What side effects does Opdivo (nivolumab) have?
Opdivo (nivolumab) can cause a range of side effects, including immune-related reactions because it works by boosting the immune system. Commonly reported effects include fatigue and skin reactions, and more serious immune reactions can affect organs such as the lungs, liver, intestines, kidneys, and endocrine glands.
What are the serious immune-related side effects people worry about?
With Opdivo, the most important risks are immune-mediated (often called immune-related adverse events). These can become severe and may require stopping treatment and starting steroids or other immune-suppressing therapy. Examples include problems such as:
- Inflammation of the lungs (pneumonitis), which can cause cough or shortness of breath
- Inflammation of the liver (hepatitis), which can show up as jaundice or elevated liver enzymes
- Colitis/diarrhea from intestinal inflammation
- Kidney inflammation (nephritis)
- Hormone gland problems (for example, thyroid or pituitary inflammation), which can affect energy, weight, or blood sugar
- Severe skin reactions
What side effects are most common?
Common side effects reported with Opdivo include:
- Fatigue
- Decreased appetite
- Nausea
- Itching and rash (skin reactions)
- Diarrhea or other GI symptoms
When do Opdivo side effects happen?
Side effects can occur any time during treatment and sometimes after doses end. Immune-related reactions can develop weeks to months after starting therapy, so new symptoms during or after treatment should be discussed with the oncology team promptly.
What symptoms should trigger urgent medical attention?
Seek urgent care or contact the treating team right away if symptoms suggest a serious immune reaction, such as:
- Trouble breathing, chest pain, or a new/worsening cough
- Severe or persistent diarrhea, blood in stool, or severe abdominal pain
- Yellowing of the skin/eyes, dark urine, or severe right-sided abdominal pain
- Severe weakness, confusion, fainting, severe headache, or major dizziness
- Fever with rash, blistering, or widespread skin pain
- Marked swelling, reduced urination, or sudden changes in urination
Can patients reduce risk or prevent side effects?
Patients typically reduce risk by reporting symptoms early. Oncologists often monitor blood tests (liver enzymes, kidney function, thyroid and other hormone levels) and evaluate new symptoms quickly. Treatments such as corticosteroids may be used when immune-related side effects occur.
Where can I check the exact side-effect list for my indication?
The full, indication-specific list of adverse reactions is on Opdivo’s prescribing information. If you want, tell me the cancer type you’re asking about (for example, lung cancer, melanoma, etc.) and I can tailor the side-effect categories to that use case and point you to the relevant prescribing source.