[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Immune checkpoint inhibitors](https://durgical.com/en/pharmacology/classes/immune-checkpoint-inhibitors/) › Nivolumab/relatlimab # 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](https://durgical.com/en/pharmacology/classes/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. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Clinical What the labels mean - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action ◎**PD-1 (nivolumab) and LAG-3 (relatlimab) on T cells**Nivolumab/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](https://www.rcsb.org/structure/7UM3) · Drag to rotate · pinch to zoom 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 →](https://durgical.com/en/conditions/melanoma/) ## Adverse effects ### Common - Muscle and joint pain - Fatigue, headache - Rash, itching - Diarrhoea, reduced appetite ### Serious (rare, important) - Immune-mediated pneumonitis, colitis, hepatitis, nephritis and skin reactions - Endocrine damage: thyroid, adrenal, pituitary, type 1 diabetes - Infusion reactions - Rejection of a transplanted organ ## 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. ## Memory aid «Two brakes off»: PD-1 and LAG-3 are two brakes on the T cell; the combination releases both. ## 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)](https://durgical.app/estudiar/?add=/en/pharmacology/nivolumab-relatlimab/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## What the labels mean **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. ## Connections ## Related drugs 2 - [Nivolumab](https://durgical.com/en/pharmacology/nivolumab/) - [Ipilimumab](https://durgical.com/en/pharmacology/ipilimumab/) ## Related conditions 1 - [Melanoma](https://durgical.com/en/conditions/melanoma/) [← Back to the class: Immune checkpoint inhibitors](https://durgical.com/en/pharmacology/classes/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](https://medlineplus.gov/druginfo/meds/a622037.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [Nivolumab and Relatlimab-rmbw - NCI](https://www.cancer.gov/about-cancer/treatment/drugs/nivolumab-and-relatlimab-rmbw) (National Cancer Institute, 2022); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01FY02) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/nivolumab-relatlimab/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/nivolumab-relatlimab/