Nivolumab

Pediatric Medication
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This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Opdivo

Brand Names: Canada

Opdivo

What is this drug used for?

  • It is used to treat colorectal cancer.
  • It is used to treat a type of skin cancer (melanoma).
  • This drug may be used with another drug called ipilimumab. Some side effects that can happen may happen more often if this drug is used with ipilimumab. If your child is also using ipilimumab, talk with your child’s doctor about the risks and side effects that may happen.
  • It may be given to your child for other reasons. Talk with the doctor.

What do I need to tell the doctor BEFORE my child takes this drug?

  • If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
  • If your child is taking any of these drugs: Lenalidomide, pomalidomide, or thalidomide.

If your child is breast-feeding a baby:

  • Be sure your child does not breast-feed a baby while taking this drug and for 5 months after the last dose.

This is not a list of all drugs or health problems that interact with this drug.

Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe to give this drug with all of your child’s other drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
  • Have your child’s blood work checked often. Talk with your child’s doctor.
  • High blood sugar has happened with this drug. This includes diabetes that is new or worse.
  • Check your child’s blood sugar as you have been told by the doctor.
  • Severe health problems in some organs can happen with this drug. These may happen in the bowels; lungs; liver; thyroid, pituitary, and adrenal glands; pancreas; kidneys; or other parts of the body. Nerve problems, muscle problems, or severe skin reactions may also happen. Sometimes, these problems have been deadly. These problems may happen anytime during treatment or even after treatment ends. If you have questions, talk with the doctor.
  • If your child is having a stem cell transplant, talk with your child’s doctor. Some problems with stem cell transplants using stem cells from someone else (allogeneic) have happened after treatment with this drug. These problems can be very bad and can lead to death.
  • If your child is of childbearing age, a pregnancy test will need to be done before starting this drug to make sure your child is not pregnant.

If your child is or may be sexually active:

  • This drug may cause harm to the unborn baby if your child takes it during pregnancy.
  • Have your child use birth control while taking this drug and for some time after the last dose. Ask the doctor how long your child must use birth control. If your child becomes pregnant, call the doctor right away.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of thyroid, pituitary, or adrenal gland problems like change in mood or behavior, change in weight or taste, constipation, deeper voice, dizziness, fainting, feeling cold, feeling very tired, hair loss, severe or long-lasting headache, change in sex interest, eye problems, fast heartbeat, more sweating, fast or deep breathing, sweet smelling breath, change in smell of urine or sweat, or passing urine more often.
  • Signs of a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up.
  • Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
  • Signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Signs of electrolyte problems like mood changes; confusion; muscle pain, cramps, or spasms; weakness; shakiness; change in balance; an abnormal heartbeat; seizures; loss of appetite; or severe upset stomach or throwing up.
  • Signs of lung or breathing problems like shortness of breath or other trouble breathing, cough, or fever.
  • Any unexplained bruising or bleeding.
  • Muscle pain or weakness.
  • Swelling.
  • Chest pain.
  • A heartbeat that does not feel normal.
  • A burning, numbness, or tingling feeling that is not normal.
  • Loss of skin color in blotches.
  • Tell your child’s doctor if your child has signs of high or low blood sugar like breath that smells like fruit, dizziness, fast breathing, fast heartbeat, feeling confused, feeling sleepy, feeling weak, flushing, headache, unusual thirst or hunger, passing urine more often, shaking, or sweating.
  • A certain brain problem has happened with this drug. Rarely, this has been deadly. Call your child’s doctor right away if your child is confused, sleepy, very tired or weak, or has a fever, hallucinations, memory problems, seizures, stiff neck, or very bad headache.
  • Some people have had side effects during the infusion. Sometimes, these could be severe or life-threatening. Tell the doctor if your child has back or neck pain, chills or shaking, dizziness, passing out, fever, flushing, itching, rash, shortness of breath, swelling of the face, or wheezing.
  • It is common to have diarrhea with this drug. However, a severe bowel problem (colitis) with diarrhea has happened with this drug. This may lead to tears or holes in the bowels and may be life-threatening. Call your child’s doctor right away if your child has bloody stools; dark, tarry, or sticky stools; diarrhea; or severe stomach pain.
  • A severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause severe health problems that may not go away, and sometimes death. Get medical help right away if your child has signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in the mouth, throat, nose, or eyes.
  • Eye problems have happened with this drug. Some types of eye problems may need to be treated right away to lower the chance of lasting eyesight loss. Call your child’s doctor right away if your child has any changes in eyesight, eye pain, or very bad eye irritation.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:

  • Headache.
  • Bone or joint pain.
  • Constipation.
  • Stomach pain or heartburn.
  • Feeling tired or weak.
  • Signs of a common cold.
  • Trouble sleeping.
  • Weight loss.
  • Dry mouth.
  • Mouth irritation or mouth sores.
  • Flu-like signs.
  • Diarrhea, throwing up, upset stomach, and decreased appetite are common with this drug. If these happen, talk with your child’s doctor about ways to lower these side effects. Call your child’s doctor right away if any of these effects bother your child, do not get better, or are severe.

These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.

You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

  • It is given as an infusion into a vein over a period of time.

What do I do if my child misses a dose?

  • Call your child’s doctor to find out what to do.

How do I store and/or throw out this drug?

  • If you need to store this drug at home, talk with your child’s doctor, nurse, or pharmacist about how to store it.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2023-03-06

Copyright

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Last Updated

Monday, December 12, 2022