Opdivo’s Side Effects: What to Know

Medically Reviewed By Tanya Kertsman, PharmD

Opdivo: Introduction

Opdivo is a brand-name prescription drug. It’s an immunotherapy drug, which means it uses parts of your immune system to fight diseases such as cancer.

Opdivo contains the active drug nivolumab. It comes as a solution and is given by IV infusion.

Opdivo is approved by the Food and Drug Administration (FDA) to treat certain types of cancer. Doctors typically prescribe Opdivo for the following cancers in adults, in certain situations:

It’s also used to treat a certain type of colorectal cancer in children ages 12 years and older. Opdivo is meant to be used as a long-term treatment.


Similar to other drugs, Opdivo may cause side effects. Read below for information about possible side effects, including common, mild, and serious ones.

For a general overview of Opdivo, including details about its uses, see this article. If you’d like to take Opdivo, search here to find a healthcare professional who might prescribe it.

Opdivo: More common side effects

Some of Opdivo’s side effects may be more common than others. These side effects may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about any side effects with Opdivo.

In Opdivo’s clinical studies, these were some side effects that occurred more often:

* For more information about this side effect, see “Side effects explained” below.

Opdivo: Mild side effects

Opdivo can cause mild side effects, which are listed below. However, this list doesn’t include all possible mild side effects. To learn more about Opdivo’s side effects, view the drug’s prescribing information.

Opdivo’s mild side effects include:

* For more information about this side effect, see “Side effects explained” below.

The side effects listed above may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Some of these side effects could also be symptoms of your cancer getting worse. Tell your doctor or pharmacist right away if you have concerns about any side effects with Opdivo.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking Opdivo and want to tell the FDA about it, visit MedWatch.

Opdivo: Serious side effects

It’s possible to have serious side effects with Opdivo. Serious side effects are listed below, but this list may not include all possibilities. To learn more about Opdivo’s side effects, view the drug’s prescribing information.

Call your doctor right away if you have serious side effects with Opdivo. However, if you think you’re having a medical emergency or have life threatening side effects, call 911 or your local emergency number.

Many of Opdivo’s serious side effects are immune-mediated, meaning they’re caused by an overactive immune system. They often lead to inflammation in certain areas of the body. Examples of these immune-mediated side effects and their possible symptoms include:

  • Pneumonitis, which affects the lungs. Symptoms can include:
  • Colitis, which affects the colon. Symptoms can include:
  • Hepatitis, which affects the liver. Symptoms can include:
    • jaundice
    • loss of appetite
    • fatigue
    • nausea and vomiting
  • Endocrine disorders, which affect hormones such as insulin or thyroid hormone. Symptoms can include:
    • fatigue
    • increased thirst or hunger
    • urinating more often than usual
    • weight loss or weight gain
  • Dermatitis, which affects the skin. Symptoms can include:
    • redness or deepening of color
    • blisters
    • peeling
    • flu-like symptoms, such as fever or chills
  • Nephritis, which affects the kidneys. Symptoms can include:
    • swelling in the face, hands, ankles, or feet
    • foamy or bloody urine
    • urinating less often or a lesser amount than usual
  • Encephalitis, which affects the brain. Symptoms can include:
    • confusion*
    • fever
    • headache
    • loss of appetite
    • seizures
    • stiffness in the neck or back
  • Myocarditis, which affects the heart. Symptoms can include:
  • Uveitis, which affects the inner eye, and other eye side effects.*

* For more information about this side effect, see “Side effects explained” below.

Other serious side effects of Opdivo and their possible symptoms include:

* For more information about this side effect, see “Side effects explained” below.

Opdivo: Common questions about side effects

Here are some common questions about the drug’s side effects and answers to them. Talk with your doctor if you have other questions about this drug.

Will I have certain side effects if I’m taking Opdivo with Yervoy?

It’s possible. For certain types of cancer, Opdivo is used in combination with ipilimumab (Yervoy). (To learn more about Opdivo’s use with Yervoy, see this article.)

Many of Opdivo’s side effects are expected to be similar whether the drug is used alone or with Yervoy. However, certain side effects of Opdivo may be more common when it’s given with Yervoy. These side effects can include:

To learn more about what to expect when Opdivo is used with Yervoy, talk with your doctor or pharmacist.

Does Opdivo cause melanoma?

No, Opdivo isn’t likely to cause melanoma (a type of skin cancer). This side effect wasn’t reported in clinical studies of the drug.

Actually, Opdivo is used to treat certain forms of melanoma in adults. To learn more about the drug’s uses, see this article.

To learn about more common side effects of Opdivo when it’s used for melanoma, see the “Opdivo: Mild side effects” and “Opdivo: Serious side effects” sections above. For a full list of the drug’s side effects, see Opdivo’s prescribing information.

Are there long-term side effects with Opdivo?

Possibly. Some of Opdivo’s side effects are temporary. Certain side effects will typically go away soon after you stop taking the drug. They may also go away shortly after you begin taking it. However, certain side effects of Opdivo may last longer.

For example, Opdivo can cause inflammation in certain areas of the body. This can lead to conditions such as kidney problems or liver problems, which may cause long-term issues for you.

If you have questions about long-term side effects that may happen with Opdivo, talk with your doctor or pharmacist.

Is Opdivo an immunotherapy drug? Are certain side effects more common with this type of drug?

Yes, Opdivo is a type of drug called a monoclonal antibody, which is a form of immunotherapy.

Immunotherapy drugs work by helping your body’s immune system fight off cancer. To learn more about how Opdivo works, see this article.

Certain side effects may be more common with immunotherapy than with other cancer treatments, such as radiation or chemotherapy. In general, immunotherapy is expected to cause fewer side effects than these other cancer treatments. This is because immunotherapy drugs target cancer cells. However, radiation and chemotherapy often affect both cancer cells and healthy cells in the body.

Side effects can vary depending on the type of immunotherapy given. Common side effects of immunotherapy drugs include:

To learn more about what to expect with Opdivo or other immunotherapy drugs, talk with your doctor or pharmacist.

Will Opdivo make me thirsty or have to urinate more than usual?

In rare cases, Opdivo can cause diabetes as a side effect. And diabetes may cause symptoms such as increased thirst or urinating more often than usual.

If you find that you’re thirstier or you’re urinating more often than usual, tell your doctor. They may order tests to check for diabetes.

To learn more about how Opdivo may affect your thirst or urination, talk with your doctor or pharmacist.

Does Opdivo cause hair loss or confusion?

Yes, Opdivo may cause hair loss. However, this side effect was rare in clinical studies of the drug.

Keep in mind that other factors can contribute to hair loss with Opdivo. For example, Opdivo may be used in combination with chemotherapy drugs, which can cause hair loss. Additionally, Opdivo can lower the level of thyroid hormone in your body. And having a low level of thyroid hormone can also cause hair loss.

If you’d like, talk with your doctor about your risk for hair loss with Opdivo. They can advise on your risk for this side effect, and they may offer ways to help manage it. If you have hair loss, your doctor might check the level of thyroid hormone in your body. If your level is low, your doctor may prescribe thyroid medication. Treating a low thyroid hormone level with medication could help ease your hair loss.

Confusion itself wasn’t reported as a side effect in clinical studies of Opdivo. However, confusion may be a symptom of a more serious condition called encephalitis. (With this condition, you have inflammation of the brain.) Encephalitis was a rare side effect in studies of the drug. It’s a serious condition that can be life threatening if it’s not treated.

If you have confusion with Opdivo, call 911 or your local emergency number right away. A healthcare professional may give you tests to see if encephalitis is the cause.

Opdivo: Side effects explained

Here’s detailed information about some of Opdivo’s side effects.

Eye side effects

Opdivo may cause eye side effects, although these were rare in clinical studies of the drug.

Eye side effects that may happen with Opdivo include:

Symptoms of these conditions include eye pain, blurry vision, and eye floaters.

What you can do

If you have eye side effects with Opdivo, call 911 or your local emergency number right away. Both uveitis and a detached retina are serious conditions that may lead to blindness if left untreated.

Your doctor may recommend medications or surgery to treat your eye condition.

Rash

Rash is possible with Opdivo. In fact, it was one of the most common side effects in clinical studies of the drug.

Rash can be a symptom of other side effects of Opdivo, such as infusion reactions. (These can happen during or shortly after receiving an IV infusion of Opdivo.) Along with rash, you may have itching, fever, dizziness, or chills with an infusion reaction.

Rash can also be a symptom of an allergic reaction or a more severe skin reaction. Aside from rash, severe skin reactions can also cause blisters, peeling, and flu-like symptoms. For possible symptoms of allergic reactions, see the “Allergic reaction” section below.

What you can do

Your doctor will likely monitor you for rash and other skin reactions while you’re receiving Opdivo IV infusions.

If you have a mild rash or another skin-related symptom with Opdivo, talk with your doctor. They can suggest treatments for itching, rash, or other skin symptoms.

However, if you have symptoms of an allergic reaction or a severe skin reaction, call 911 or your local emergency number right away.

Joint pain

Joint pain may occur with Opdivo. This was a common side effect in clinical studies of the drug.

Keep in mind that joint pain can also be a symptom of pneumonitis. With this condition, you have inflammation in the lungs. Pneumonitis is a rare but serious side effect of Opdivo.  

What you can do

If you have joint pain with Opdivo, talk with your doctor. They can help you figure out if this may be a symptom of a more serious condition.

Your doctor can also suggest ways to manage your joint pain. For example, they may recommend over-the-counter pain relievers such as ibuprofen (Advil) or acetaminophen (Tylenol). Always check with your doctor before taking any medications with Opdivo.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Opdivo. A more severe allergic reaction is rare but possible.

Possible symptoms of mild and serious allergic reactions are listed in the table below.

Mild allergic reaction symptoms Serious allergic reaction symptoms
• itching trouble breathing
rash • swelling in your throat or mouth
flushing • swelling under your skin, possibly in your hands, feet, lips, or eyelids

If you have an allergic reaction to Opdivo, call your doctor right away. This is important to do because  the reaction could become severe.

However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or your local emergency number.

Opdivo: Precautions

Be sure to talk with your doctor about your health history before you take Opdivo. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health.

The conditions and factors to consider include those described below.

Nervous system conditions or problems with your immune system. Opdivo can cause side effects that are immune-mediated, meaning they’re caused by an overactive immune system. Tell your doctor if you have any nerve conditions, such as myasthenia gravis or Guillain-Barré syndrome. Also tell them if you have a condition caused by a problem with your immune system, such as lupus, ulcerative colitis, or Crohn’s disease. Opdivo may worsen these conditions. Your doctor can recommend whether it’s safe for you to take Opdivo.

Organ or stem cell transplant. Before taking Opdivo, tell your doctor if you’ve ever had an organ transplant. Also tell them if you’ve had or are planning to have a stem cell transplant using stem cells from another person. In rare cases, taking Opdivo in these situations can cause life threatening complications. Your doctor can recommend the best treatment option for your condition.

Allergic reaction. If you’ve had an allergic reaction to Opdivo or any of its ingredients, your doctor will likely not prescribe Opdivo. Ask your doctor what other medications may be better options for you.

Chest radiation in the past. Opdivo may cause pneumonitis. (With this condition, you have  inflammation in your lungs.) Your risk for this side effect may be higher if you’ve ever had radiation treatment of your chest. Your doctor can advise whether it’s safe for you to take Opdivo.

Consuming alcohol during Opdivo treatment

There aren’t any known interactions between alcohol and Opdivo.

That said, keep in mind that drinking a lot of alcohol can lead to liver damage. And Opdivo may cause hepatitis (inflammation in the liver). To lower your risk of liver problems with Opdivo, it may be best to limit the amount of alcohol you drink while taking this drug.

If you drink alcohol, talk with your doctor. They can advise on the amount of alcohol that may be safe for you while you’re taking Opdivo.

Pregnancy and breastfeeding during Opdivo treatment

You shouldn’t use Opdivo while pregnant or breastfeeding.

To make sure you aren’t pregnant, doctors will typically order a pregnancy test for you before you start Opdivo. And they’ll typically recommend that you use birth control during treatment and for at least 5 months after your last dose.

You should also avoid breastfeeding for at least 5 months after your last dose of Opdivo.

To learn more about the risks of taking Opdivo during pregnancy or while breastfeeding, talk with your doctor.

Opdivo: What to discuss with your doctor

Talk with your doctor or pharmacist to find out more about Opdivo. If you have questions about the drug’s side effects, your pharmacist or healthcare professional can help answer them for you.

Opdivo’s more common side effects are typically mild. To view a list of these, see the “Opdivo: More common side effects” section above. Be sure to tell your doctor about any severe or bothersome side effects with this drug.

In addition to discussing Opdivo with your doctor, you may find the following articles helpful in learning more.

Disclaimer: Healthgrades has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Medical Reviewer: Tanya Kertsman, PharmD
Last Review Date: 2022 Feb 4
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.