Standard Dosage for Adults
Nivolumab (Opdivo) dosing varies by cancer type, indication, and combination therapy. For monotherapy in adults:
- Most solid tumors (e.g., melanoma, NSCLC, renal cell carcinoma): 240 mg intravenously every 2 weeks or 480 mg every 4 weeks, until disease progression or unacceptable toxicity.[1]
- Classical Hodgkin lymphoma: 240 mg every 2 weeks.[1]
- MSI-H/dMMR colorectal cancer (after fluoropyrimidine/oxaliplatin): 240 mg every 2 weeks.[1]
Administer over 30 minutes. Adjust for body weight in some pediatric contexts, but adults use flat dosing.
Dosage in Combination Therapies
- With ipilimumab (e.g., melanoma, RCC, MSI-H/dMMR): Nivolumab 1 mg/kg every 3 weeks plus ipilimumab 3 mg/kg every 3 weeks for 4 doses, followed by nivolumab 240 mg every 2 weeks or 480 mg every 4 weeks.[1]
- With chemotherapy (e.g., NSCLC, gastric cancer): Nivolumab 360 mg every 3 weeks plus platinum-doublet chemo for 4 cycles, then nivolumab 240 mg every 2 weeks or 480 mg every 4 weeks.[1]
- With relatlimab (Opdualag for melanoma): Fixed 480 mg nivolumab + 160 mg relatlimab every 4 weeks.[1]
Dose reductions are not recommended; manage toxicity by holding or discontinuing.
Dose Adjustments and Special Cases
- Renal/hepatic impairment: No adjustment needed for mild-moderate issues; limited data for severe.[1]
- Elderly patients: No specific changes, but monitor closely.[1]
- Premedication: Not routinely required, unlike some immunotherapy combos.
Always confirm with latest prescribing info, as approvals evolve.
[1]: Opdivo Prescribing Information
[2]: DrugPatentWatch.com - Nivolumab Patents