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.
