Opdivo (nivolumab) is a prescription brand-name medication. It’s approved by the Food and Drug Administration (FDA) to treat certain types of the following cancers in adults:

Opdivo is also approved to treat certain types of colorectal cancer in children ages 12 years and older.

Here are some fast facts about Opdivo:

  • Active ingredient: nivolumab
  • Drug class: monoclonal antibody
  • Drug form: liquid solution for IV infusion

As with other drugs, Opdivo can cause side effects. Read on to learn about potential common, mild, and serious side effects. For a general overview of Opdivo, including details about its uses, see this article.

These are just a few of the more common side effects reported by people who took Opdivo alone in clinical studies. (Side effects may also be referred to as adverse effects.)

These side effects are also seen when Opdivo is used in combination with other drugs.† Additional side effects may also occur in those situations because two or more medications are used.

More common side effects in people taking Opdivo alone include:

* For more information about this side effect, see the “Side effect details” section below.
† Other drugs that Opdivo may be used with include: ipilimumab (Yervoy), ipilimumab and chemotherapy, cabozantinib (Cabometyx, Cometriq), and chemotherapy that’s fluoropyrimidine- or platinum-based.

Mild side effects can occur when Opdivo is used alone. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Opdivo’s medication guide.

These side effects are also seen when Opdivo is used in combination with other drugs.† Additional side effects may also occur in those situations because two or more medications are used.

Mild side effects that have been reported when Opdivo was used alone 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 or pharmacist.

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 taking Opdivo and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see the “Side effect details” section below.
† Other drugs that Opdivo may be used with include: ipilimumab (Yervoy), ipilimumab and chemotherapy, cabozantinib (Cabometyx, Cometriq), and chemotherapy that’s fluoropyrimidine- or platinum-based.

Opdivo may cause serious side effects when used alone. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Opdivo’s medication guide.

These side effects are also seen when Opdivo is used in combination with other drugs.† Additional side effects may also occur in those situations because two or more medications are used.

If you develop serious side effects while taking 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 when Opdivo was used alone include:

  • Encephalitis (swelling in your brain). Symptoms can include:
    • sensitivity to light
    • weakness
  • Hormonal problems, including changes in your cortisol or thyroid hormone levels. Symptoms can include:
    • loss of appetite
    • trouble sleeping
    • weakness
    • weight loss
  • Hepatitis (inflammation in your liver). Symptoms can include:
    • jaundice (yellowing of your skin and the whites of your eyes)
    • loss of appetite
  • Immune system reaction (when your immune system attacks your organs by mistake). This can result in swelling in other body parts, including your:
    • eyes
    • heart
    • intestines
    • lungs
    • muscles
    • nerves
    • stomach
  • Kidney damage. Symptoms can include:
    • blood in your urine
    • urinating less often than usual
    • nausea and vomiting
    • swelling in your feet and legs
  • Severe skin reactions, including Stevens-Johnson syndrome. Symptoms can include:
    • flu-like symptoms
    • skin that’s red or a deeper color than usual
    • severe rash
  • Type 1 diabetes. Symptoms can include:
    • fatigue
    • feeling very hungry or thirsty
    • urinating more often than usual
    • weight loss
  • Infusion reactions.*
  • Allergic reaction.*

* For more information about this side effect, see the “Side effect details” section below.
† Other drugs that Opdivo may be used with include: ipilimumab (Yervoy), ipilimumab and chemotherapy, cabozantinib (Cabometyx, Cometriq), and chemotherapy that’s fluoropyrimidine- or platinum-based.

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?

Confusion on its own wasn’t reported as a side effect of Opdivo in clinical studies. But confusion can be a symptom of immune system reactions, which are 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 while taking 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?

Opdivo’s side effects when treating melanoma depend on whether your treatment includes Opdivo alone or in combination with ipilimumab (Yervoy).

In both situations, more common side effects include:

When Opdivo is used alone, muscle pain is another common side effect. When Opdivo is used with ipilimumab, nausea is another common side effect.

For a full list of side effects Opdivo may cause when used for melanoma treatment, you can refer to Opdivo’s prescribing information.

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

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

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

But your doctor, pharmacist, 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.

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

When do people usually start having side effects from Opdivo?

Researchers in clinical studies didn’t measure 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 receiving 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 used 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 be at risk for based on your Opdivo treatment plan. They can also advise you on when the side effects could occur.

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

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

Joint pain

Joint pain is one of the more common side effects people taking Opdivo reported in clinical studies. The pain is mild in most people.

The risk of joint pain from Opdivo varies depending on whether Opdivo is used alone or with other medications. The risk can also vary based on the condition Opdivo is treating.

What you can do

If you experience joint pain while taking Opdivo, talk with your doctor or pharmacist. They may recommend ways to ease this side effect, such as:

  • using a cold press on the affected area
  • taking over-the-counter medications for pain, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol)

Skin rash

Skin rash is a common side effect of Opdivo in clinical studies.

In most cases, skin rash from Opdivo is a mild side effect. But in rare cases, it may be a symptom of a severe skin reaction, including Stevens-Johnson syndrome. It could also be a symptom of an infusion reaction.*

* For more information about this side effect, see the “Infusion reactions” below.

What you can do

If you develop a skin rash while using 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

A lack of energy called fatigue is a common side effect from Opdivo treatment in clinical studies.

Most people experience mild fatigue, if they have this side effect at all. But in rare cases, some people have reported extreme fatigue with Opdivo. With extreme fatigue, the fatigue doesn’t go away with rest and affects your daily activities.

What you can do

If you have 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, and the drug may cause infusion reactions. In clinical studies, these reactions were common, but 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 or shortly after you receive Opdivo.

Symptoms of an infusion reaction from Opdivo can include:

  • chills or shaking
  • dizziness or feeling like you’ll pass out
  • fever
  • itchy skin
  • low blood pressure
  • pain in your back or neck
  • skin rash
  • trouble breathing

What you can do

A healthcare professional will monitor you for reactions during your Opdivo infusion. You should also let them know if you have symptoms of an infusion reaction.

If they notice a mild infusion reaction, they’ll typically either pause or slow the rate of your infusion. If you have a severe infusion reaction, your doctor will usually have you stop using Opdivo.

Allergic reaction

As with most drugs, Opdivo can cause an allergic reaction in some people. This side effect was common in clinical studies.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your lips, eyelids, feet, or hands
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, talk with your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep using Opdivo. But if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Be sure to talk with your doctor about your health history before you take Opdivo. This drug may not be the right treatment if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:

Problems with your immune system. Opdivo can cause immune system problems as a side effect. If you already have immune system problems, such as Crohn’s disease or ulcerative colitis, you may have an increased risk for this side effect. Before you begin treatment with Opdivo, be sure your doctor is aware of whether you have any immune system problems. They can advise you on the right treatment for you.

Nervous system condition. Opdivo can cause immune system problems as a side effect. This may affect the nervous system. If you already have a condition that affects your nervous system, such as myasthenia gravis, you may have an increased risk for this side effect. Before you begin Opdivo treatment, make sure your doctor knows whether you have any nervous system problems. They can recommend the right treatment for you.

Organ transplant recipient. Opdivo can cause your immune system to attack your organs by mistake. There have been a few rare reports of Opdivo causing organ transplant rejection in people who had received an organ transplant. Before you start using Opdivo, be sure your doctor knows whether you have received an organ transplant. They can advise you on the right treatment for you.

Stem cell transplant. If you have a stem cell transplant before or after treatment with a medication such as Opdivo, you may have an increased risk of stem cell transplant complications. These complications can be severe and, rarely, life threatening. Before you start Opdivo treatment, make sure your doctor is aware of whether you have received a stem cell transplant. They can advise you on the right medication for you.

Allergic reaction. You should not take Opdivo if you’ve ever had an allergic reaction to Opdivo or any of its ingredients. Talk with your doctor about other treatments that might be better choices for you.

Alcohol use with Opdivo

There are no known interactions between consuming alcohol and being treated with Opdivo.

However, in rare cases, Opdivo can cause liver inflammation. Alcohol can also cause damage and inflammation to your liver.

If you drink alcohol, talk with your doctor before you start receiving Opdivo. They can offer specific guidance based on your treatment plan, including other medications you may be using with Opdivo. The guidance will also depend on which condition Opdivo will be treating.

Pregnancy and breastfeeding while taking Opdivo

Here’s some information on Opdivo, pregnancy, and breastfeeding.

Pregnancy. Opdivo is not safe to take while pregnant. The drug may cause pregnancy loss. If you become pregnant during your Opdivo treatment, talk with your doctor right away.

Breastfeeding. It’s recommended that you do not breastfeed while receiving Opdivo and for 5 months after you receive your last dose.

Your doctor can advise you on healthy ways to feed your child and different treatment options.

Side effects from Opdivo can occur, including mild and serious side effects. Most mild side effects of the drug go away with time and don’t require medical attention.

You should talk with your doctor if you experience symptoms of serious side effects. These could be severe and require medical attention. For more information, see the “Serious side effects of Opdivo” section above.

If you become pregnant while during Opdivo treatment, talk with your doctor right away.

To learn more about Opdivo, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

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.