Opdivo (nivolumab) and Keytruda (pembrolizumab) are brand-name biologic drugs prescribed for several types of cancer. They are given by a healthcare professional as an intravenous (IV) infusion.
This article explains the main similarities and differences between Opdivo and Keytruda. If you’re considering taking one of these drugs, discussing this information with your doctor can help you decide whether one of these treatments may be right for you.
For more comprehensive information about these two drugs, you can refer to our Opdivo and Keytruda articles.
Key differences between Opdivo and Keytruda
These are a few of the main differences between Opdivo and Keytruda:
- Active ingredient: Opdivo has nivolumab, and Keytruda has pembrolizumab.
- Dose schedule: Opdivo infusions are given every 2, 3, or 4 weeks. Keytruda infusions are given every 3 or 6 weeks.
- Conditions treated: Opdivo and Keytruda can both treat 10 types of cancer. Keytruda also treats several other cancers that Opdivo is not approved to treat.
Although they contain different active ingredients, both Opdivo and Keytruda belong to a class of medications known as programmed death receptor-1 (PD-1) inhibitors. A medication class is a group of drugs that work in a similar way. PD-1 inhibitors are a type of immunotherapy for cancer.
Opdivo and Keytruda have been approved by the Food and Drug Administration (FDA) to treat the following cancers:
| Type of cancer | Opdivo | Keytruda |
|---|---|---|
| bladder cancer | ✓ | ✓ |
| classical Hodgkin’s lymphoma | ✓ | ✓ |
| colorectal cancer | ✓ | ✓ |
| esophageal cancer | ✓ | ✓ |
| kidney cancer | ✓ | ✓ |
| liver cancer | ✓ | ✓ |
| melanoma skin cancer | ✓ | ✓ |
| mesothelioma | ✓ | ✓ |
| non-small cell lung cancer (NSCLC) | ✓ | ✓ |
| squamous cell head and neck cancer | ✓ | ✓ |
| cervical cancer | ✓ | |
| Merkel cell cancer | ✓ | |
| primary mediastinal large B-cell lymphoma | ✓ | |
| gastric cancer | ✓ | |
| certain metastatic or unresectable solid tumors | ✓ | |
| triple-negative breast cancer | ✓ | |
| endometrial cancer | ✓ | |
| biliary tract cancer | ✓ | |
| squamous cell skin cancer | ✓ |
Opdivo and Keytruda may be used alone or in combination with other drugs to treat the conditions in the above table.
Both Opdivo and Keytruda are FDA approved to treat melanoma in children. Also, Keytruda is FDA approved to treat other kinds of cancer in children.
Because Opdivo and Keytruda are approved to treat some of the same types of cancer, you may be able to switch from one drug to the other.
Depending on the cancer being treated, there may be specific recommendations for which drug needs to be used first or how to switch from one to the other. Your doctor will be able to provide detailed information on switching between Opdivo and Keytruda based on the condition you’re receiving treatment for.
Both Opdivo and Keytruda come as liquid solutions given as an IV infusion, which is an injection into your vein given over a period of time. Infusions for both Opdivo and Keytruda typically last for about 30 minutes. You’ll receive these injections at a healthcare facility, such as an infusion center or a hospital.
Opdivo infusions are given every 2, 3, or 4 weeks. Keytruda infusions are given every 3 or 6 weeks. Your infusion schedule will depend on the condition you’re using the drug to treat and the specific treatment plan your doctor prescribes for you.
For more information about the drugs’ dosing schedules, see our Opdivo dosage guide and Keytruda dosage guide.
Both Opdivo and Keytruda treat certain types of cancer. They also belong to the same medication class. Because of this, these drugs can cause some of the same side effects, as well as some different ones. Some of these side effects are mentioned below.
For more details about side effects of these drugs, see our articles about Opdivo side effects and Keytruda side effects. You can also refer to Opdivo’s medication guide and Keytruda’s medication guide.
Mild side effects
The following lists address some of the most common mild side effects of Opdivo and Keytruda, as well as some that both drugs share.
- Can occur with Opdivo alone:
- headache
- upper respiratory infections, such as the common cold
- weakness
- Can occur with Keytruda alone:
- Can occur with both Opdivo and Keytruda:
Most of these side effects may go away within a few days or weeks after each dose. But if they’re more severe or don’t go away, talk with your doctor.
Serious side effects
The following list addresses the serious side effects that Opdivo and Keytruda share:
- colitis (colon inflammation)
- liver damage or hepatitis
- hormone disorders, such as hypothyroidism or hyperthyroidism
- inflammation that can affect any organ or tissue, such as the heart, eyes, or brain
- infusion reaction
- kidney problems, including nephritis (kidney inflammation)
- pneumonitis (lung inflammation)
- severe allergic reaction
- severe rashes
If you have serious side effects while using Opdivo or Keytruda, call your doctor immediately. If the side effects feel life threatening or you believe you’re having a medical emergency, call 911 or your local emergency number right away.
Opdivo and Keytruda have both been found effective at treating certain types of cancer.
Both drugs are recommended in certain guidelines from the National Comprehensive Cancer Network (NCCN), National Cancer Institute (NCI), and American Cancer Society (ACS) to treat certain types of cancers.
The following chart lists the cancers, the guidelines, and whether Opdivo, Keytruda, or both drugs are recommended.
| Condition | Guidelines | Recommends Opdivo | Recommends Keytruda |
|---|---|---|---|
| Bladder cancer | ✓ | ✓ | |
| Classical Hodgkin’s lymphoma | NCCN | ✓ | ✓ |
| Colorectal cancer | NCCN | ✓ | ✓ |
| Esophageal cancer | NCCN | ✓ | ✓ |
| Kidney cancer | ✓ | ✓ | |
| Liver cancer | ✓ | ✓ | |
| Mesothelioma | ✓ | ✓ | |
| Melanoma skin cancer | ✓ | ✓ | |
| Non-small cell lung cancer | ✓ | ✓ | |
| Squamous cell head and neck cancer | NCCN | ✓ | ✓ |
How much Opdivo or Keytruda costs depends on the treatment plan your doctor prescribes and your insurance plan. It will also depend on the cost of the visit to your doctor to receive doses of either drug.
Opdivo and Keytruda are both brand-name
To learn more about Opdivo versus Keytruda prices and how to save money on your prescriptions, check out our Opdivo cost and Keytruda cost articles.
Opdivo and Keytruda may not be right for you if you have certain medical conditions or other factors that affect your health. Here, these are referred to as warnings. The two drugs share the same warnings.
If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before starting Opdivo or Keytruda.
Warnings for both Opdivo and Keytruda include:
- allergic reaction
- immune system problems, such as lupus
- organ transplant recipient
- allogeneic hematopoietic stem cell transplant recipient
- past treatment with radiation therapy to your chest
- nervous system problems, such as myasthenia gravis or Guillain-Barré syndrome
- having certain multiple myeloma treatments
- pregnancy
- breastfeeding
For more information about medical conditions and other factors that may affect Opdivo and Keytruda treatment, you can review the following articles:
Disclaimer: Medical News Today 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 other 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.
