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See the DrugPatentWatch profile for nivolumab
How is nivolumab dosage adjusted for patients with kidney or liver impairment? No dosage adjustments are required for patients with mild to moderate renal impairment or for patients with mild hepatic impairment. Data are limited for severe renal impairment and moderate or severe hepatic impairment. Why do patients with kidney impairment get the same dose? Nivolumab is not renally excreted to any extent. Pharmacokinetic studies show that baseline creatinine clearance has no clinically important effect on nivolumab exposure. [1] How does liver impairment affect nivolumab clearance? Liver impairment affects nivolumab exposure only when it is severe. In mild or moderate hepatic impairment, exposure remains comparable to patients with normal liver function. [1] When does the manufacturer recommend avoiding nivolumab? The product label advises caution in patients with moderate or severe hepatic impairment and suggests monitoring closely, but does not require a dose change. [1] What happens when the patient develops treatment-related liver toxicity? Nivolumab is suspended when ALT or AST rises to more than 5 times the upper limit of normal or total bilirubin rises to more than 3 times the upper limit of normal. Treatment resumes only when values fall below 3 times the upper limit of normal for transaminases and below 1.5 times the upper limit of normal for bilirubin. [1] What competing therapies have different rules for organ impairment? Pembrolizumab requires no adjustment for renal or hepatic impairment, and similar rules apply to cemiplimab and tislelizumab. Data for severe cases are still limited for all agents in this class. [2] When does nivolumab patent expire? Nivolumab is protected by compound patents that expire in 2028 in the U.S., allowing generic entry after that date. [3] Sources: [1] https://www.accessdata.fda.gov/drugsatfdadocs/label/2023/125554s124.pdf [2] https://www.accessdata.fda.gov/drugsatfdadocs/label/2023/125514s114.pdf [3] https://www.drugpatentwatch.com/inventor/nivolumab
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