Anti-PD-1 immune checkpoint inhibitor

Nivolumab (Specialist drug)

Brand names: Opdivo

Adult dose

Dose: Specialist initiation only — refer to BNF/SmPC

Route: IV

Frequency: per protocol

Clinical pearls

Many indications: melanoma, NSCLC, RCC, urothelial, HCC, CRC (MSI-H), Hodgkin lymphoma, oesophageal, head & neck
Specialist immunotherapy toxicity protocols (steroids ± additional immunosuppression)

Contraindications

Active autoimmune disease (relative)
Severe immune-related toxicity from previous course

Side effects

Immune-mediated adverse events: pneumonitis, hepatitis, colitis, dermatitis, endocrinopathies (thyroid, hypophysitis, adrenal, T1DM); rare myocarditis
Infusion reactions
Fatigue

Interactions

Systemic corticosteroids/immunosuppressants reduce efficacy unless treating irAE
Live vaccines

Monitoring

LFTs
TFTs
Cortisol
Glucose
Skin
Bowel/respiratory symptoms

Reference: BNF; multiple NICE TAs; ESMO immunotherapy toxicity guidelines; https://bnf.nice.org.uk/drugs/nivolumab-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways