of action involves slowing down or stopping the growth of cancer cells by working with the immune system (immune checkpoint blockade). 

The medication is contraindicated if the patient is allergic to the drug and if the drug produces any serious reaction, with history of organ transplant, any autoimmune disease like Crohn’s disease, lung or liver disease, during pregnancy and breastfeeding.

The recommended dose is 3mg/kg to be injected as an intravenous infusion over one hour. It is administered once every two weeks.

Nivolumab comes in the form of a liquid to be injected into the vein over one hour. It is usually given once every two weeks. When administered with ipilimumab, it is given for once every three weeks.

• Nivolumab treatment might result in side effects like immune-mediated pneumonitis (lung inflammation), colitis (inflammation of the intestines), hepatitis, kidney dysfunction and thyroid disorders. Consult your physician immediately if any signs or symptoms of these conditions are seen after taking nivolumab.

• Symptoms like chest pain, severe cough, breathing difficulties, abdominal pain, diarrhea, jaundice, ankle swelling, hormonal problems, muscle weakness or changes in vision should be taken to the physician’s notice immediately.

• Avoid pregnancy and breastfeeding while taking nivolumab as it might pose a potential risk to the fetus. Women are advised contraception for at least 5 months following the completion of treatment with nivolumab.

• Inform your doctor if you ever had an organ transplantation or auto immune diseases like Crohn’s disease (immune system attacks the digestive tract), ulcerative colitis which might cause sores or swelling in the intestines before nivolumab treatment.

•  Respiratory: Persistent cough, chest pain, breathing difficulties.
•  Gastrointestinal: Diarrhea, nausea, vomiting, abdominal pain, blood in the stools, dark or black stools, loss of appetite.
•  Endocrine glands: Headache, tiredness, dizziness, weight gain or weight loss, hair loss, excessive thirst, decreased interest in sexual activity.
•  Skin problems: Rash, itching, blistering of the skin, losing color in the skin and hair, mouth sores and ulcers.
•  Kidney problems: Decreased or increased production of urine, swelling of the ankles, increased thirst and blood in the urine.
•  Central nervous system: Brain inflammation which might result in memory problems, confusion, hallucinations, seizures, headaches, tiredness, fever or stiff neck.Nerve problems resulting in paralysis, weakness, numbness or tingling in hands and the feet.
•  Eye problems: Blurred vision, eye pain or redness.

• Do not use nivolumab for children /individuals below 18 years of age as the safety and efficacy of the drug in this population is not clearly known.
• Nivolumab infusion might lead to serious life-threatening conditions, therefore the patient should be monitored by a doctor or nurse while taking the infusion.

No formal drug interactions have been carried out for nivolumab.

Store the injection in the original container and protect it from light. Keep it in the refrigerator at a temperature of 2-8°C. Do not freeze.