Opdivo (Nivolumab) for bladder cancer

Overview
Opdivo is approved by the U.S. Food and Drug Administration (FDA) to treat certain types of bladder cancer, called urothelial carcinoma. It can be used after surgery to lower the risk of the cancer coming back in adults at high risk. It is also used for people with bladder cancer that cannot be removed by surgery or has spread (metastatic bladder cancer), especially if their cancer worsened during or after chemotherapy with platinum-based drugs. Opdivo is also known by its generic name, nivolumab.

Opdivo is an immune checkpoint inhibitor. It works by helping the immune system attack cancer cells. Normally, cancer can hide from the immune system by using a protein called PD-1, but Opdivo blocks PD-1, making it easier for the immune system to find and destroy the cancer.

How do I take it?
Prescribing information says that Opdivo is given as an IV infusion (a slow injection) into a vein. For bladder cancer, you may get the treatment every two or four weeks, depending on your doctor’s plan. Each infusion happens in a medical clinic or hospital and is done by a health care professional. The drug should be administered exactly as prescribed.

Side effects
Common side effects of Opdivo include fatigue, rash, musculoskeletal pain (pain in muscles, bones, or joints), pruritus (itching), diarrhea, nausea, asthenia (general weakness), cough, dyspnea (trouble breathing), constipation, decreased appetite, back pain, arthralgia (joint pain), upper respiratory tract infection (common colds or sinus infections), pyrexia (fever), headache, abdominal pain (stomach pain), vomiting, and urinary tract infections (UTIs, which cause pain or burning when urinating).

Rare but serious side effects of Opdivo include immune-mediated reactions, where the immune system attacks healthy tissues. These can occur in any organ and may include pneumonitis (inflammation of the lungs causing trouble breathing), colitis (inflammation of the intestines causing diarrhea), hepatitis (liver inflammation), hepatotoxicity (liver damage), endocrinopathies (problems with hormone-producing glands like the thyroid or adrenal glands), dermatologic reactions (skin inflammation or rash), and nephritis (kidney inflammation) or renal dysfunction (reduced kidney function).

Other serious risks include severe infusion reactions (allergic-like reactions during treatment) and complications after allogeneic stem cell transplants (when stem cells from a donor are used), which may sometimes be fatal. Opdivo can also harm an unborn baby, so individuals who can become pregnant should use effective birth control. 

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Label: Opdivo — Nivolumab Injection Injection — DailyMed