OPDIVO SINJ 40MG (1VLX4ML)

Opdivo (generic name: Nivolumab) is a monoclonal antibody used in the treatment of various cancers. It is classified as an immune checkpoint inhibitor, specifically targeting the programmed cell death protein 1 (PD-1) pathway. This pathway plays a crucial role in suppressing the immune system’s ability to attack cancer cells. By inhibiting PD-1, Opdivo helps enhance the body’s immune response against cancer.

How Opdivo Works

Mechanism of Action

1. PD-1 Inhibition:
   • Opdivo works by binding to the PD-1 receptor on immune cells. Normally, PD-1 interacts with its ligands (PD-L1 and PD-L2) on tumor cells to inhibit the immune response. By blocking this interaction, Opdivo helps prevent tumors from evading immune surveillance, thereby allowing the immune system to better recognize and attack cancer cells.
2. Activation of T-Cells:
   • By blocking the PD-1 pathway, Opdivo reactivates T-cells, a type of white blood cell crucial for targeting and destroying cancer cells. This activation boosts the immune system’s ability to identify and destroy cancerous cells more effectively.
3. Enhanced Anti-Tumor Activity:
   • The increased activity of T-cells leads to a stronger anti-tumor response, potentially resulting in tumor shrinkage or stabilization in various cancers.

Side Effects

Common Side Effects

• Fatigue:
  • Many patients report feeling unusually tired or weak, which can affect daily activities.
• Rash:
  • Skin rashes, which may vary from mild to severe, are commonly observed.
• Diarrhea:
  • Gastrointestinal issues such as diarrhea are frequently experienced and can often be managed with medication.
• Nausea:
  • Some patients may experience nausea, which can be alleviated with anti-nausea medications.
• Pruritus:
  • Itching or pruritus is another common side effect that can be managed with antihistamines or topical treatments.

Serious Side Effects

• Pneumonitis:
  • Inflammation of the lungs, which can lead to coughing, chest pain, and difficulty breathing. Requires prompt medical evaluation.
• Hepatitis:
  • Liver inflammation may present with symptoms like jaundice, dark urine, or abdominal pain, necessitating liver function tests.
• Colitis:
  • Inflammation of the colon can cause severe diarrhea and abdominal pain, which may need treatment with corticosteroids.
• Endocrinopathies:
  • Disorders of endocrine glands, such as thyroiditis or adrenalitis, can lead to symptoms like weight changes, fatigue, or hormonal imbalances.
• Nephritis:
  • Kidney inflammation can result in changes in urine output or swelling, and may require adjustment in therapy or further investigation.

Indications

Opdivo is indicated for the treatment of several cancers, including:

• Non-Small Cell Lung Cancer (NSCLC):
  • For patients with NSCLC that has progressed following chemotherapy and/or targeted therapy.
• Melanoma:
  • For patients with unresectable or metastatic melanoma.
• Renal Cell Carcinoma (RCC):
  • For patients with advanced RCC, particularly after prior treatment.
• Classical Hodgkin Lymphoma (cHL):
  • For patients with relapsed or refractory cHL.
• Head and Neck Squamous Cell Carcinoma (HNSCC):
  • For patients with recurrent or metastatic HNSCC.
• Urothelial Carcinoma:
  • For patients with advanced urothelial carcinoma who have progressed during or after platinum-based chemotherapy.

Contraindications

Opdivo should not be used in the following conditions:

• Hypersensitivity:
  • Known hypersensitivity to nivolumab or any of its components.
• Severe Immune-Related Adverse Reactions:
  • History of severe immune-mediated adverse reactions to other checkpoint inhibitors, which may not be managed effectively with Opdivo.
• Active Autoimmune Disease:
  • Patients with active autoimmune diseases may experience exacerbation of their condition.
• Severe Hepatic Impairment:
  • Patients with severe liver impairment may require alternative therapies due to the risk of increased adverse effects.

Price in Different Countries

The price of Opdivo 100 mg/10 ml varies by country and healthcare system. Below is a table showing approximate price ranges in various countries.

Country	Price (Per 100 mg/10 ml Injection)	Reference
United States	$10,000 – $12,000	GoodRx
United Kingdom	£8,000 – £10,000	NHS UK
Canada	CAD $12,000 – $14,000	Health Canada
Australia	AUD $13,000 – $15,000	PBS Australia
India	₹700,000 – ₹900,000	Medlife

Top 5 Global Brands

1. Opdivo – Bristol-Myers Squibb:
   • The original brand of nivolumab, widely used and recognized for its efficacy in treating various cancers.
2. Nivolumab – Mylan:
   • A generic version providing a cost-effective alternative to the brand name.
3. Nivolumab – Teva:
   • Another reputable generic option, offering competitive pricing.
4. Nivolumab – Sandoz:
   • Provides a widely available generic version of nivolumab.
5. Nivolumab – Apotex:
   • Offers a generic version with accessibility and affordability in mind.