Managing Potential Side Effects of Opdivo: Guidance for Users
Opdivo, a popular cancer treatment drug, is known for its effectiveness, but like many medications, it comes with potential side effects. Here's a breakdown of the common and less common side effects you may experience during treatment.
The less common side effects of Opdivo, reported in clinical trials, include rare immune-related inflammatory conditions such as myositis (muscle inflammation), myocarditis (heart muscle inflammation), and rhabdomyolysis (breakdown of skeletal muscle). Symptoms may involve muscle/joint pain, chest pain, irregular heartbeat, severe fatigue, and difficulty walking. Other rare side effects include neurological problems like inflammation of the spinal cord, leading to pain, numbness, bladder/bowel issues, and nerve function loss or paralysis. Additionally, rarer organ issues such as pancreatitis, swollen lymph nodes, and peripheral swelling have been reported.
By contrast, the more common side effects of Opdivo — reported in over 5% of patients — are generally less severe and include asthenic conditions (abnormal weakness or lack of energy), cough, nausea, and rash. These effects are comparatively frequent and usually manageable.
Infusion reactions may occur with Opdivo, with symptoms including chills or shaking, dizziness or feeling faint, fever, itchy skin, low blood pressure, pain in your back or neck, skin rash, and difficulty breathing. If you experience any of these symptoms during your infusion, inform your healthcare team immediately.
Fatigue due to Opdivo is expected to be mild in most cases, but there have been rare reports of extreme fatigue that affects your daily activities and doesn't go away with rest. If you experience persistent fatigue, discuss this with your doctor.
Confusion on its own was not a reported side effect of Opdivo in clinical trials, but confusion can be a symptom of an immune system reaction, which is a rare side effect of Opdivo. Similarly, skin rash, joint pain, and hormonal imbalances can also be symptoms of immune system reactions.
If you have questions about the timing of side effects from Opdivo, talk with your doctor, pharmacist, or another member of your care team. They can explain what side effects you may have a higher risk of based on your Opdivo treatment plan and advise you on when the side effects could occur.
In clinical trials, hepatitis (inflammation in the liver), encephalitis (swelling in the brain), kidney damage, and severe skin reactions, such as Stevens-Johnson syndrome, have been reported as serious side effects of Opdivo. Symptoms may vary depending on the specific reaction, but can include jaundice, itchy skin, loss of appetite, nausea and vomiting, swelling in the feet and legs, confusion, fever, headache, seizure, sensitivity to light, and weakness.
When used to treat melanoma, the side effects of Opdivo may depend on whether the drug is given alone or with ipilimumab (Yervoy). In such cases, more common side effects may include additional side effects.
If you develop a skin rash during Opdivo treatment with symptoms such as blisters, skin peeling, flu-like symptoms, fever, or difficulty breathing, seek emergency medical help right away. If you experience any severe or persistent side effects, do not hesitate to contact your healthcare team.
[1] ClinicalTrials.gov. (2021). Nivolumab. https://clinicaltrials.gov/ct2/show/NCT01005624 [2] Food and Drug Administration. (2014). FDA approves Opdivo (nivolumab) for metastatic melanoma. https://www.fda.gov/news-events/press-announcements/fda-approves-opdivo-nivolumab-metastatic-melanoma [3] Kwak, E., Kim, J., Kim, Y., Lee, S., & Kim, Y. (2016). Nivolumab-induced cystitis/ureteritis leading to acute renal failure: a case report. Case Reports in Urology, 2016, 9382657. https://doi.org/10.1155/2016/9382657 [4] National Cancer Institute. (2021). Nivolumab. https://www.cancer.gov/about-cancer/treatment/drugs/nivolumab
- The less common side effects of Opdivo, a cancer treatment drug, can include immune-related inflammatory conditions such as myositis, myocarditis, and rhabdomyolysis, which may cause symptoms like muscle/joint pain, chest pain, irregular heartbeat, severe fatigue, and difficulty walking.
- If you experience a rare skin reaction with Opdivo, such as Stevens-Johnson syndrome, seek emergency medical help right away, as it can involve blisters, skin peeling, flu-like symptoms, fever, or difficulty breathing.
- When used to treat melanoma, the side effects of Opdivo may depend on whether the drug is given alone or with ipilimumab, and more common side effects may include additional symptoms.
