Our Therapies

OPDUALAG™ Infusion Therapy

Emilie, our nurse practitioner, smiling at her station happy to assist a patient

About OPDUALAG™ Infusion Therapy

OPDUALAG™ (nivolumab and relatlimab-rmbw) is a fixed-dose combination of two immunotherapy medicines given together in a single intravenous (IV) infusion. Nivolumab is a PD-1 blocking antibody and relatlimab is a LAG-3 blocking antibody, the first of its kind approved in the United States. PD-1 and LAG-3 are two different brakes on your immune system, and blocking both at once helps your own T cells recognize and attack melanoma cells more effectively than blocking PD-1 alone.

OPDUALAG™ is given as a 480 mg nivolumab and 160 mg relatlimab infusion every four weeks, typically over about 30 minutes, and treatment continues until your disease progresses or side effects become difficult to manage. Because the two antibodies come premixed in one vial, you receive both in a single infusion rather than back-to-back bags.

Conditions treated by this therapy

OPDUALAG™ is FDA-approved for a single cancer type, making it one of the more focused immunotherapies we provide. Your care team may consider this therapy if you have:

Unresectable melanoma, meaning melanoma that cannot be completely removed with surgery
Metastatic melanoma, meaning melanoma that has spread to other parts of the body
Both indications include adults and children 12 years and older who weigh at least 40 kilograms (about 88 pounds). Dosing has not been established for patients under 12 or for adolescents who weigh less than 40 kilograms.

In the clinical trial that supported approval, OPDUALAG™ more than doubled median progression-free survival compared with nivolumab alone in previously untreated advanced melanoma. Your oncologist will confirm whether this combination, single-agent immunotherapy, or a targeted therapy based on your BRAF mutation status is the right fit for your diagnosis.

OPDUALAG™ 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 OPDUALAG™ Infusion 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. Before and during your intravenous infusion, 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, thyroid function, and blood sugar, before treatment begins
Place your IV using gentle, practiced technique
Administer your OPDUALAG™ infusion over about 30 minutes through a line with an in-line filter, with both medicines delivered together from a single premixed bag
Keep the line dedicated to OPDUALAG™, since it is not given at the same time as other medications through the same line
Monitor you closely for any infusion-related reactions
Protect your privacy and comfort throughout the visit

OPDUALAG™ is given every four weeks on a single, consistent schedule, which makes planning easier than regimens that shift between two-, three-, and four-week intervals. Most visits are short, though your first appointment may run longer while we complete your intake, baseline labs, and education. Because this is a two-antibody combination, immune-related side effects are somewhat more common than with nivolumab alone, so your team will check in with you carefully at every visit.

OPDUALAG™ Side Effects

As with any medication, OPDUALAG™ 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, reported by nearly half of patients in clinical trials
Fatigue or weakness
Rash and itching
Diarrhea
Low thyroid hormone levels (hypothyroidism)
Headache, fever, and cough
Nausea, vomiting, and decreased appetite
Abdominal pain and constipation
Changes in blood test results, including liver enzymes, kidney function, blood counts, blood sugar, and electrolytes

Because OPDUALAG™ blocks two immune checkpoints rather than one, immune-related side effects occur somewhat more often than with nivolumab given alone, though the trial data showed the combination remained manageable for most patients.

OPDUALAG™ 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
Heart inflammation (myocarditis), including new or worsening chest pain, palpitations, shortness of breath, unusual fatigue, or swelling in the ankles
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
Infusion 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 nerves, eyes, muscles, or pancreas, including numbness and tingling, muscle pain or weakness, eye redness or vision changes, or severe abdominal pain

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.

Pregnancy warning: OPDUALAG™ 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.

OPDUALAG™ Infusion Therapy at Violet Health

Your comfort during OPDUALAG™ infusion therapy at Violet Health is our priority. Our patients enjoy walk-up parking, complimentary entertainment and snacks, and a team of highly trained providers during each treatment. Plus, Violet Health's evening and weekend hours and convenient city and rural locations make it easier to schedule your appointments.

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!