Description
Nivolumab is a generic form of brand name Nivolumab which is a targeted therapy drug presently used to cure melanoma, non-small cell lung cancer or kidney (renal cell) cancer. Nivolumab belongs to a group of cancer drugs known as monoclonal antibodies.
Nivolumab is also known as an immune checkpoint inhibitor. Sometimes these drugs are called targeted therapies because they target specific proteins (receptors) on the surface of cells.
Indication
Nivolumab is indicated for the treatment of patients having conditions like :
• Melanoma which has spread or can’t be removed with surgery
• Non-Small Cell Lung Cancer which has spread or come back after chemotherapy
• Kidney (Renal Cell) Cancer which has come back after chemotherapy.
Mechanism Of Action
Nivolumab stops the molecule activity called PD-1, and it is a protein which inhibits T cells from identifying and attacking inflamed tissues and cancer cells. PD-1 can trick the immune system into overlooking melanoma cells as normal cells. Nivolumab triggers your immune system’s reacting to melanoma by inhibiting the PD-1 protein on T cells. The drug activates T cells so which they can attack melanoma cells anywhere in your body.
Dosage and administration
Nivolumab recommended dosage for unresectable or metastatic melanoma :
As a single agent is either 240mg every 2 weeks or 480mg every 4 weeks given as IV infusion over 30 minutes until disease progression or unacceptable toxicity
With ipilimumab. The recommended dose of Nivolumab is 1mg/kg administrated as an intravenous infusion over 30 minutes, followed by ipilimumab 3mg/kg given as IV over 90 minutes on the same day. Duration 3 weeks of max 4 doses, after completing combination does continue the single agent treatment
Side Effects
Common side effects :
Fatigue, Lymphocytopenia (Low White Blood Cells), Low Sodium, Shortness of breath, Musculoskeletal Pain, Decreased Appetite, Cough.
Precautions
Immune-mediated pneumonitis may appear to the patients; withhold for moderate and permanently discontinue for serious or life-threatening pneumonitis
Immune-mediated colitis resulted; withhold for moderate or serious and permanently stop for life-threatening colitis
Immune-mediated hepatitis seen in clinical trials; check for liver function changes; withhold for limited and permanently stop for serious or life-threatening transaminase or total bilirubin elevation.
Pregnancy
The effects of Nivolumab are expected to be greater during the second and third trimesters of pregnancy. There are no available human data informing the drug-associated risk. Advise pregnant women of the potential risk to a fetus.
Lactation
Nivolumab Excretion in human breast milk is not known; advise women to discontinue breastfeeding during treatment
Missed Dose
If you missed a dose take it as soon as possible, if time reach for next dose, then skip the missed dose and continue regular schedule. Avoid taking two doses at a time. Avoid taking a missed dose within 12hrs of the next dose.
Storage
Store at under refrigeration at 2°C to 8°C.
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