Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Nivolumab

Immunotherapy (PD-1 checkpoint inhibitor)

Brand names: Opdivo

Oral health effects

  • Immune-related oral lichenoid reaction / mucositis / dry mouth

    Checkpoint inhibitors can trigger immune-related adverse events including oral lichenoid mucositis, ulceration, and a Sjögren-like dry mouth.

    Clinical management: Recognize as immune-related; topical care; report to oncology (may need immunomodulation).

  • Taste change (dysgeusia)

    Dysgeusia is listed among the most common adverse reactions when nivolumab is given with cabozantinib (label), and is recognised as an oral immune-related adverse event.

    Clinical management: Ask about taste change at each visit; exclude candidiasis and dry mouth, keep the mouth clean, and inform the oncology team if it affects eating — symptom management is the mainstay.

Sources

  1. A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Wolff A, Joshi RK, Ekström J, et al. Drugs in R&D, 2017.
  2. A review and guide to drug-associated oral adverse effects-Oral mucosal and lichenoid reactions. Part 2. Teoh L, Moses G, McCullough MJ. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2019.
  3. Nivolumab (Opdivo) prescribing information (FDA label) E.R. Squibb & Sons, L.L.C. / DailyMed, 2026.
  4. MASCC/ISOO Clinical Practice Statement: management of oral complications of immunotherapy. Fregnani ER, Epstein JB, Blijlevens NMA, et al. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025.