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Opdivo vs Keytruda

Drug facts and comparison

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Medically reviewed by  Jamie Winn, PharmD

Uses

  • Melanoma
  • Non-Small Cell Lung Cancer
  • Malignant Pleural Mesothelioma
  • Renal Cell Carcinoma
  • Classical Hodgkin Lymphoma
  • Squamous Cell Carcinoma of the Head and Neck
  • Urothelial Carcinoma
  • Colorectal Cancer
  • Hepatocellular Carcinoma
  • Esophageal Squamous Cell Carcinoma
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  • Melanoma or Merkel cell carcinoma
  • Non-small cell lung cancer or small cell lung cancer
  • Head and neck squamous cell cancer
  • Classical Hodgkin lymphoma
  • Mediastinal B-cell lymphoma
  • Bladder and urinary tract cancer
  • Microsatellite instability-high or a mismatch repair deficient solid tumor
  • Gastric or gastroesophageal junction  adenocarcinoma
  • Squamous cell carcinoma of the esophagus
  • Cervical cancer
  • Hepatocellular carcinoma
  • Renal cell carcinoma
  • Endometrial carcinoma
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Summary

Brand name: Opdivo
Brand name: Keytruda
Manufacturer: Bristol-Myers Squibb
Manufacturer: Merck
Active ingredient: nivolumab
Active ingredient: pembrolizumab
Indication: Melanoma Non-Small Cell Lung Cancer Malignant Pleural Mesothelioma Renal Cell Carcinoma Classical Hodgkin Lymphoma Squamous Cell Carcinoma of the Head and Neck Urothelial Carcinoma Colorectal Cancer Hepatocellular Carcinoma Esophageal Squamous Cell Carcinoma
Indication: Melanoma or Merkel cell carcinoma  Non-small cell lung cancer or small cell lung cancer  Head and neck squamous cell cancer  Classical Hodgkin lymphoma Mediastinal B-cell lymphoma  Bladder and urinary tract cancer  Microsatellite instability-high or a mismatch repair deficient solid tumor Gastric or gastroesophageal junction  adenocarcinoma Squamous cell carcinoma of the esophagus Cervical cancer Hepatocellular carcinoma Renal cell carcinoma Endometrial carcinoma
Injection method: Intravenous infusion
Injection method: Intravenous infusion

Side Effects

Most common

  • Nausea
  • Diarrhea
  • Feeling weak or tired
  • Skin rashes
  • Decrease in white blood cells

More serious

  • Heart problems such as an abnormal rhythm
  • Breathing difficulties
  • Problems with glands that produce hormones
  • Inflammation of the intestines, kidneys, liver, skin, muscles, and the brain

Most common

  • Headaches, dizziness
  • Cough, shortness of breath
  • Stomach pain, diarrhea, constipation
  • Nausea, vomiting
  • Decreased red and white blood cells
  • Reduced thyroid activity
  • Loss of appetite
  • Feeling tired and weak
  • Skin rash, itching
  • Muscle and joint pain

More serious

  • Severe allergic reactions
  • Severe infusion reactions
  • Rejection of a transplanted organ

Drug Interactions

Severe interactions
  • Immunomodulatory drugs – lenalidomide, thalidomide
Serious interactions
  • Corticosteroids – betamethasone, cortisone, dexamethasone, hydrocortisone, prednisolone
Moderate interactions
  • No moderate interactions
Severe interactions
  • Immunomodulatory drugs – lenalidomide, thalidomide
Serious interactions
  • Corticosteroids – betamethasone, cortisone, dexamethasone, hydrocortisone, prednisolone
Moderate interactions
  • No moderate interactions

Warnings

You should not use Opdivo if you:

  • Are allergic to the active ingredient nivolumab
  • Are allergic to any of the other ingredients in Opdivo
  • Are under 18 years of age

You should talk to your doctor before using Opdivo if you:

  • Have had an organ transplant
  • Have melanoma of the eye
  • Have  cancer that has spread to your brain
  • Have liver problems
  • Have problems with your lungs or breathing
  • Have any immune system problems, like autoimmune disease, Crohn’s disease, ulcerative colitis, lupus, or sarcoidosis
  • Have ever had a bad reaction to the medication ipilimumab
  • Are taking medications to suppress your immune system
  • Are pregnant or trying to become pregnant
  • Are breastfeeding or are planning to breastfeed

You should not use Keytruda if you:

  • Are allergic to the active ingredient pembrolizumab
  • Are allergic to any of the other ingredients in Keytruda

You should talk to your doctor before using Keytruda if you:

  • Are taking any of the medications that could affect your immune system and interact with Keytruda
  • Have an autoimmune disease, such as  Crohn’s disease, ulcerative colitis, or lupus
  • Have pneumonia or inflammation of your lungs
  • Were previously given a medication called ipilimumab and you experienced serious side effects
  • Have had an allergic reaction to other monoclonal antibody therapies
  • Have had any liver problems or liver damage
  • Have had any kidney problems or kidney damage
  • Have HIV or AIDS
  • Have had an organ transplant
  • Have had a bone marrow transplant that used donor stem cells
  • Are pregnant or are planning to get pregnant
  • Are breastfeeding or are planning to breastfeed

Dosage

Based on indication

Based on indication

Cost

1, Opdivo 40 mg/4 ml solution in a single dose vial will cost around $1,000

2, 4 ml vials of 100 mg/ml Keytruda will cost around $11,000

 

FAQs

Opdivo and Keytruda are brand names for prescription drugs used to treat cancer. Opdivo was the first to be approved for the adjuvant treatment of patients with high-risk urothelial carcinoma. Opdivo and Keytruda are used for treating other cancer patients with advanced or metastatic urothelial carcinoma. Here we explain how they work, their similarities and differences, their side effects, and more. This should provide you with the basics to better understand your options.

What is Opdivo?

Opdivo is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Bristol-Myers Squibb. Opdivo is a cancer drug used to treat a number of different cancers in adults. Opdivo treats cancer by helping your immune system attack and kills cancerous cells. It’s usually given via an intravenous drip (a solution delivered directly into a vein) under the supervision of a doctor or nurse.

Opdivo is an immune checkpoint inhibitor that may be used to treat many different types of cancers including melanoma (a type of skin cancer). Opdivo can also be prescribed to treat other advanced forms of cancer. This includes advanced non-small cell lung cancer, advanced renal cell carcinoma, advanced head and neck cancer, advanced urothelial carcinoma (urinary tract and bladder cancer), and Hodgkin lymphoma that has returned or not responded to other therapies.

Cancer is a disease where some of the cells in your body grow out of control. Usually, your cells go through a lifecycle. They grow, and as they age, they are killed by your body and replaced with new ones. Cancer happens when your body’s control mechanisms stop working and old cells don’t die. They grow instead, multiply, and create new, abnormal cells. The cancerous cells may form masses of cells, called tumors, and they may spread around your body. Cancerous cells disrupt the normal functioning of your body, resulting in a wide range of symptoms.

The active ingredient in Opdivo is called nivolumab. It works by helping your body to kill certain cancerous cells. When you have cancer, cells produced by your immune system called T-cells attack and kill the cancerous cells. But some cancers produce a substance called PD-1 that attaches to T-cells and turns them off. Opdivo helps by attaching itself to PD-1, blocking it from working. This stops your T-cells from being turned off and lets them fight your cancer.

Opdivo dosage

Opdivo is available in injection form, in the following doses: 40 mg/4 mL, 100 mg/10 mL, and 240 mg/24 mL solution in a single-dose vial.

Your dose and duration of treatment will be based on the condition you are being treated for as well as your age, and any other medication you are taking.

What is Keytruda?

Keytruda is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Merck & Co. Keytruda has been FDA approved for cancer treatment that Opdivo is not approved for including:

  • As first-line treatment for stage III or metastatic non-small cell lung cancer (NSCLC patients) expressing programmed death-ligand 1 (PD-L1). Both drugs are also approved for second-line therapy of NSCLC with other drugs
  • Merkel cell carcinoma
  • Endometrial carcinoma
  • Tumor mutational burden-high cancer
  • Triple-negative breast cancer
  • A skin cancer called melanoma
  • A lung cancer called non-small cell lung cancer (NSCLC)
  • A lung cancer called small cell lung cancer (SCLC)
  • Head and neck squamous cell cancer (HNSCC)
  • Classical Hodgkin lymphoma (cHL)
  • Mediastinal B-cell lymphoma (PMBCL)
  • A bladder and urinary tract cancer called urothelial carcinoma
  • Cancer called a microsatellite instability-high (MSI-H) or a mismatch repair deficient (dMMR) solid tumor
  • A stomach cancer called gastric or gastroesophageal junction (GEJ) adenocarcinoma
  • Cancer called squamous cell carcinoma of the esophagus
  • Cervical cancer
  • A liver cancer called hepatocellular carcinoma
  • A kidney cancer called renal cell carcinoma (RCC)

Keytruda is often used when your cancer has spread, if it can’t be removed by surgery, it hasn’t responded to chemotherapy, and/or if your cancer tumors have certain abnormal genes. Rather than being a type of chemotherapy or radiotherapy, Keytruda is an immunotherapy that works with your immune system to help you fight your cancer. It’s given through a drip attached to one of your veins (intravenous), usually under the supervision of a doctor or nurse.

Keytruda dosage

Keytruda is available in injection form, in the following doses: 100 mg/4 mL (25 mg/mL) solution in single-dose vials

Your dose and duration of treatment will be based on the condition you are being treated for as well as your age, and any other medication you are taking.

Common side effects of Opdivo and Keytruda

The most common side effects of Opdivo in clinical trials include:

  • Nausea
  • Diarrhea
  • Feeling weak or tired
  • Skin rashes
  • Decrease in some of your white blood cells

More serious side effects of Opdivo include:

  • Heart problems like an abnormal rhythm
  • Breathing difficulties
  • Problems with glands that produce hormones
  • Inflammation of the intestines, kidneys, liver, skin, muscles, and the brain

The most common side effects of Keytruda in clinical trials include:

  • Headaches
  • Cough, shortness of breath
  • Stomach pain, diarrhea, constipation
  • Nausea, vomiting
  • A fall in your red and white blood cells
  • Reduced thyroid activity
  • Feeling less hungry
  • Feeling tired and weak
  • Dizziness
  • Itching
  • A skin rash
  • Muscle pain
  • Pain in your bones
  • Joint pain

More serious side effects of Keytruda include

  • Severe allergic reactions
  • Severe infusion reactions,
  • Rejection of a transplanted organ
  • Lung problems (pneumonitis) – chest pain, shortness of breath, a new or worse cough
  • Intestinal problems (colitis) – diarrhea or more bowel movements than usual, stomach tenderness and pain, stools that are black, sticky, or have blood or mucus in them
  • Liver problems (hepatitis) – pain on the right side of your stomach, yellowing of your skin or the whites of your eyes, dark urine, bruising or bleeding more easily than normal
  • Kidney problems – changes in the amount or color of your urine
  • Hormone gland problems (particularly the thyroid, pituitary, adrenal glands, and pancreas) – weight loss or weight gain, feeling more hungry or thirsty, increased sweating, a rapid heartbeat, feeling cold, hair loss, feeling very weak, dizziness or fainting, headaches that will not go away
  • Skin problems – itching, rashes, peeling, sores, and ulcers in your mouth, nose, throat, or genital area
  • Ocular toxicities including vision loss and retinal detachment
  • Severe or persistent muscle or joint pains
  • Swollen lymph nodes

These aren’t all the side effects Opdivo or Keytruda can cause. You can find more details in the patient leaflet that comes with your medication. If you have any concerns about side effects, talk to your physician or a pharmacist.

Opdivo and Keytruda interactions

Opdivo can interact with other medications. These include:

  • Immunomodulatory drugs – lenalidomide, thalidomide
  • Corticosteroids – betamethasone, cortisone, dexamethasone, hydrocortisone, prednisolone

Keytruda can interact with other medications. These include:

  • Immunomodulatory drugs – lenalidomide, thalidomide
  • Corticosteroids – betamethasone, cortisone, dexamethasone, hydrocortisone, prednisolone

Opdivo and Keytruda can interact with other medications. This can change how Opdivo and Keytruda and other medications work and can make side effects more likely. Tell your prescribing physician about all your drugs, including vitamins and dietary supplements.

Opdivo and Keytruda contraindications

You should not use Opdivo if you:

  • Are allergic to the active ingredient nivolumab
  • Are allergic to any of the other ingredients in Opdivo
  • Are under 18 years of age

Talk to your doctor before using Opdivo if you:

  • Have had an organ transplant
  • Have melanoma of the eye
  • Your cancer has spread to your brain
  • Have liver problems
  • Have problems with your lungs or breathing
  • Have any immune system problems, like autoimmune disease, Crohn’s disease, ulcerative colitis, lupus, or sarcoidosis
  • Have ever had a bad reaction to the medication ipilimumab
  • Are taking medications to suppress your immune system
  • Are pregnant or trying to become pregnant
  • Are breastfeeding or are planning to breastfeed

You should not use Keytruda if you:

  • Are allergic to the active ingredient pembrolizumab
  • Are allergic to any of the other ingredients in Keytruda

Talk to your doctor before using Keytruda if you:

  • Are taking any of the medications that could affect your immune system and interact with Keytruda
  • Have an autoimmune disease, like Crohn’s disease, ulcerative colitis, or lupus
  • Have pneumonia or inflammation of your lungs (pneumonitis)
  • Were previously given a medication called ipilimumab and you experienced serious side effects
  • Have had an allergic reaction to other monoclonal antibody therapies
  • Have had any liver problems or have liver damage
  • Have had any kidney problems or have kidney damage
  • Have HIV or AIDS
  • Have had an organ transplant
  • Have had a bone marrow transplant that used donor stem cells
  • Are pregnant or are planning to get pregnant
  • Are breastfeeding or are planning to breastfeed

Other drugs for cancer treatment

If you have any concerns about Opdivo or Keytruda’s side effects, talk to your physician, or pharmacist for medical advice. Also inform your healthcare provider about any medical conditions, supplements, and over-the-counter meds you are taking. You are also encouraged to report side effects to the FDA: visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.
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