Opdivo (nivolumab) and Keytruda (pembrolizumab) are prescription brand-name medications. They’re approved by the Food and Drug Administration (FDA) to treat certain types of the following cancers:
- bladder cancer
- classical Hodgkin’s lymphoma
- colorectal cancer
- esophageal cancer
- kidney cancer
- liver cancer
- melanoma skin cancer
- non-small cell lung cancer
- small cell lung cancer
- squamous cell head and neck cancer
Opdivo and Keytruda have other uses as well. In addition, the two drugs are both
There are some similarities and differences between these two medications, including their uses for approved conditions and their side effects. These will be discussed in this article.
Both nivolumab and pembrolizumab belong to a class of medications known as programmed death receptor-1 (PD-1) inhibitors. A medication class is a group of drugs that work in a similar way.
Opdivo and Keytruda have been approved by the Food and Drug Administration (FDA) to treat the following.
- Both Opdivo and Keytruda are FDA-approved to treat certain types of:
- classical Hodgkin’s lymphoma
- non-small cell lung cancer
- squamous cell head and neck cancer
- Opdivo is also FDA-approved to treat a certain type of:
- Keytruda is also FDA-approved to treat certain types of:
- primary mediastinal large B cell lymphoma
- certain metastatic or unresectable solid tumors
Both Opdivo and Keytruda are FDA-approved to treat colorectal cancer in children. Also, Keytruda is FDA-approved to treat other kinds of cancer in children.
Opdivo and Keytruda may be used alone or in combination with other drugs to treat the conditions in the above lists.
Both Opdivo and Keytruda come as liquid solutions. The two drugs are given as an intravenous (IV) infusion, which is an injection into your vein given over a period of time.
Infusions for both Opdivo and Keytruda typically last for about 30 minutes. You’ll receive these injections at a healthcare facility, such as an infusion center or a hospital.
Opdivo infusions are given every 2, 3, 4, or 6 weeks. Keytruda infusions are given every 3 or 6 weeks. Your infusion schedule will depend on the condition you’re using the drug to treat and the specific treatment plan your doctor prescribes for you.
Both Opdivo and Keytruda treat certain types of cancer. They also belong to the same medication class. Because of this, these drugs can cause some of the same side effects, as well as some different ones. Some of these side effects are mentioned below. For more information on the side effects of these two drugs, see Opdivo’s medication guide and Keytruda’s medication guide.
Mild side effects
The following lists address some of the most common mild side effects of Opdivo and Keytruda, as well as some that both drugs share.
- Can occur with Opdivo:
- upper respiratory infections, such as the common cold
- weakness
- Can occur with Keytruda:
- few unique side effects
- Can occur with both Opdivo and Keytruda:
- belly pain
- bone, joint, or muscle pain
- decreased appetite
- nausea and diarrhea
- fatigue (lack of energy)
- rash
- shortness of breath
Most of these side effects may go away within a few days or weeks after each dose. But if they’re more severe or don’t go away, talk with your doctor.
Serious side effects
The following list addresses the serious side effects that Opdivo and Keytruda share:
- colitis (inflammation in your colon)
- liver damage or hepatitis (inflammation in your liver)
- hormone disorders, such as hypothyroidism or hyperthyroidism
- inflammation that can affect any organ or tissue, such as the heart, eyes, or brain
- infusion reaction (an immune system reaction that occurs during or shortly after receiving a drug infusion)
- kidney problems, including nephritis (inflammation in your kidneys)
- pneumonitis (inflammation in your lungs)
- severe allergic reaction
- severe rashes
If you have serious side effects while using Opdivo or Keytruda, call your doctor immediately. If the side effects feel life threatening or you believe you’re having a medical emergency, call 911 or your local emergency number right away.
Opdivo and Keytruda have both been found effective at treating certain types of the following cancers:
- bladder cancer
- classical Hodgkin’s lymphoma
- colorectal cancer
- esophageal cancer
- kidney cancer
- liver cancer
- melanoma skin cancer
- non-small cell lung cancer
- small cell lung cancer
- squamous cell head and neck cancer
Both drugs are recommended in certain guidelines from the National Comprehensive Cancer Network (NCCN) and National Cancer Institute (NCI) to treat certain types of cancers.
The following chart lists the cancers, the guidelines, and whether Opdivo, Keytruda, or both drugs are recommended.
Condition | Guidelines | Recommends Opdivo | Recommends Keytruda |
Bladder cancer | NCCN | X | X |
Classical Hodgkin’s lymphoma | NCCN | X | X |
Colorectal cancer | NCCN | X | X |
Esophageal cancer | NCCN | * | X |
Kidney cancer | X | X | |
Liver cancer | X | † | |
Melanoma skin cancer | NCCN | X | X |
Non-small cell lung cancer | X | X | |
Small cell lung cancer | X | X | |
Squamous cell head and neck cancer | NCCN | X | X |
For information on how these drugs performed in clinical trials, see the prescribing information for Opdivo and Keytruda.
* Opdivo was approved to treat esophageal cancer in 2020. The guidelines are from 2019 and haven’t been updated to make a recommendation for Opdivo.
† For liver cancer, Keytruda is listed as “under investigation,” which means that more studies are needed.
How much Opdivo or Keytruda costs depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy. It will also depend on the cost of the visit to your healthcare provider to receive doses of either drug.
Opdivo and Keytruda are both brand-name
Opdivo and Keytruda may not be right for you if you have certain medical conditions or other factors that affect your health. Here, these are referred to as warnings. The two drugs share some of the same warnings, but they also have different ones. Some of these warnings are mentioned below.
If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before using Opdivo or Keytruda.
- Warnings for Opdivo:
- no unique warnings
- Warnings for Keytruda:
- having certain multiple myeloma treatments
- Warnings for both Opdivo and Keytruda:
- immune system problems, such as lupus
- organ transplant recipient
- past treatment with radiation therapy to your chest
- nervous system problems, such as myasthenia gravis or Guillain-Barre syndrome
- pregnancy
- breastfeeding
Because both Opdivo and Keytruda are approved to treat certain types of cancer, you may be able to switch from one drug to the other. Depending on the cancer being treated, there may be specific recommendations for which drug needs to be used first or how to switch from one to the other. Your doctor will be able to provide detailed information on switching between Opdivo and Keytruda based on the condition you’re receiving treatment for.
Note: You shouldn’t switch medications or stop your current treatment unless your doctor tells you to.
Some of the key points to remember when comparing these drugs include:
- Opdivo and Keytruda are both
biologic medications. There aren’tbiosimilar versions of either drug available. Brand-name medications are often more expensive than biosimilars. - Both drugs can cause many of the same serious side effects. For details, see the “Side effects of Opdivo vs. Keytruda” section above.
- Opdivo infusions are given every 2, 3, 4, or 6 weeks. Keytruda infusions are given every 3 or 6 weeks. Your infusion schedule will depend on the condition you’re using the drug to treat and the specific treatment plan your doctor prescribes for you.
If you’d like to learn more about Opdivo or Keytruda, talk with your doctor or pharmacist. They can help answer any questions you have about the similarities and differences between the drugs.
For more information on your particular cancer, see our full list of articles.
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 other 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.