Opdivo (nivolumab) is a brand-name IV infusion that’s prescribed for some types of cancer in adults and certain children. As with other drugs, Opdivo can cause side effects, such as joint pain and fatigue.

Opdivo can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who received Opdivo in clinical trials.

If you receive Opdivo with another drug, such as ipilimumab (Yervoy) or platinum-based chemotherapy, it’s possible to experience additional side effects. To learn more about the other medications your doctor may prescribe with Opdivo, see this article.

More common side effects reported with Opdivo include:

* For more information about this side effect, see the “Side effect specifics” section below.

Mild side effects can occur when Opdivo is given alone or with other drugs. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Opdivo’s prescribing information.

Mild side effects that have been reported with Opdivo include:

These side effects may be temporary, lasting a few days or weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor.

Receiving Opdivo with another drug, such as ipilimumab (Yervoy) or platinum-based chemotherapy, may cause additional side effects. To learn more about the other medications your doctor may prescribe with Opdivo, see this article.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while receiving Opdivo and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see the “Side effect specifics” section below.

Opdivo may cause serious side effects when given alone or with other drugs. The list below may not include all possible serious side effects of Opdivo. For more information, you can refer to the drug’s prescribing information.

If your doctor prescribes another cancer treatment in combination with Opdivo, it’s possible to experience additional side effects. To learn more about the other medications your doctor may prescribe with Opdivo, see this article.

If you develop serious side effects during treatment with Opdivo, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

  • Encephalitis (swelling in the brain). Symptoms can include:
  • Hormonal imbalance, including changes in your cortisol or thyroid hormone levels. Symptoms can include:
    • loss of appetite
    • fatigue
    • trouble sleeping
    • weakness
    • weight loss
  • Hepatitis (inflammation in the liver). Symptoms can include:
  • Overactive immune system (when your immune system attacks your organs by mistake). Symptoms may depend on the specific reaction. However, they can include:
    • edema (swelling)
    • confusion
    • shortness of breath
  • Kidney damage. Symptoms can include:
    • blood in your urine
    • less frequent urination
    • nausea and vomiting
    • swelling in the feet and legs
  • Severe skin reactions, such as Stevens-Johnson syndrome. Symptoms can include:
  • Type 1 diabetes. Symptoms can include:
    • fatigue
    • excessive hunger or thirst
    • frequent urination
    • weight loss
  • Infusion reactions.*

* For more information about this side effect, see the “Side effect specifics” section below.

Allergic reaction

For some people, Opdivo infusions can cause an allergic reaction.

In general, symptoms of allergic reaction can be mild or serious. You can learn more about possible symptoms in this article.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should continue treatment with the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Opdivo infusions, your doctor may recommend a different cancer treatment instead.

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Opdivo may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Is confusion a side effect of Opdivo?

No, confusion on its own wasn’t a reported side effect of Opdivo in clinical trials. However confusion can be a symptom of an immune system reaction, which is a rare side effect of Opdivo.

With these reactions, your immune system attacks your organs by mistake. Some of these reactions can cause confusion and symptoms, including:

  • changes in your behavior or mood
  • problems with your balance
  • problems with your memory
  • numbness or tingling in your arms or legs
  • sleepiness

If you notice confusion or any of the above symptoms during treatment with Opdivo, talk with your doctor right away. It could be a sign of a rare but serious immune system reaction.

What side effects does Opdivo cause when it’s used for melanoma treatment?

It depends. When used to treat melanoma, Opdivo’s side effects may depend on whether the drug is given alone or with ipilimumab (Yervoy).

In both situations, more common side effects include itchy skin, diarrhea, skin rash, and fatigue.

In clinical trials, muscle pain was a commonly reported side effect of treatment with Opdivo on its own. In addition, nausea is a common side effect of treatment with Opdivo and ipilimumab together.

If you have concerns about the possible side effects of your melanoma treatment, talk with your doctor.

Are there any tips about how to manage Opdivo side effects?

There aren’t general tips for managing Opdivo side effects.

But your doctor and other members of your care team can help you with any side effects you have. For example, Opdivo is given as an IV infusion. If you have infusion reactions, a healthcare professional may pause your infusion for a time. Or they may slow down the rate of your infusion.

If you have side effects while receiving Opdivo, be sure to let your doctor know right away. They can work with you to either manage your side effects or explore other treatments for your condition.

When do people usually start having side effects from Opdivo?

It can vary. In clinical trials, it’s not clear how soon or when people started having side effects from Opdivo. Side effects from the drug may happen at any time, including after you stop treatment with the drug.

Some side effects, such as infusion reactions, may occur while you receive your infusion. Other side effects could happen weeks or months after you’ve been receiving the drug.

Keep in mind that side effects from Opdivo can vary depending on whether it’s given alone or in combination with other drugs. This could affect the timing of Opdivo side effects.

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. They can also advise you on when the side effects could occur.

Learn more about some of the side effects that Opdivo may cause.

Joint pain

It’s possible for Opdivo to cause joint pain. In the drug’s clinical trials, this was one of the more common side effects. In most cases, the joint pain was mild.

The risk of this side effect may depend on certain factors. This includes:

  • whether Opdivo is prescribed alone or with another medication
  • the condition Opdivo is prescribed to treat

What you can do

If you experience joint pain during Opdivo treatment, talk with your doctor or pharmacist. They can advise on ways to ease this side effect, such as applying a cold compress to the affected area.

They may also recommend taking an over-the-counter pain medication, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol).

Skin rash

A skin rash is possible after receiving Opdivo. This was another common side effect in the drug’s clinical trials. In most cases, this side effect was considered mild.

A skin rash may occur on its own or as a symptom of another side effect, such as an infusion reaction. Rarely, it may be a symptom of a severe skin reaction, such as Stevens-Johnson syndrome.

What you can do

If you develop a skin rash during treatment with Opdivo, talk with your doctor. If they determine that it’s not severe, they may recommend a topical medication, such as a hydrocortisone cream. (You apply topical medications to the skin.)

If you have a skin rash with any of the following during your Opdivo treatment, get emergency medical help right away:

These could be symptoms of a rare but life threatening reaction. If you experience a severe skin rash or reaction while receiving Opdivo, your doctor will pause your infusions or stop your treatment completely.

They’ll typically manage the reaction with corticosteroids, such as prednisone, and other drugs that make your immune system less active. (Opdivo may cause your immune system to attack your own body.)

Fatigue

Fatigue is a possible side effect of treatment with Opdivo. In clinical trials, fatigue was commonly reported.

In most cases, fatigue due to Opdivo is expected to be mild. However, there have been rare reports of extreme fatigue with this drug. With extreme fatigue, the fatigue affects your daily activities and doesn’t go away with rest.

What you can do

If you experience fatigue while receiving Opdivo, talk with your doctor. They can recommend ways to manage your energy levels during treatment.

Infusion reactions

Opdivo is given as an IV infusion. As such, it may cause an infusion reaction. In clinical trials, certain reactions were common. However, severe reactions were rare.

An infusion is a type of injection in which a drug is given into a vein slowly over time. Infusion reactions can occur during the infusion or shortly after it.

Symptoms of an infusion reaction with Opdivo can include:

What you can do

A healthcare professional will monitor you for any side effects during your Opdivo infusion. It’s also important to let them know if you experience a reaction after your infusion.

If you experience a mild infusion reaction, your doctor will typically either pause or slow the rate of your infusion. However, if you have a severe infusion reaction, your doctor will likely have you stop treatment with Opdivo.

Before starting treatment with Opdivo, discuss your health history with your doctor. Opdivo may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

  • immune system problems
  • nervous system condition
  • organ transplant recipient
  • stem cell transplant
  • previous allergic reaction to this or a similar drug
  • pregnancy
  • breastfeeding
  • alcohol consumption

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.