Anthropometric Measurements as Predictors of Low Birth Weight Among Tanzanian Neonates: A Hospital-Based Study
November 7, 2025
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Brand Name :
Opdivo
(United States) [Available]Synonyms :
relatlimab
Class :
Class: antineoplastic agents, PD-1/PD-L1 Inhibitors, LAG-3 Inhibitors 
Brand Name :
Opdivo
(United States) [Available]Synonyms :
relatlimab
Class :
Class: antineoplastic agents, PD-1/PD-L1 Inhibitors, LAG-3 Inhibitors 
Dosage Forms & Strengths:Â Â
Solution for injection
10mg/mL (4mL, 10mL)
Before administrating, dilute it further
360
mg
Solution
Intravenous (IV)
every 3 weeks
Malignant Pleural Mesothelioma
360
mg
Solution
Intravenous (IV)
every 3 weeks
Continue the dose until disease progression or up to 2 years
240
mg
Intravenous (IV)
every 2 weeks
Continue the dose until unacceptable toxicity or disease progression
Combination with cabozantinib:
Indicated in combination with cabozantinib for the first-line treatment of RCC advanced renal cell carcinoma
240 mg intravenously every 2 weeks or 480 mg intravenously every 4 weeks plus 40 mg cabozantinib orally each day
nivolumab, continue until the unacceptable toxicity or disease progression up to 2 years
cabozantinib, continue until disease progression or unacceptable toxicity
Combination with ipilimumab
Indicated for patients with a risk of previously untreated advanced renal cell carcinoma 3 mg/kg nivolumab intravenously every 3 weeks with 1 mg/kg ipilimumab intravenously on the same day as 4 doses
After 4 doses, administer nivolumab 240 mg intravenously every 2 weeks or 480 mg intravenously every 4 weeks
Continue until the unacceptable toxicity or disease progression
Adjuvant Treatment of Melanoma:
Recommended for melanoma in patients who have undergone complete resection and have lymph node involvement or metastatic disease in the adjuvant context
240 mg intravenously every 2 weeks or 480 mg intravenously every 4 weeks
Continue the therapy until the unacceptable toxicity or disease progression for up to a year
Unresectable or Metastatic Melanoma
It is indicated for single-agent use or in combination with ipilimumab.
Single-agent
240 mg intravenously every 2 weeks or 480 mg intravenously every 4 weeks
Continue until the disease is progressed or unacceptable toxicity is achieved
In combination with ipilimumab
1 mg/kg nivolumab intravenously every 3 weeks, with
3 mg/kg ipilimumab intravenously on the same day (maximum of 4 doses)
After completion of combination therapy: administer 240 mg nivolumab intravenously every 2 weeks or 480 mg intravenously every 4 weeks
Continue the therapy until the disease is progressed or unacceptable toxicity is reduced
480 mg of nivolumab/160 mg of relatlimab Intravenous every four Weeks
Continue till unacceptable toxicity or disease progression occurs
Dose Adjustments
Dosage Modifications
Immune mediated adverse reactions (IMARs) general dose modifications
IMARs of severe (Grade 3): Delay
Life-threatening Recurrent severe (Grade 3) or Grade 4 Inability to lower corticosteroid dosage to 10 mg or less on prednisone or an equivalent within 12 weeks of starting steroids or IMARs requiring systemic immunosuppressive therapy: discontinue permanently
Pneumonitis
Grade 2
Delay therapy; Resume once complete or partial improvement (Grade below 1) has been achieved following corticosteroid tapering
If there isn't any complete or partial improvement within 12 weeks of starting steroids or if prednisone cannot be reduced to below 10 mg/day (or an equivalent amount) within 12 weeks of starting steroids, permanently discontinue.
Grade 3 and 4: Discontinue permanently
Colitis
Grade 2 and 3
Delay therapy; Resume once complete or partial improvement (Grade below 1) has been achieved following corticosteroid tapering
If there isn't any complete or partial improvement within 12 weeks of starting steroids or if prednisone cannot be reduced to below 10 mg/day (or an equivalent amount) within 12 weeks of starting steroids, permanently discontinue.
Grade 4: Discontinue permanently
Hepatitis
Total bilirubin increasing to more than 1.5 and 3 times ULN or AST or ALT increasing to more than 3 and 8 times ULN: Delay therapy; Resume once complete or partial improvement (Grade below 1) has been achieved following corticosteroid tapering
If there isn't any complete or partial improvement within 12 weeks of starting steroids or if prednisone cannot be reduced to below 10 mg/day (or an equivalent amount) within 12 weeks of starting steroids, permanently discontinue.
AST or ALT increasing to more than 8 times ULN or TB increasing to more than 3 times ULN: discontinue Permanently
Endocrinopathies
Grade 3 and 4: Delay till clinically gets stable or discontinue permanently based on the severity
Nephritis with the renal impairment
Grade 2 and 3 increased blood creatinine
Delay therapy; Resume once complete or partial improvement (Grade below 1) has been achieved following corticosteroid tapering
If there isn't any complete or partial improvement within 12 weeks of starting steroids or if prednisone cannot be reduced to below 10 mg/day (or an equivalent amount) within 12 weeks of starting steroids, permanently discontinue.
Grade 4 increase in the blood creatinine levels: discontinue Permanently
Dermatologic Exfoliative conditions
toxic epidermal necrolysis (TEN), Suspected Stevens-Johnson Syndrome (SJS), or Drug Rash with Eosinophilia Systemic Symptoms (DRESS): Delay therapy
Confirmed SJS, DRESS or TEN: discontinue Permanently
Myocarditis
Grade 2, 3, and 4: discontinue Permanently
Neurologic toxicities
Grade 2
Delay therapy; Resume once complete or partial improvement (Grade below 1) has been achieved following corticosteroid tapering
If there isn't any complete or partial improvement within 12 weeks of starting steroids or if prednisone cannot be reduced to below 10 mg/day (or an equivalent amount) within 12 weeks of starting steroids, permanently discontinue.
Grade 3 and 4: discontinue Permanently
Infusion-related reactions
Grade 1 or 2: slow the infusion rate or interrupt
Grade 3 or 4: discontinue Permanently
Hepatic impairment
Mild and moderate (TB below 3 times ULN and at any AST): dosage adjustment is not necessary
Severe: pharmacokinetics effects of relatlimab and nivolumab are not known
Renal impairment
Mild and moderate (eGFR 30 to 89 mL/min/1.73 m2): dosage adjustment is not necessary
Severe: pharmacokinetics effects of relatlimab and nivolumab are not known
Dosage Forms & Strengths:Â Â
Solution for injection
10mg/mL (4mL, 10mL)
Before administrating, dilute it further.
Safety and efficacy not established in pediatrics
Indicated for Unresectable or Metastatic Melanoma as a single-agent use or in combination with ipilimumab.
Single-agent
• For <12 years: 3 mg/kg intravenously every 2 weeks or 6 mg/kg intravenously every 4 weeks
• For >12 years: 240 mg intravenously every 2 weeks or 480 mg intravenously every 4 weeks
• Continue until the disease is progressed or unacceptable toxicity is achieved
In combination with ipilimumab
• 1 mg/kg nivolumab intravenously every 3 weeks, with 3 mg/kg ipilimumab intravenously on the same day (maximum of 4 doses)
• After completion of combination therapy administer nivolumab
• For >12 years: 240 mg intravenously every 2 weeks or 480 mg intravenously every 4 weeks
• Continue the therapy until the disease is progressed or unacceptable toxicity is reduced
It is indicated as a single agent or in combination with ipilimumab.
For <12 years: Safety and efficacy are not seen
For ≥12 years:
Single-agent
<40 kg: 3 mg/kg intravenously every 2 weeks
≥40 kg: 240 mg intravenously every 2 weeks or 480 mg intravenously every 4 weeks
Continue until disease progression or unacceptable toxicity.
Combination with ipilimumab
nivolumab 3 mg/kg intravenously every 3 weeks with ipilimumab 1 mg/kg intravenously on the same day for 4 doses
After completing the combination therapy: Administer nivolumab 3 mg/kg intravenously every 2 weeks.
Continue until disease progression or unacceptable toxicity.
Refer to adult dosing.
Corticosteroids may diminish the therapeutic effect of Immune Checkpoint Inhibitors.
Corticosteroids may diminish the therapeutic effect of Immune Checkpoint Inhibitors.
Corticosteroids may diminish the therapeutic effect of Immune Checkpoint Inhibitors.
Corticosteroids may diminish the therapeutic effect of Immune Checkpoint Inhibitors.
Corticosteroids may diminish the therapeutic effect of Immune Checkpoint Inhibitors.
may diminish the therapeutic effect of corticosteroids
may decrease the therapeutic effect
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may decrease the therapeutic effect when combined with immune checkpoint inhibitors
may decrease the therapeutic effect when combined with immune checkpoint inhibitors
may decrease the therapeutic effect when combined with immune checkpoint inhibitors
may decrease the therapeutic effect when combined with immune checkpoint inhibitors
may decrease the therapeutic effect when combined with immune checkpoint inhibitors
the effect of nivolumab decreases on interacting with betamethasone
the effect of nivolumab decreases on interacting with budesonide.
the effect of nivolumab decreases on interaction with cortisone.
the effect of nivolumab decreases on interacting with deflazacort.
the effect of nivolumab decreases on interacting with dexamethasone.
it may decrease the effect of nivolumab and reduce blood levels.
the effect of nivolumab decreases on interacting with hydrocortisone
idelalisib itself causes diarrhea, and when taken with nivolumab, it increases the risk of fatal diarrhea.
risk and life-threatening effects occur when nivolumab is co-administered with lenalidomide for treating multiple myeloma
the effect of nivolumab decreases on interacting with methylprednisolone
when co-administered with nivolumab to treat multiple myeloma, pomalidomide poses a severe threat
the effect of nivolumab decreases on interacting with prednisolone.
the effect of nivolumab decreases on interacting with prednisone
taken in combination; with thalidomide and nivolumab for treating multiple myeloma may result in serious risk and life-threatening effects
the impact of nivolumab decreases on interacting with triamcinolone
It may enhance the immunosuppressive effects when combined with idecabtagene vicleucel
By immunosuppressive effects, the both the drugs action either decreases and results in risk of infection.
when melphalan is combined with nivolumab, the risk or severity of adverse effects can be increased
Risk of infection enhanced due to increased immunosuppressive effects of nivolumab.
in combination with ofatumumab, nivolumab increases the risk of adverse events
may decrease the therapeutic effect of antibiotics
amoxicillin and clavulanate potassium
may diminish the therapeutic effect of immune checkpoint inhibitors
lansoprazole, amoxicillin, and clarithromycin
may diminish the therapeutic effect of immune checkpoint inhibitors
bismuth subcitrate, metronidazole and tetracycline
may diminish the therapeutic effect of immune checkpoint inhibitors
may diminish the therapeutic effect of immune checkpoint inhibitors
may diminish the therapeutic effect of immune checkpoint inhibitors
may decrease the therapeutic effect when combined with immune checkpoint inhibitors
may decrease the therapeutic effect when combined with immune checkpoint inhibitors
may decrease the therapeutic effect when combined with immune checkpoint inhibitors
It may diminish the effects when combined with rozanolixizumab by receptor binding competition
It may enhance the risk of adverse effects when combined with antihyperlipidemic
It may enhance the risk of adverse effects when combined with antihyperlipidemic
It may enhance the risk of adverse effects when combined with antihyperlipidemic
It may enhance the risk of adverse effects when combined with antihyperlipidemic
It may enhance the risk of adverse effects when combined with antihyperlipidemic
it may diminish the therapeutic effect of Immune Checkpoint Inhibitors
it may diminish the therapeutic effect of Immune Checkpoint Inhibitors
it may diminish the therapeutic effect of Immune Checkpoint Inhibitors
it may diminish the therapeutic effect of Immune Checkpoint Inhibitors
it may diminish the therapeutic effect of Immune Checkpoint Inhibitors
imipenem/cilastatin/relebactamÂ
may decrease the therapeutic effect of antibiotics
amoxicillin and clavulanate potassium
antibiotics may reduce the therapeutic effect of immune checkpoint inhibitors
lansoprazole, amoxicillin, and clarithromycin
antibiotics may reduce the therapeutic effect of immune checkpoint inhibitors
bismuth subcitrate, metronidazole and tetracycline
antibiotics may reduce the therapeutic effect of immune checkpoint inhibitors
antibiotics may reduce the therapeutic effect of immune checkpoint inhibitors
antibiotics may reduce the therapeutic effect of immune checkpoint inhibitors
may diminish the therapeutic effect of immune Checkpoint inhibitors
may diminish the therapeutic effect of immune Checkpoint inhibitors
may diminish the therapeutic effect of immune Checkpoint inhibitors
may diminish the therapeutic effect of immune Checkpoint inhibitors
may diminish the therapeutic effect of immune Checkpoint inhibitors
may diminish the therapeutic effect of immune checkpoint inhibitors
may diminish the therapeutic effect of immune checkpoint inhibitors
may diminish the therapeutic effect of immune checkpoint inhibitors
may diminish the therapeutic effect of immune checkpoint inhibitors
may diminish the therapeutic effect of immune checkpoint inhibitors
may decrease the therapeutic effect of antibiotics
may decrease the therapeutic effect of antibiotics
may decrease the therapeutic effect of antibiotics
may decrease the therapeutic effect of antibiotics
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may decrease the therapeutic effect of antibiotics
may decrease the therapeutic effect of antibiotics
may decrease the therapeutic effect when combined with immune checkpoint inhibitors
may decrease the therapeutic effect when combined with immune checkpoint inhibitors
may decrease the therapeutic effect when combined with immune checkpoint inhibitors
may diminish the therapeutic effect
amoxicillin and clavulanate potassium
may diminish the therapeutic effect
bismuth subcitrate, metronidazole and tetracycline
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
may diminish the therapeutic effect
It may enhance the adverse effects when combined with sotrovimab
neomycin/polymyxin B/gramicidin ophthalmicÂ
may decrease the therapeutic effect of Antibiotics
may decrease the therapeutic effect of acetaminophen
acetaminophen and phenyltoloxamine
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
may reduce the therapeutic effect of immune checkpoint inhibitors
acetaminophen and phenyltoloxamine
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may decrease the therapeutic effect when combined
acetaminophen/doxylamine/dextromethorphanÂ
may decrease the therapeutic effect when combined.
may decrease the therapeutic effect of Antibiotics
may decrease the therapeutic effect of Antibiotics
ciprofloxacin inhaled (Pending FDA approval)Â
may diminish the therapeutic effect of antibiotics
it increases the effect of ototoxicity of aminoglycosides Immune Checkpoint Inhibitors
It may diminish the metabolism when combined with Fluroquinolones
It may diminish the metabolism when combined with Fluroquinolones
It may diminish the metabolism when combined with Fluroquinolones
It may diminish the metabolism when combined with Fluroquinolones
It may diminish the metabolism when combined with Fluroquinolones
meningococcal A C Y and W-135 diphtheria conjugate vaccine
may decrease the therapeutic effect of Antibiotics
may decrease the therapeutic effect of Antibiotics
may decrease the therapeutic effect of Antibiotics
may decrease the therapeutic effect of Antibiotics
may decrease the therapeutic effect of Antibiotics
may decrease the therapeutic effect when combined with immune checkpoint inhibitors
may decrease the therapeutic effect of drug
may diminish the therapeutic effect of drug
neomycin/polymyxin B/bacitracin topical
may diminish the therapeutic effect of drug
may diminish the therapeutic effect of drug
may diminish the therapeutic effect of drug
may diminish the therapeutic effect of drug
may diminish the therapeutic effect of drug
may diminish the therapeutic effect of drug
may diminish the therapeutic effect of drug
Actions and Spectrum:
nivolumab is an immunotherapy medication that acts as a checkpoint inhibitor by blocking the programmed cell death protein 1 (PD-1) receptor found on the surface of T cells.
The PD-1 receptor normally functions to prevent T cells from attacking the body’s own healthy cells, but cancer cells can exploit this mechanism to evade the immune system and continue to grow.
By blocking the PD-1 receptor, nivolumab allows T cells to recognize and attack cancer cells, helping to boost the body’s natural immune response against cancer.
Adverse drug reactions:Â Â
Frequency defined:Â Â
>10%
Increased AST (28%)
Hyponatremia (25%)
Increased alkaline phosphatase (22%)
Rash (21%)
Pruritus (19%)
Cough (17%)
Increased ALT (16%)
Hyperkalemia (15%)
URTI (11%)
Fatigue (50%)
Lymphopenia (47%)
Cough (32%)
Nausea (29%)
Increases creatinine (22%)
Dyspnea, hyponatremia (38%)
Musculoskeletal pain (36%)
Hypercalcemia (20%)
Hypokalemia (20%)
Hypocalcemia (17%)
Hyperkalemia (17%)
Hypomagnesemia (20%)
Vomiting, asthenia (19%)
Abdominal pain (16%)
Rash (16%)
Thrombocytopenia (14%)
Increased ALT (12%)
Diarrhea (18%)
Edema, pyrexia (17%)
Increased AST (16%)
1% to 10%Â Â
Melanoma
Hyponatremia (5%)
Increased alkaline phosphatase (2.4%)
Hyperkalemia (2%)
Increased ALT (1.6%)
Increased AST (2.4%)
NSCLC
Dyspnea (9%)
Musculoskeletal pain (6%)
Fatigue (7%)
Pneumonia (5%)
Pain (2.6%)
Nausea (1.7%)
Decreased appetite (2.6%)
Edema (1.7%)
Cough (1.7%)
Abdominal pain (1.7%)
Asthenia (1.7%)
Contraindication/Caution:
Contraindications:
Cautions:
Pregnancy
The drug may cause harm to the fetus; it is not recommended for pregnant females.
Breastfeeding warnings:Â Â
The excretion of a drug into the breast milk is unknown.
Pregnancy Â
The animal study reports show brentuximab is not suitable for the ingrowing fetus; hence is not advised to be administered during pregnancy.Â
As IgG4 possibly crosses the placenta, nivolumab & relatlimab should not be given during the 2nd & 3rd pregnancy trimesters.Â
Breastfeeding warnings:   Â
The excretion of a drug into the breastmilk is unknownÂ
The patients should breastfeed only after five months of the last treatment doseÂ
Pregnancy Categories:     Â
Pharmacology:
nivolumab is an IgG4 monoclonal antibody that works by blocking the programmed cell death protein 1 (PD-1) receptor found on the surface of T cells. PD-1 is an immune checkpoint that helps regulate the immune response and prevent autoimmunity.
nivolumab works by binding to the PD-1 receptor, thereby blocking its interaction with its ligands PD-L1 and PD-L2. This blockade of the PD-1 receptor helps to activate T cells and enhance the immune response against cancer cells.
Pharmacodynamics:
nivolumab can enhance the function of T cells, which play a critical role in the immune response against cancer cells. By blocking the PD-1 receptor, nivolumab can activate T cells, enabling them to recognize and destroy cancer cells. This activation of T cells can result in long-lasting immune responses against cancer cells.
The effect of nivolumab on the immune system can be evaluated through laboratory testing, which can measure changes in T cell activity and other immune system parameters. Additionally, clinical studies have shown that nivolumab can produce objective tumor responses and increase progression-free survival in patients with various types of cancer.
Pharmacokinetics:
Absorption
Time to reach a steady state is 12 weeks (monotherapy)
Distribution
The volume of distribution is 6.8L (in monotherapy) and 7.92 L (when combined with ipilimumab)
Elimination
The rate of clearance is 8.2 mL/h (in monotherapy); 10 mL/hr (when combined with ipilimumab)
Half-life is 25 days (for monotherapy); 24.8 days (when combined with ipilimumab)
Administration:
nivolumab is administered as an intravenous (IV) infusion. The dosing and schedule of nivolumab may vary depending on the indication and the patient’s response to treatment. Generally, the recommended dose for most indications is 240 mg every two weeks, administered over 30 minutes as an IV infusion.
Patient information leaflet
Generic Name: nivolumab
Pronounced: nye-VOL-ue-mab
Why do we use nivolumab?
nivolumab is used to treat several types of cancer, including melanoma, non-small cell lung cancer, renal cell carcinoma, Hodgkin’s lymphoma, and squamous cell carcinoma of the head and neck.
It is a monoclonal antibody that blocks the programmed death-1 (PD-1) receptor on T-cells, which helps restore the immune response against cancer cells.
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