Nivolumab/relatlimab

Immune checkpoint inhibitors
Immune checkpoint inhibitors
High alert
An error with this medicine can cause serious harm: double checks and protocols are used.
Pregnancy: avoid
Avoid in pregnancy. It may harm the fetus: a pregnancy test is done first, contraception is used during and for months after treatment, and breastfeeding is stopped.

Two checkpoint antibodies in one infusion: nivolumab blocks PD-1, relatlimab blocks LAG-3. Used in advanced melanoma; watch for immune side effects.

Updated Nov 12, 2026

Also called: nivolumab and relatlimab-rmbw

Quick facts

Group: Immune checkpoint inhibitors
Target: PD-1 (nivolumab) and LAG-3 (relatlimab) on T cells
Used for: Unresectable or metastatic melanoma
Key effects: Muscle and joint pain · Fatigue · Rash
Monitor: Liver · Blood glucose · New cough or breathlessness
ATC: L01FY02

No doses: the clinician sets them by the current guideline.

Mechanism of action

PD-1 (nivolumab) and LAG-3 (relatlimab) on T cellsNivolumab/relatlimab

The crystal, from the preclinical study of relatlimab, shows an antibody Fab bound to a peptide from the loop of LAG-3 domain 1, the region relatlimab recognises.

Target in 3D: PD-1 (nivolumab) and LAG-3 (relatlimab) on T cells. PDB structure 7UM3 (RCSB PDB, public domain). View the structure at RCSB PDB

Exhausted T cells inside tumours carry several inhibitory receptors. Nivolumab blocks PD-1 and relatlimab blocks LAG-3, two separate brakes that act together. Releasing both restores T-cell activity against melanoma cells more than PD-1 blockade alone, at the price of immune attacks on normal organs.

Nivolumab blocks PD-1; relatlimab blocks LAG-3
Two inhibitory brakes on T cells are released
Reactivated T cells attack melanoma cells

Indications

Unresectable or metastatic melanoma in adults and children aged 12 and older. Melanoma →

Adverse effects

Common

Muscle and joint pain
Fatigue, headache
Rash, itching
Diarrhoea, reduced appetite

Contraindications

Severe hypersensitivity to either antibody

Key interactions

Pre-existing autoimmune disease or organ transplant (and their immunosuppressants): Releasing the immune brakes can flare the disease or trigger rejection; reviewed before starting.

What is monitored

Liver, kidney and thyroid tests at baseline and during treatment
Blood glucose
New cough or breathlessness, diarrhoea, rash
Symptoms of adrenal or pituitary failure (fatigue, low blood pressure, headache)

Administration and safety

Intravenous infusion in a hospital or clinic; it is not given as a push.
The patient is watched for chills, flushing, itching or breathing difficulty during the infusion.
Look-alike names: nivolumab alone and the combination are different products; the order is checked.

Pregnancy and breastfeeding

Avoid in pregnancy. It may harm the fetus: a pregnancy test is done first, contraception is used during and for months after treatment, and breastfeeding is stopped.

Nursing care

Teach that side effects can appear months after starting, even after stopping.
Teach to report diarrhoea, abdominal pain, cough, jaundice, rash, extreme fatigue or thirst.
Check laboratory tests before each infusion.
Effective contraception during and for months after treatment; breastfeeding is stopped.

Pharmacokinetics

Absorption: Intravenous infusion every few weeks.

Test yourself

Think of the answer, then tap the question to see it.

Which checkpoint does relatlimab block?

LAG-3 (lymphocyte activation gene 3).

What is the indication of nivolumab/relatlimab?

Unresectable or metastatic melanoma.

Which family of adverse effects defines this drug?

Immune-mediated inflammation of organs: lung, gut, liver, kidney, skin and endocrine glands.

Add to my cards (3)

Connections

← Back to the class: Immune checkpoint inhibitors

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: Nivolumab and relatlimab-rmbw: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2025); Nivolumab and Relatlimab-rmbw - NCI (National Cancer Institute, 2022); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.