medicationsopdivoOpdivo dosage

Opdivo Dosage, forms & strengths

Jamie Winn, PharmD
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Medically reviewed by  Jamie Winn, PharmD

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Opdivo (nivolumab) is a PD-1/PD-L1 Inhibitor that is manufactured by Bristol-Myers Squibb Company. It is FDA-approved to be used as first-line or adjuvant therapy in the treatment of certain types of cancer, including head and neck cancer, colorectal cancer, advanced melanoma (skin cancer), and lymphomas.

How does Opdivo work?

Opdivo is a human IgG4 monoclonal antibody that inhibits the programmed death receptors-1 (PD-1), which are found on T-cells in your immune system. Opdivo binds and inhibits other proteins from attaching to the PD-1 receptors. Your immune system can then make proteins that attack and kill cancer cells.

Opdivo dosage forms and strengths

  • 40mg/4ml (10mg/ml) solution
  • 100mg/10 mL (10 mg/ml) solution
  • 120mg/12ml (10mg/ml) solution
  • 240mg/24ml (10mg/ml) solution

Opdivo dosage

Unresectable or metastatic melanoma

  • Opdivo 240mg every 2 weeks or 480mg every 4 weeks when used as monotherapy.
  • Opdivo 1mg/kg of followed by Yervoy 3mg/kg on the same day every 3 weeks for 4 doses, then 240mg of Opdivo every 2 weeks or 480mg every 4 weeks.

Adjuvant treatment of melanoma

  • Opdivo 240mg every 2 weeks or 480mg every 4 weeks when used as a single agent.

Neoadjuvant treatment of resectable non-small cell lung cancer (NSCLC)

  • Opdivo 360mg with platinum-containing chemotherapy on the same day every 3 weeks for 3 cycles.

Metastatic non-small cell lung cancer

  • Opdivo 240mg every 2 weeks or 480mg every 4 weeks when used alone.
  • Opdivo 360mg every 3 weeks along with Yervoy 1mg/kg every 6 weeks and 2 cycles of platinum-based chemotherapy.

Malignant pleural mesothelioma

  • Opdivo 360mg every 3 weeks with Yervoy 1mg/kg every 6 weeks.

Advanced renal cell carcinoma (RCC):

  • Opdivo 240mg every 2 weeks or 480mg every 4 weeks when used alone.
  • Opdivo 3mg/kg followed by Yervoy 1mg/kg on the same day every 3 weeks for 4 doses, then Opdivo 240mg every 2 weeks or 480mg every 4 weeks.
  • Opdivo 240mg every 2 weeks or 480mg every 4 weeks given in combination with cabozantinib 40mg once daily without food.

Relapsed or refractory classical Hodgkin lymphoma (cHL)

  • Opdivo 240mg every 2 weeks or 480mg every 4 weeks.

Metastatic squamous cell carcinoma of the head and neck

  • Opdivo 240mg every 2 weeks or 480mg every 4 weeks.

Adjuvant treatment of urothelial carcinoma

  • Opdivo 240mg every 2 weeks or 480mg every 4 weeks.

Metastatic urothelial carcinoma

  • Opdivo 240mg every 2 weeks or 480mg every 4 weeks.

Microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer (CRC)

  • Pediatric patients weighing less than 40kg: Opdivo 3mg/kg every 2 weeks.
  • Adult and pediatric patients weighing 40kg or greater: Opdivo 240mg every 2 weeks or 480mg every 4 weeks when used alone.
  • Adult and pediatric patients weighing 40 kg or greater: Opdivo 3mg/kg followed by Yervoy 1mg/kg on the same day every 3 weeks for 4 doses, then Opdivo 240mg every 2 weeks or 480mg every 4 weeks.

Hepatocellular carcinoma (HCC)

  • Opdivo 1mg/kg followed by Yervoy 3mg/kg on the same day every 3 weeks for 4 doses, then Opdivo 240mg every 2 weeks or 480mg every 4 weeks.

Adjuvant treatment of esophageal or gastroesophageal cancer

  • Opdivo 240mg every 2 weeks or 480mg every 4 weeks for 1 year.

Esophageal squamous cell carcinoma

  • Opdivo 240mg every 2 weeks or 480mg every 4 weeks when used alone.
  • Opdivo 240mg every 2 weeks or 480mg every 4 weeks along with fluoropyrimidine- and platinum-based therapy.
  • Opdivo 3mg/kg every 2 weeks or 360mg every 3 weeks with Yervoy 1mg/kg every 6 weeks.

Gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma

  • Opdivo 360mg every 3 weeks with fluoropyrimidine- and platinum-based therapy every 3 weeks.
  • Opdivo 240mg every 2 weeks with fluoropyrimidine- and platinum-based therapy every 2 weeks.

Your duration of treatment will be determined by factors such as disease progression and incidence of adverse effects.

Opdivo dosage restrictions

No dose adjustment or discontinuation is recommended in patients with hepatic (liver) or renal (kidney) impairment.

How to take Opdivo

  • Opdivo is typically given by your healthcare provider at a hospital or infusion center. It is administered as a 30-minute intravenous (IV) infusion. You will receive a treatment every 2 to 4 weeks, depending on the condition being treated.
  • You may take Opdivo alone or in combination with other immunotherapy medications or chemotherapy.
  • Your doctor will determine how many treatments of Opdivo you will receive. You may have blood tests to help monitor you for side effects.
  • If you miss an infusion, call your doctor right away to reschedule.
  • For more information, please see the Full Prescribing Information and Medication Guide for this medication.

Opdivo dosage FAQs

What are some side effects of Opdivo?

Some common adverse reactions to Opdivo seen in clinical trials include:

  • Infusion-related reactions
  • Hair loss
  • Abdominal pain
  • Skin rash or blistering
  • Muscle and joint pain
  • Cough
  • Constipation
  • Fatigue
  • Decreased appetite
  • Weight loss
  • Anemia
  • Fever
  • Headache
  • Upper respiratory tract infection
  • Urinary tract infection (UTI)
  • Hypothyroidism
  • Electrolyte imbalances

Opdivo can sometimes cause more severe adverse effects such as:

  • Severe, life-threatening hypersensitivity reactions (hives, swelling of the face or throat, and shortness of breath)
  • Adrenal insufficiency
  • Myocarditis (inflammation of the heart muscle)
  • Skin reactions such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN)
  • Liver toxicity and elevated ALT and AST levels
  • Immune-mediated nephritis, hyperthyroidism, or renal dysfunction
  • Pneumonitis, colitis, and hepatitis
  • Graft-versus-host-disease (GVHD) after allogeneic HSCT

Contact your healthcare professional for medical advice about any side effects you experience while taking Opdivo. You can report your side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What are some drug interactions with Opdivo?

The use of Opdivo with other medications may change the way it works or increase the frequency and severity of side effects. You should ask your doctor if any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with Opdivo.

Are there any contraindications or precautions with Opdivo?

You should avoid Opdivo if you have an allergy to nivolumab or any inactive ingredients in this product. You should use Opdivo with caution if you have had an organ transplant, are taking corticosteroids, have received an allogeneic stem cell transplant (HSCT), have had chest radiation, have a nervous system disorder such as Guillain-Barré syndrome, have an autoimmune disease such as lupus, ulcerative colitis, or Crohn’s disease, or are pregnant, plan on becoming pregnant, or are breastfeeding. Your healthcare provider may perform tests to check your liver enzymes, creatinine, total bilirubin, and thyroid function at baseline and periodically while on Opdivo.

Is it safe to use Opdivo while pregnant or breastfeeding?

There have not been any studies involving Opdivo use by pregnant women. It is thought that Opdivo may cause fetal harm based on animal studies and its mechanism of action. You should make sure you are not pregnant before starting this medication and use an effective form of contraception during treatment and for at least 5 months after your last dose. The use of Opdivo while breastfeeding is not recommended. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.

What is the average price of Opdivo?

Opdivo is an expensive medication. The average cost of #2 vials of Opdivo 100mg/10ml is almost $5,500.

Who should not take Opdivo?

You should not take Opdivo if you are allergic to nivolumab or any other ingredients in this medication.

Where do you receive Opdivo treatments?

You and your doctor will determine the best place to receive your Opdivo infusions. It is typically done in your doctor’s office, an infusion center, or a local hospital.

How do I know if I am responding to Opdivo treatment?

While you’re taking Opdivo, your healthcare provider will order periodic scans to evaluate whether there are any changes in the size of your tumors.

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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.