Nivolumab Injection
What is this medication?
NIVOLUMAB (nye VOL ue mab) treats some types of cancer. It works by helping your immune system slow or stop the spread of cancer cells. It is a monoclonal antibody.
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.
COMMON BRAND NAME(S): Opdivo
What should I tell my care team before I take this medication?
They need to know if you have any of these conditions:
- Allogeneic stem cell transplant (uses someone else's stem cells)
- Autoimmune diseases, such as Crohn disease, ulcerative colitis, lupus
- History of chest radiation
- Nervous system problems, such as Guillain-Barre syndrome or myasthenia gravis
- Organ transplant
- An unusual or allergic reaction to nivolumab, other medications, foods, dyes, or preservatives
- Pregnant or trying to get pregnant
- Breast-feeding
How should I use this medication?
This medication is infused into a vein. It is given in a hospital or clinic setting.
A special MedGuide will be given to you before each treatment. Be sure to read this information carefully each time.
Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as 12 years for selected conditions, precautions do apply.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
What if I miss a dose?
Keep appointments for follow-up doses. It is important not to miss your dose. Call your care team if you are unable to keep an appointment.
What may interact with this medication?
Interactions have not been studied.
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What should I watch for while using this medication?
Your condition will be monitored carefully while you are receiving this medication. You may need blood work while taking this medication.
This medication may cause serious skin reactions. They can happen weeks to months after starting the medication. Contact your care team right away if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. You may also notice a red rash with swelling of the face, lips, or lymph nodes in your neck or under your arms.
Tell your care team right away if you have any change in your eyesight.
Talk to your care team if you are pregnant or think you might be pregnant. A negative pregnancy test is required before starting this medication. A reliable form of contraception is recommended while taking this medication and for 5 months after the last dose. Talk to your care team about effective forms of contraception.
Do not breast-feed while taking this medication and for 5 months after the last dose.
What side effects may I notice from receiving this medication?
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dry cough, shortness of breath or trouble breathing
- Eye pain, redness, irritation, or discharge with blurry or decreased vision
- Heart muscle inflammation—unusual weakness or fatigue, shortness of breath, chest pain, fast or irregular heartbeat, dizziness, swelling of the ankles, feet, or hands
- Hormone gland problems—headache, sensitivity to light, unusual weakness or fatigue, dizziness, fast or irregular heartbeat, increased sensitivity to cold or heat, excessive sweating, constipation, hair loss, increased thirst or amount of urine, tremors or shaking, irritability
- Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
- Kidney injury (glomerulonephritis)—decrease in the amount of urine, red or dark brown urine, foamy or bubbly urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Pain, tingling, or numbness in the hands or feet, muscle weakness, change in vision, confusion or trouble speaking, loss of balance or coordination, trouble walking, seizures
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Bone, joint, or muscle pain
- Diarrhea
- Fatigue
- Loss of appetite
- Nausea
- Skin rash
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Where should I keep my medication?
This medication is given in a hospital or clinic. It will not be stored at home.
NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.
Additional Information From Chemocare.com About Nivolumab
Self-Care Tips:
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
- Nivolumab can cause visual changes, dizziness and tiredness. If you have any of these symptoms, use caution when driving a car, using machinery, or anything that requires you to be alert.
- Wash your hands often.
- Avoid contact sports or activities that could cause injury.
- To reduce any potential nausea eat small, frequent meals. Sucking on lozenges and chewing gum may also help.
- Eat foods that may help reduce diarrhea (see managing side effects - diarrhea).
- Avoid sun exposure. Wear SPF 30 (or higher) sunblock and protective clothing.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition. (see eating well during chemotherapy)
- If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
- Fever of 100.4° F (38° or higher, chills)
- Signs of an allergic reaction, like rash; hives; itching; red, peeling, or blistered, skin with or without fever; tightness in the chest or throat; wheezing; trouble breathing or talking; unusual hoarseness; or swelling of the lips, mouth, face, throat, or tongue.
Always inform your health care provider if you experience any unusual symptoms.
The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:
- Diarrhea should be reported to your health care provider
- Nausea (interferes with ability to eat and unrelieved with prescribed medication)
- Vomiting (vomiting more than 4-5 times in a 24 hour period)
- Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness
- Sudden change in eyesight
- Sudden onset of shortness of breath, accompanied by cough and/or fever
- Skin or the whites of your eyes turn yellow
- Light colored stools
- Blood in stools
- Dark, tarry or sticky stools
- Urine turns dark or brown (tea color)
- Blood in the urine
- Big weight gain
- Unable to pass urine or change in the amount of urine passed
- Decreased appetite
- Stomach pain or upset stomach
- Bleed or bruise more easily than normal
- Fast heartbeat
- Cough with or without mucus
- Any skin change, irritation, itching or rash
- Very bad muscle or weakness
- Very bad joint pain
- Swelling in the arms or legs
- Signs of trouble with your thyroid or pituitary gland (change in mood or the way you act, change in weight, constipation, dizziness, deeper voice, feeling cold, fainting, hair loss, feeling very tired, headache or loss of sex drive)
Always inform your health care provider if you experience any unusual symptoms.
