Our Therapies

OPDIVO QVANTIG™ Infusion Therapy

Next-generation infusion care - Violet Health Infusion Care

About OPDIVO QVANTIG™ Injection Therapy

OPDIVO QVANTIG™ (nivolumab and hyaluronidase-nvhy) is a fixed-combination medication given as an injection under the skin. It pairs nivolumab, a PD-1 blocking antibody that releases a brake on your immune system so your own T cells can recognize and attack cancer cells, with hyaluronidase-nvhy, an enzyme that temporarily loosens the tissue under the skin so the full dose can be absorbed quickly and comfortably.

The injection itself takes about three to five minutes and is given in the abdomen or thigh, so there is no IV line and no infusion pump. As a single agent, the usual dosing is 600 mg/10,000 units every two weeks or 1,200 mg/20,000 units every four weeks. When it is part of a chemotherapy regimen, the dose is 900 mg/15,000 units every three weeks. Treatment may continue until your disease progresses or side effects become difficult to manage, though some regimens are capped at one or two years.

OPDIVO QVANTIG™ is not interchangeable with other immunotherapies. It cannot be substituted for intravenous pembrolizumab or any other PD-1 product. If you are already receiving intravenous nivolumab, your oncologist can switch you to OPDIVO QVANTIG™ at your next scheduled dose.

Conditions treated by this therapy

OPDIVO QVANTIG™ is FDA-approved for adults across a wide range of solid tumors, used alone or alongside other therapies. Your care team may consider this therapy if you have:

Advanced renal cell carcinoma (kidney cancer), as a first treatment for intermediate or poor risk disease, given with cabozantinib, or on its own after prior anti-angiogenic therapy
Unresectable or metastatic melanoma, melanoma treated after complete surgical removal (adjuvant therapy) for Stage IIB through Stage IV disease, and continued treatment after an initial course of intravenous nivolumab with ipilimumab
Resectable non-small cell lung cancer (NSCLC), given with platinum-doublet chemotherapy before surgery, with or without continued treatment after surgery
Metastatic non-small cell lung cancer that has progressed after platinum-based chemotherapy
Recurrent or metastatic squamous cell carcinoma of the head and neck after platinum-based therapy
Urothelial carcinoma (bladder cancer), including adjuvant treatment after surgery for high-risk disease, first-line treatment with cisplatin and gemcitabine, and treatment after platinum-containing chemotherapy
Microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer that has progressed after fluoropyrimidine, oxaliplatin, and irinotecan
Hepatocellular carcinoma (liver cancer) previously treated with sorafenib, and continued treatment after an initial course of intravenous nivolumab with ipilimumab
Esophageal cancer, including adjuvant treatment after chemoradiotherapy and surgery, first-line treatment of advanced esophageal squamous cell carcinoma with chemotherapy, and recurrent or metastatic esophageal squamous cell carcinoma after prior fluoropyrimidine and platinum therapy
Gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma, given with fluoropyrimidine and platinum chemotherapy

Not every indication approved for intravenous OPDIVO® carries over to the subcutaneous formulation, and OPDIVO QVANTIG™ is approved for adults only. Your oncologist will confirm which indication and regimen apply to your diagnosis, including any required biomarker testing such as PD-L1 expression or MSI-H/dMMR status.

OPDIVO QVANTIG™ Price

The cost of prescription medications can vary depending on your insurance coverage. If you're concerned about the price of your medication:

Contact your insurance provider to understand your coverage
Ask your doctor or pharmacist about lower-cost alternatives
Check with the drug manufacturer about financial assistance programs
Explore patient assistance options if you're uninsured or underinsured

Remember, many resources exist to help patients access necessary medications. Don't hesitate to ask for help if you're struggling with medication costs. No patient should go without necessary treatment due to financial limitations. If you have questions about financial assistance opportunities, contact a member of our Violet Health team.

What to Expect During OPDIVO QVANTIG™ Injection Therapy

When you arrive at our Violet Health location, you'll settle into a private, welcoming space designed with your comfort and peace of mind in mind. Because OPDIVO QVANTIG™ is given as an injection under the skin, there is no IV line and no infusion pump. Before and during your visit, our experienced team will:

Review your current health status and any symptoms you've noticed
Check your vital signs and review recent lab work, including liver enzymes, kidney function, and thyroid function, before treatment begins
Choose and prepare an injection site in your abdomen or thigh, rotating between the four quadrants of the abdomen or between thighs from visit to visit, and avoiding skin that is tender, red, bruised, hardened, or marked by scars, moles, or tattoos
Give your OPDIVO QVANTIG™ injection over about three to five minutes using a fine 23G to 25G needle or butterfly set
Give OPDIVO QVANTIG™ first on days when chemotherapy is also scheduled
Monitor you after the injection for any reaction at the injection site or elsewhere
Protect your privacy and comfort throughout the visit

OPDIVO QVANTIG™ may be given every two, three, or four weeks depending on your diagnosis and whether chemotherapy is part of your regimen. When it is given on its own, most visits are very short. Plan to be with us longer on days when chemotherapy is also scheduled, since those infusions and the monitoring that follows add time to your appointment.

OPDIVO QVANTIG™ must never be given intravenously. It is a ready-to-use solution that is not diluted and is administered only by a healthcare professional, always by subcutaneous injection.

OPDIVO QVANTIG™ Side Effects

As with any medication, OPDIVO QVANTIG™ may cause side effects. Being informed helps you know what to watch for and when to contact your healthcare team. Common Side Effects:

Muscle, joint, and bone pain
Fatigue or weakness
Itching and rash
Low thyroid hormone levels (hypothyroidism)
Diarrhea
Cough
Abdominal pain
Reactions where the injection is given, including pain, redness, swelling, bruising, itching, or a firm area under the skin
Changes in blood test results, including liver enzymes, kidney function, blood counts, and electrolytes

Side effects tend to be broader and more frequent when OPDIVO QVANTIG™ is given with chemotherapy. When it is used on its own, the most common effects are musculoskeletal pain, fatigue, itching, rash, hypothyroidism, diarrhea, cough, and abdominal pain.

OPDIVO QVANTIG™ can cause your immune system to attack healthy organs and tissues. These immune-mediated reactions can become severe or life-threatening, can affect more than one organ at a time, and may occur during treatment or after it has ended. Please alert our clinical staff or seek medical attention immediately if you experience any of the following:

Lung inflammation (pneumonitis), including new or worsening cough, chest pain, or shortness of breath
Intestinal inflammation (colitis), including diarrhea, stool changes, severe abdominal pain, or blood or mucus in the stool
Liver problems (hepatitis), including yellowing of the skin or eyes, dark urine, severe nausea, bruising or bleeding more easily, or pain on the right side of the abdomen
Hormone gland problems affecting the thyroid, adrenal glands, or pituitary, including headaches, extreme tiredness, weight changes, increased hunger or thirst, dizziness or fainting, constipation, hair loss, mood changes, or feeling cold
New-onset type 1 diabetes, including increased thirst, frequent urination, or diabetic ketoacidosis
Kidney problems (nephritis), including changes in the amount or color of your urine, blood in the urine, or swelling in the ankles
Serious skin reactions, including rash, blistering or peeling skin, painful sores or ulcers in the mouth, nose, throat, or genital area, fever or flu-like symptoms, and swollen lymph nodes
Administration-related reactions, including chills or shaking, itching or rash, flushing, wheezing, shortness of breath, dizziness, feeling faint, fever, and back or neck pain
Other immune-mediated problems affecting the heart, nerves, eyes, muscles, or pancreas, including irregular or rapid heartbeat, muscle pain or weakness, eye redness or vision changes, or numbness and tingling

Hyaluronidase allergy: Because OPDIVO QVANTIG™ contains hyaluronidase, tell your care team if you have ever had an allergic reaction to hyaluronidase or to any product that contains it.

Before treatment, tell your care team if you have an immune system condition such as Crohn's disease, ulcerative colitis, or lupus, if you have had or plan to have an organ or donor stem cell transplant, if you have received radiation to your chest, or if you take medicines that suppress your immune system. Fatal and other serious complications have occurred in patients who received an allogeneic stem cell transplant before or after PD-1 blocking therapy, and organ transplant rejection has been reported.

Multiple myeloma warning: OPDIVO QVANTIG™ is not approved for multiple myeloma. In clinical trials, adding a PD-1 blocking antibody to a thalidomide analogue and dexamethasone increased the risk of death.

Pregnancy warning: OPDIVO QVANTIG™ may harm an unborn baby. Tell your care team if you are pregnant or plan to become pregnant. Use effective birth control during treatment and for five months after your last dose, and do not breastfeed during treatment or for five months after your last dose.

Patient Forms

Before you attend your first appointment at Violet Health, please make sure to review the documents below. Please contact us if you have any questions!