Opdivo: Use with Yervoy, Side Effects, Cost, and More - Healthline

Like most drugs, Opdivo may cause mild or serious side effects. The lists below describe some of the more common side effects. These lists don't include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you may be taking

Your doctor or pharmacist can tell you more about the potential side effects of Opdivo. They can also suggest ways to help reduce side effects.

Mild side effects

Here's a list of some of the mild side effects that Opdivo can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Opdivo's medication guide.

Mild side effects of Opdivo that have been reported include:

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* For more information about this side effect, see the "Side effect focus" section below.

Serious side effects

Serious side effects from Opdivo can occur, but they aren't common. If you have serious side effects from Opdivo, call your doctor right away. However, if you think you're having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Opdivo that have been reported include:

  • pneumonia
  • infusion reactions, which may cause fever, dizziness, shaking, back or neck pain, itching or rash, shortness of breath, and chills
  • serious skin reactions, such as Stevens-Johnson syndrome
  • problems caused by your immune system attacking your healthy cells, such as:
    • blood cell disorders, such as anemia (low level of red blood cells)
    • kidney damage, such as nephritis (inflammation in your kidneys)
  • low sodium level
  • high potassium level
  • diabetic ketoacidosis (a dangerous buildup of acids called ketones in your blood)
  • encephalitis (swelling in the brain)
  • meningitis (swelling of the lining around the brain and spinal cord)
  • allergic reaction*

* For more information about this side effect, see the "Side effect focus" section below.

Side effect focus

Learn more about some of the side effects Opdivo may cause.

Joint, muscle, or back pain

Opdivo may cause joint, muscle, and back pain. These are more common side effects of the drug.

Your risk for these side effects may be greater if you're receiving other drugs that also cause them.

The risk of joint, back, or muscle pain may also be greater depending on the condition you're treating. For example, some people with lung cancer may have back pain as a symptom of their condition. And Opdivo is used to treat a certain type of lung cancer.

Inflammatory arthritis is a less common side effect of Opdivo and other immunotherapy drugs. With inflammatory arthritis, you have joint pain and swelling due to your immune system attacking your own tissue. In some cases, inflammatory arthritis may continue even after you've stopped treatment with Opdivo.

What might help

If you have joint, muscle, or back discomfort with Opdivo, tell your doctor. They can check to see what's causing your symptoms. And they can suggest ways to manage your pain.

For mild pain, this might include using over-the-counter nonsteroidal anti-inflammatory drugs.

For more severe pain, your doctor may discuss other options, including corticosteroids or stopping Opdivo treatment.

Liver damage

In some cases, Opdivo may cause your immune system to attack healthy cells in your body, leading to inflammation. This could include the cells of your liver. Serious inflammation in your liver can cause hepatitis.

Your risk for this type of immune system reaction may be higher if you take ipilimumab (Yervoy) together with Opdivo.

Possible symptoms of liver damage include:

  • dark urine
  • reduced appetite
  • jaundice (yellowing of your skin or the whites of your eyes)
  • tiredness
  • pain on the right side of your belly
  • severe nausea or vomiting
  • easily bleeding or bruising

What might help

Before starting Opdivo, tell your doctor if you've had hepatitis or other liver problems in the past. Your doctor may check to see how your liver is functioning. They'll also closely monitor you while you receive Opdivo. This could help you avoid serious immune-related problems with treatment.

Call your doctor right away if you have symptoms of liver damage while taking Opdivo. If you have severe liver problems with Opdivo, your doctor may have you stop taking the drug and they'll treat your liver condition.

Before you take Opdivo, your doctor will discuss the risks and benefits of the drug. They can talk with you about possible immune-related reactions that may happen.

Skin rash

Opdivo can cause different types of skin rash. This may be a common side effect of immunotherapy drugs, including Opdivo.

It's possible to get a rash from Opdivo as part of an infusion reaction. These reactions may happen when you receive medications as injections into your vein.

Additionally, some people may have an allergic reaction to Opdivo, which can also cause a skin rash. See the "Allergic reaction" section just below for more information.

Opdivo can sometimes cause a severe skin rash called Stevens-Johnson syndrome. With this condition, you may have painful sores on your body, mouth, genitals, and eyes. This reaction is extremely rare, but it can be life threatening and need to be treated in a hospital.

Your risk for skin rash with Opdivo may be higher if you receive other drugs with it that also have this side effect. And your risk will vary depending on the condition you're treating.

What might help

Your doctor will monitor you for skin reactions while you're receiving doses of Opdivo. If you have an infusion reaction, your doctor may slow, pause, or stop the infusion. This depends on the severity of your reaction.

If you develop a skin rash after receiving a dose of Opdivo, call your doctor. They may suggest treatment with an over-the-counter medication if your rash is mild.

If your rash is severe, your doctor may stop your Opdivo treatment and manage your skin reaction. And they'll tell you if it's safe to continue taking Opdivo.

If you have a severe allergic reaction or symptoms that seem life threatening, call 911 or your local emergency number. Or go to an emergency medical center right away.

Ask your doctor for more information about the risk of skin reactions with Opdivo treatment.

Allergic reaction

Some people may have an allergic reaction to Opdivo.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Opdivo. But if you think you're having a medical emergency, call 911 or your local emergency number.

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