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Nivolumab- Relatlimab (Opdualag)

This leaflet provides information for patients having treatment with Nivolumab-Relatlimab. The leaflet will explain what Nivolumab-Relatlimab is, and when and how it is given.  It will also tell you about common side effects that you may experience.  Contact telephone numbers and details of how to obtain further information on Nivolumab-Relatlimab are given at the end of the leaflet.


What is Nivolumab-Relatlimab and why am I having it?

Nivolumab-Relatlimab is a treatment which helps your immune system to attack and destroy cancer cells. Nivolumab-Relatlimab is used to treat your type of cancer, but it is not a chemotherapy drug.


How often will I receive Nivolumab-Relatlimab?

For this treatment to be most effective, it is given at specific time intervals.  Nivolumab-Relatlimab is given every 4 weeks. Your doctor will discuss with you how long you will have to continue having the treatment.



How often will I see the specialist team?

You will need to be reviewed before each treatment. You will either be seen in the outpatient clinic or have a telephone call before each treatment.  At each outpatient clinic the medical team who prescribes your Nivolumab-Relatlimab will check how you are feeling and discuss any problems you may have. You will also have regular blood tests so we can check how the treatment is affecting you.  If your blood results are satisfactory, your treatment will be given.


ow is Nivolumab-Relatlimab given?

Nivolumab-Relatlimab is given through a drip into a vein in the back of your hand or arm, or a central line if you have one.


Where will my treatment be given?

Nivolumab-Relatlimab will be given in the day case treatment areas at Velindre,

or one of our Outreach Clinics.

How long will I be in the hospital?

Nivolumab-Relatlimab treatment is given over 30minutes, however please allow approximately 1.5 hours for your appointment.


Can I bring relatives and friends with me?

You are welcome to bring someone to stay with you during your treatment. Space is limited so there is not room for more than one person.  Treatment areas are not suitable for young children.


Reactions during the treatment

If you experience any of the following during the treatment infusion, please tell the nurses on the unit straight away:

  • Feeling hot and feverish
  • Chills or shivering
  • Headache
  • Dizziness or faintness
  • Problems with breathing
  • Rash
  • Feeling sick or vomiting
  • Acute back pain


If any of these occur, we will slow down or stop the Nivolumab-Relatlimab until you feel better.  The treatment may then be re-started, usually without any further problems.


What are the possible side effects?

Some people have very few side effects whilst others may experience more.  Most of the side effects happen because Nivolumab-Relatlimab affects the immune system causing inflammation of other parts of the body such as the skin, bowels, and hormone producing glands. Most, if not all severe side effects can be controlled with steroid medication immediately, either as tablets or through a drip.  However, in severe immune related reactions, hospital admission may be necessary.


Most side effects are mild and can be managed at home. But it is important that if you have more severe side effects that you contact Velindre Cancer Centre. The telephone number is at the end of the leaflet.  Further details of when to contact Velindre are included in the individual side effects listed below.


You will be given an alert card. If you are admitted to another hospital, you must inform the medical/nursing team that you are receiving Nivolumab-Relatlimab.  It is possible you could be having an immune reaction and should be started on steroids. The doctors/nurses need to contact Velindre Cancer Centre for advice by either telephoning the Treatment Helpline or contacting your oncologist directly.




Effects on the bowels  

This treatment has been known to cause constipation and diarrhoea. 

  • If you experience constipation, it is important that you increase the amount of fluids you drink.  You may also need laxatives.  You can speak to us or your GP for advice.


  • If you experience diarrhoea, it is important that you drink plenty of fluids.  Medication is available to control diarrhoea.  If you have 4 or more bowel movements in 24 hours above what is normal for you, please contact Velindre Cancer Centre immediately.  The telephone number is at the end of the leaflet.


There is a risk of inflammation of the bowel (colitis) or rupture of the bowel (perforation) in a small minority of patients. If you have any of the symptoms below you must inform Velindre Cancer Centre immediately, the telephone numbers are at the end of the leaflet.


  • 4 or more bowel movements in 24 hours above what is normal for you.
  • if you have any problems with diarrhoea or an increase in bowel movements which lasts for more than 3 days.
  • If you have severe stomach pains
  • If you have blood or mucus in your bowel motions



Effects on the skin

You may develop an itching skin rash which can be treated with moisturising cream.  However, if you get a severe skin reaction you may need to be treated in hospital. Please contact Velindre Cancer Centre if:


  • the rash covers more than half of your body and is painful
  • you have large blisters, or your skin is peeling
  • your skin feels very raw
  • you have itchy eyes
  • you have mouth ulcers


Effects on your hormone glands

Nivolumab-Relatlimab can cause inflammation of the glands that produce hormones (chemicals that control many of the body’s functions) in the body. Symptoms will vary depending on which glands are affected. It is important to contact Velindre cancer Centre if you have the following:

  • a headache that will not go away
  • Visual disturbances
  • nausea and vomiting
  • severe mood swings
  • severe tiredness (mild to moderate tiredness is common with Nivolumab-Relatlimab)
  • If you have a noticeable increase in energy levels or restlessness.
  • If you feel forgetful and/or confused


Effects on the liver

This is rare, but if you are affected you may feel more tired than usual and may also feel sick or vomit.  Your doctor will give you anti sickness medicine to take.

Please contact Velindre Cancer Centre if:


  • you vomit more than once in 24 hours despite taking anti sickness medication.


More severe effects on the liver are very rare but can be very serious so you should contact Velindre Cancer Centre if:


  • If you have yellowing of your skin and the whites of your eyes.
  • If you have darker urine than normal.
  • If you have unusual bruising or bleeding



Myalgia (pain in the muscles)

Some patients may experience myalgia which is muscle or joint pain.   If you already have painkillers at home, you may find they relieve the pain.  If these are not effective in relieving the pain, please contact Velindre Cancer Centre. The telephone number is at the end of the leaflet.


Hair loss

Nivolumab-Relatlimab should not make you lose your hair.  However, a small number of people may experience some hair thinning.  We have a leaflet that tells you more about coping with hair loss.  Please ask your nurse if you would like a copy.


Tiredness and fatigue

Nivolumab-Relatlimab can make you feel more tired than usual.  It is important to listen to your body and rest if you need to but carry out your normal activities if you feel able.  Some people find it beneficial to take gentle exercise as well as taking rest.  If you are sleeping more than 50% during the daytime, you need to contact Velindre Cancer Centre on the treatment helpline. The telephone number is at the end of the leaflet.




Loss of appetite

You may experience a loss of appetite and some people may feel sick, but this can usually be well controlled with anti-sickness medication.  If you are sick more than once in 24 hours despite taking regular anti-sickness medicine, you should contact Velindre Cancer Centre for advice.  The telephone number is at the end of the leaflet.



Effects on the nerves

You may have numbness or tingling in your hands or feet. Please contact Velindre Cancer Centre if:


  • If numbness in your hands and feet is severe
  • If you develop weakness in your arms or legs
  • If you become dizzy or giddy
  • If you become very drowsy and have difficulty staying awake



You are at an increased risk of picking up infections because your white blood cells which help fight infections can be reduced by this treatment.  Contact Velindre Cancer Centre immediately if you develop any signs of infection, for example flu like symptoms or a temperature above 37.5°centigrade.  The telephone number is at the end of the leaflet.


Other side effects:

You may have these additional side effects, if so please contact Velindre Cancer Centre:


  • Urinary Tract Infection
  • Increased frequency of passing urine
  • Increased thirst
  • Decreased urine output
  • Dizziness or light headedness
  • Shortness of breath, dry cough or difficulty breathing
  • Blurred vision or red sore eyes.
  • Confusion



Other information

It is important you do not become pregnant, breastfeed, or father a child whilst having Nivolumab-Relatlimab treatment and for a year after treatment. 


Sometimes cancer drugs can have very serious side effects which can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects.


A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis) and having cancer treatment may increase this risk further.  It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your legs/arms, or breathlessness and chest pain.  Blood clots can be very serious.  However, most clots can usually be successfully treated with drugs to thin the blood.  Your doctor or nurse can give you more information.



Side effects may continue for up to 18 months after treatment.  If you have any side effects, contact your consultant. If you are admitted to hospital or see your GP during this period, inform the doctor you have had Nivolumab-Relatlimab.




Manufacturer’s patient information leaflets

Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects). For more information regarding these and the less common side-effects please refer to the manufacturer’s patient information leaflets, obtained from Velindre pharmacy and/or on the internet at Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy.



























Contact telephone numbers



Velindre Cancer Centre                 029 2061 5888

If you are unwell at home and need immediate advice, please call the above number and ask for the treatment helpline – it is available day and night, 24hours a day.



Pharmacy department                   029 2061 5888 ext 6223

Monday – Friday 9am – 5pm for queries about your medicines



Tenovus freephone                       0808 808 1010

cancer helpline


Macmillan freephone Helpline              0808 808 0000




This leaflet was written by health professionals.  The information contained in this leaflet is evidence based.  The leaflet has been approved by doctors, nurses, and pharmacists.  It is reviewed and updated every 2 years.



Prepared April 2024

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