What Are Opdivo and Yervoy — and Why Are They Taken Together?
Opdivo and Yervoy treat certain kinds of lung cancer, skin cancer, and more. Learn more about how they’re used, their side effects, and more.
Yervoy
Used for Colon Cancer, Esophageal Cancer, Liver Cancer, Lung Cancer, Melanoma, Mesothelioma, Renal Cancer
Used for Colon Cancer, Esophageal Cancer, Liver Cancer, Lung Cancer, Melanoma, Mesothelioma, Renal Cancer
Yervoy (ipilimumab) is an immunotherapy cancer medication. It's used to treat many different types of cancer, such as melanoma, non-small cell lung cancer, and renal cell cancer (a type of kidney cancer). It works as a CTLA-4 inhibitor to help your immune system fight cancer. Yervoy (ipilimumab) is often given with another cancer medication called Opdivo (nivolumab). It's given as an infusion into a vein at an infusion center or medical office. Side effects can include diarrhea, rash, and tiredness.
What is Yervoy (ipilimumab)?
What is Yervoy (ipilimumab) used for?
Certain types of:
How Yervoy (ipilimumab) works
Yervoy (ipilimumab) is an immunotherapy medication. More specifically, it's a CTLA-4 inhibitor. It's also called a checkpoint inhibitor.
Yervoy (ipilimumab) works by blocking a protein called CTLA-4. CTLA-4 acts like a brake on certain immune cells in your body. This brake helps keep your immune system from becoming too active. But it can also make it harder for your immune cells to attack cancer cells.
By blocking CTLA-4, Yervoy (ipilimumab) takes the brake off your immune system. This helps your immune cells become more active and better able to attack cancer cells.
Drug facts
| Common Brands | Yervoy |
|---|---|
| Drug Class | CTLA-4 inhibitor |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
More on Yervoy (ipilimumab) essentials
Side effects of Yervoy (ipilimumab)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Tiredness
- Diarrhea
- Nausea
- Rash
- Itching
Less Common Side Effects
- Stomach pain
- Lower appetite
- Vomiting
- Headache
- Fever
- Hypothyroidism
Note: Note: Side effects can differ depending on the type of cancer being treated. It can also differ whether Yervoy (ipilimumab) is given by itself or with other cancer medications.
Yervoy (ipilimumab) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious immune-related side effects: rash, diarrhea, trouble breathing, severe stomach pain, chest pain
- Serious reaction during infusion: itching, trouble breathing, fast heartbeat, feeling warm or hot, nausea
When do Yervoy (ipilimumab) possible side effects begin and end?
Time passed since treatment started:
H
D
W
M
Diarrhea
Rash or itchiness
Thyroid problems
Seek immediate medical care if you experience this side effect.
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.
The following Yervoy (ipilimumab) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Bloody, black, or tarry stools
indigestion
itching, skin rash
severe stomach pain, cramping, or burning
unusual tiredness or weakness
vomiting
vomiting of material that looks like coffee grounds, severe and continuing
watery or bloody diarrhea
Less common
Blistering, crusting, irritation, itching, or reddening of the skin
bloody or cloudy urine
blurred vision or other changes in vision
burning, dry, or itching eyes
burning, tingling, numbness or pain in the hands, arms, feet, or legs
chills
clay-colored stools
cracked, dry, or scaly skin
dark urine
darkening of the skin
decreased appetite
decreased frequency or amount of urine
difficulty with breathing, chewing, swallowing, or talking
dizziness
double vision
drooping eyelids
drowsiness
eye discharge or excessive tearing
eye pain or sensitivity to light
fainting
headache, possibly severe
hives or welts
loss of appetite
mental depression
muscle weakness
pain, itching, burning, swelling, bleeding, or a lump under the skin where the needle was placed
painful or difficult urination
redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
sensation of pins and needles
severe tiredness
sores, ulcers, or white spots on the lips or in the mouth
stabbing pain
stomach tenderness
swelling of the face, feet, or lower legs
swollen glands
unusual bleeding or bruising
unusual weight gain
yellow eyes or skin
Rare
blue or pale skin
chest pain, possibly moving to the left arm, neck, or shoulder
confusion
difficulty with moving
fast heartbeat
general feeling of discomfort or illness
increased thirst
lower back or side pain
muscle pain or stiffness
muscle weakness
pain or burning in the throat
pain, swelling, or redness in the joints
pains in the stomach or side, possibly radiating to the back
skin irritation or rash, including rash that looks like psoriasis
sores, welts, or blisters on the skin
stiff neck or back
Incidence not known
Back, leg, or stomach pains
blistering, peeling, or loosening of the skin
bleeding gums
general body swelling
inability to move the arms and legs
joint or muscle pain
nosebleeds
red irritated eyes
red skin lesions, often with a purple center
throbbing pain
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Yervoy (ipilimumab)
Pharmacist tips for Yervoy (ipilimumab)
- Plan enough time for your Yervoy (ipilimumab) infusion appointments. The infusion takes about 30 minutes, but your full visit can take longer. You might need time to check in or receive other cancer medications. Consider bringing a book or something else to do while you wait.
- Yervoy (ipilimumab) can be given by itself or with other cancer medications. If you get Opdivo (nivolumab) on the same day, you'll get Opdivo first and then Yervoy. If chemotherapy is also part of your treatment, you'll get it after Yervoy.
- Tell your nurse right away if you don't feel well during the Yervoy (ipilimumab) infusion. Rarely, infusion reactions can happen. Signs can include itching, feeling warm, nausea, trouble breathing, or a fast heartbeat. Your care team can slow or stop the infusion if needed and help treat these symptoms.
- Tell your cancer care team early about any new or worsening symptoms. Yervoy (ipilimumab) can cause your immune system to attack healthy parts of your body. Watch for symptoms like diarrhea, rash, itching, trouble breathing, or feeling very tired. These problems can happen during treatment or even after you stop Yervoy (ipilimumab).
- Talk to your care team before treating new side effects on your own. For example, diarrhea from Yervoy (ipilimumab) might need more than an over-the-counter medication. Some side effects might need a steroid or other treatment.
- Keep your lab appointments while taking Yervoy (ipilimumab). Your care team will check how well your liver, kidneys, and thyroid are working. These tests can help find immune-related problems before you notice symptoms.
- If you can become pregnant: Use reliable birth control during treatment and for 3 months after your last Yervoy (ipilimumab) dose. This medication can harm an unborn baby. Tell your oncologist right away if you become pregnant during treatment.
- If you're breastfeeding or plan to breastfeed: Don't breastfeed during treatment with Yervoy (ipilimumab) or for 3 months after your last dose. It's not known if the medication can pass into breast milk. But it could cause serious side effects in a breastfed baby. Talk to your oncologist or a lactation consultant about safe ways to feed your baby.
Risks and warnings for Yervoy (ipilimumab)
Yervoy (ipilimumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Immune-related side effects
Immunotherapy medications like Yervoy (ipilimumab) can cause immune-related adverse events (irAEs). These side effects happen when your immune system becomes too active. It causes your immune system to start attacking healthy cells, not just cancer cells.
These side effects can happen anywhere in your body and at any time while receiving Yervoy (ipilimumab). They can also sometimes appear after stopping the medication. These side effects can be mild or very serious.
Some side effects show up on your lab test results. These include liver, kidney, or thyroid problems. That's why it's important to get your blood work done on time, even if you feel fine. This helps your care team check for any side effects that you can't easily spot.
Other side effects can cause symptoms you can feel. Examples include diarrhea, rash, and trouble breathing. Tell your care team right away if you notice these symptoms or anything unusual. Depending on how severe your symptoms are, you might need to stop Yervoy (ipilimumab) for a while and take a steroid to help you feel better.
Infusion reactions
Rarely, serious reactions can happen during the Yervoy (ipilimumab) infusion. Tell your nurse right away if you feel itchy or warm, have trouble breathing, feel nauseous, or have a fast heartbeat during your infusion. Your care team might slow or stop the infusion to help. If the reaction is severe, you might need to stop Yervoy (ipilimumab) treatment.
Complications from stem cell transplants
- Risk factors: People who’ve had a stem cell (bone marrow) transplant
Some people who take Yervoy (ipilimumab) either before or after a stem cell transplant can have serious problems. They can develop a problem called graft-versus-host disease (GVHD).
Before starting Yervoy (ipilimumab), tell your oncologist if you’ve had a stem cell transplant. They can weigh the risks and benefits of treatment. Also tell them if you have a stem cell transplant after Yervoy (ipilimumab). Your care team will follow up with you often to watch for GVHD.
Harm to an unborn baby
Based on animal studies and how it works, Yervoy (ipilimumab) might harm an unborn baby. If you can become pregnant, your care team might give you a pregnancy test before starting Yervoy (ipilimumab). Use birth control during treatment and for 3 months after your last dose. Tell your care team right away if you become pregnant during treatment.
Yervoy (ipilimumab) dosage
Typical dosage for Yervoy (ipilimumab)
Yervoy (ipilimumab) is given as an intravenous (IV) infusion. This means it's given as an infusion. You'll receive it at a medical center or infusion clinic. Your dose is based on your body weight and treatment plan.
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When given by itself (for certain melanomas)
- Advanced or metastatic melanoma: The typical dose is 3 mg/kg given IV every 3 weeks for up to 4 doses.
- After surgery for melanoma: The typical dose is 3 mg/kg given IV every 3 weeks for up to 4 doses. After that, it's given every 12 weeks for up to 4 more doses.
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When given with Opdivo (nivolumab): The Yervoy dose depends on the type of cancer being treated. Common doses include 1 mg/kg given IV every 3 or 6 weeks, or 3 mg/kg given IV every 3 weeks.
Interactions between Yervoy (ipilimumab) and other drugs
Yervoy (ipilimumab) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Yervoy (ipilimumab). Please note that only the generic name of each medication is listed below.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
What are alternatives to Yervoy (ipilimumab)?
There are a number of medications that your doctor can prescribe in place of Yervoy (ipilimumab). Compare a few possible alternatives below.
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