Keytruda vs Opdivo, Uses, Dosage, Side Effects, Costs, Guide

Posted December 14, 2020 by Michael Chamberlain - See Editorial Guidelines

There are many different medications that are used in treating cancer, and patients should know the differences among similar medications. For example, patients may often ask about the comparisons between Keytruda vs Opdivo.

So in this article, we’re going to compare Keytruda vs Opdivo. First, here is a quick answer before we get into the specifics.

Keytruda vs Opdivo: Both are medications from the category of PD-1 inhibitors used to treat different types of cancer. They work by blocking PD-1 receptors and allowing T-cells to detect and fight cancer cells. They exhibit similar interactions and side effects with equal efficacies, but Keytruda is more expensive.

That’s the brief answer, but there’s more to understand, so let’s head into more details.

What are Keytruda and Opdivo?

Keytruda vs Opdivo

Both Keytruda and Opdivo are cancer medications that are used for the treatment of different types of cancers. They fall into the category of PD-1 inhibitors. PD-1 inhibitors are a group of checkpoint inhibitor anticancer medications.

They both work by blocking the activity of PD-1 receptors.

However, the range of cancer types these medications are prescribed for varies from one another. 

Keytruda is the trade name for the generic drug pembrolizumab

This medication can be used as a first-line treatment or as a combination medication, depending on your condition and what your doctor recommends.

Keytruda is used for the treatment of the following types of cancer:

  • Advanced stomach cancer or esophageal cancer 
  • Cancer of the cervix or uterus
  • Cancer of the kidney, bladder, and urinary tract (urothelial carcinoma)
  • Cervical cancer
  • Classical Hodgkin lymphoma
  • Colorectal cancer
  • Head and neck cancer
  • Hepatocellular carcinoma
  • Liver cancer
  • lung cancer (non-small cell lung cancer or small cell lung cancer)
  • Primary mediastinal large b-cell lymphoma
  • Renal cell carcinoma 
  • Skin cancer (melanoma or Merkel cell carcinoma)
  • Squamous cell carcinoma of the esophagus.
  • Stomach cancer called gastric or gastroesophageal (GE) junction adenocarcinoma
  • Uterine cancer 

Opdivo is the trade name for the generic drug nivolumab

Opdivo is often used as a first-line treatment for adults. However, in some situations, it can be used as a combination medication.

Below are the types of cancers Opdivo is prescribed for:

  • Adjuvant treatment of melanoma
  • Advanced or metastatic urothelial carcinoma
  • Advanced renal cell carcinoma
  • Esophageal squamous cell carcinoma
  • Hepatocellular carcinoma
  • Hodgkin lymphoma
  • Malignant pleural mesothelioma
  • Metastatic small cell lung cancer
  • Microsatellite instability-high or mismatch repair deficient metastatic colorectal cancer
  • Non-small cell lung cancer (NSCLC)
  • Recurrent metastatic squamous head & neck carcinoma
  • Unresectable or metastatic melanoma

So, as you can see, although there are potentially some crossover points, each is an effective treatment for different variations of the same ailment.

How They Work – Keytruda vs Opdivo

Let’s take a look at how each of these treatments work, starting with Keytruda.


Keytruda is considered an immunotherapy treatment. This means that it works alongside your body’s immune system to fight cancer. It works by blocking the PD-1 receptors, which prevents cancer cells from hiding.

This cancer therapy is given to cancer types where the antigens and relative antibodies are identified already.

This will then, in turn, activate the T-cell mediated immune responses against tumor cells. Meaning, this will help the immune system to activate effectively in detecting and fighting cancer cells.


Opdivo, on the other hand, is also a highly selective human monoclonal antibody and is targeted cancer therapy, just like Keytruda.

This also means that Opdivo works similarly to Keytruda. Opdivo, just like Keytruda, blocks the PD-1 receptors.

This will block the receptors’ ability to interact with PD-L1 and PD-L2. This allows the T-cells to detect and destroy cancer cells. 

Administration and Dosage – Keytruda vs Opdivo

Keytruda vs Opdivo

Keytruda is given as an injection directly into the vein. The injection is given every 3 weeks for over 30 minutes. Depending on your body type, you may receive some medications prior to the injection in order to reduce any possible allergic reactions. 

Opdivo is also given just like Keytruda, as an injection through the vein (intravenously). The injection is given every 2 weeks for over 60 minutes. 

While that deals with administering the medication, the dosage of both these meds depends on several factors such as the following:

  • Health condition 
  • Type of cancer it’s prescribed for 
  • The severity of cancer (stage)
  • Weight 
  • Age
  • Improvement/progress 

Your doctor will administer your dose since both Keytruda and Opdivo are given through an IV. Talk to your doctor about getting on a schedule so that your treatment is most effective.

Interactions – Keytruda vs Opdivo 

Both Keytruda and Opdivo interact with similar medications. Below are some common medications that Keytruda and Opdivo interact with:

  • Betamethasone
  • Budesonide
  • Cortisone
  • Deflazacort
  • Dexamethasone
  • Hydrocortisone
  • Lenalidomide
  • Methylprednisolone
  • Pomalidomide
  • Prednisolone
  • Prednisone
  • Thalidomide
  • Triamcinolone

Apart from these, be sure to inform your doctor of any other supplements or vitamins you’re taking, so they can assess if Keytruda or Opdivo will interact with anything you’re taking.

Cost – Keytruda vs Opdivo

The consumer cost of Keytruda on average for a quantity of 4 ml (which gives a dosage of 25 mg/ml) is around $5,160.

The average cost of Opdivo for a quantity of 4ml (which gives a dose of 10mg/ml) is around $1,1540.

Comparatively, Keytruda has a higher price than Opdivo, which mainly comes from the brand reputation Keytruda has over Opdivo.

However, these prices are for cash paying customers only and may vary depending on your insurance programs/plans.

There are still options even when your insurance doesn’t cover your medications.

The best cost option

To dramatically reduce the cost of these and other medications, you can take advantage of the patient assistance programs via us here at Prescription Hope.

This can potentially reduce your meds to just $50 per month per medication. It’s simple and quick to enroll too! 

Side Effects – Keytruda vs Opdivo

Side effects common for both Keytruda and Opdivo include:

  • Aches and pain in muscles and joints
  • Feeling weak or short of breath 
  • Tiredness
  • Fever
  • Cough
  • Sore throat 
  • Itching or skin rash
  • Nausea
  • Vomiting
  • Stomach pain
  • Loss of appetite
  • Diarrhea
  • Constipation

Common Keytruda side effects may include:

  • Hair loss
  • Hoarse voice
  • Increased blood pressure
  • Low sodium levels, abnormal liver function, or thyroid function
  • Soreness in or around the nose, eyes, or vagina.

Common Opdivo side effects may include:

  • Cold symptoms such as a runny or stuffy nose, 
  • Headache and dizziness
  • Hormonal problems
  • Weight loss 

Which is the Most Effective? – Keytruda vs Opdivo

Both Keytruda and Opdivo are approved to treat non-small cell lung cancer (NSCLC) and melanoma by the FDA because both these medications exhibit similar properties and functioning mechanisms.

Based on the information we’ve covered, these medications seem to be very similar.

Accordingly, a study conducted to compare the efficacies of these two medications concluded that both Keytruda and Opdivo showed similar survival benefits in patients with recurrent or advanced NSCLC. 

The conclusion of the study thereby agreed with the current clinical procedures, where either of these medications is used based on the patient’s condition, and other clinician preferences.


We hope this has provided a good overview of the comparisons between Keytruda and Opdivo. Be sure to consult your doctor before changing or starting any medications and any concerns you have about the dosage.

If you’re having trouble affording any of your medications, enroll with us and see if you qualify to pay only $50 a month for each of your medications.