Yervoy (Ipilimumab) — NZ Medication Guide | KiwiMeds
✅ Reviewed by Ramon Wong, BPharm, Registered Pharmacist (New Zealand) | May 2026 — This information is for educational purposes only and is not a substitute for personalised advice from your doctor or pharmacist. Always seek professional guidance before making changes to your medications.
What is Yervoy (ipilimumab)?
Yervoy (generic name: ipilimumab) is an immunotherapy medicine — specifically a CTLA-4 inhibitor — used to treat melanoma and other cancers. Like nivolumab, ipilimumab works by helping the immune system recognise and fight cancer, rather than directly attacking cancer cells. It is given as an intravenous (IV) infusion at a hospital or cancer centre. Ipilimumab is often combined with nivolumab (Opdivo) for a more powerful dual-checkpoint immunotherapy effect.
What is it used for? (NZ context)
In New Zealand, ipilimumab (Yervoy) is funded by Pharmac for cancer treatment. The latest funding change, effective 1 May 2026, widens access for melanoma:
New — Nivolumab + ipilimumab (combination) before surgery (neoadjuvant):
Funded for adults with resectable stage 3B–4 melanoma — melanoma that has spread but can still be surgically removed. Using immunotherapy before surgery can shrink the tumour and may mean patients need less treatment after surgery. Around 155 people per year are expected to receive this treatment.
Nivolumab + ipilimumab is also funded in NZ for some other cancers (e.g., advanced melanoma that cannot be surgically removed). Your oncologist will advise whether you are eligible.
New Zealand has one of the highest melanoma rates in the world. See the Pharmac announcement for full eligibility details.
How does it work?
Ipilimumab blocks a protein called CTLA-4 (cytotoxic T-lymphocyte-associated protein 4) on immune T-cells. Normally, CTLA-4 acts as a brake, slowing down the immune system early in the process of immune cell activation. Cancer cells can exploit this brake to avoid being attacked. By blocking CTLA-4, ipilimumab releases this brake and allows T-cells to become more strongly activated and better at recognising and attacking cancer cells.
When ipilimumab is combined with nivolumab (which blocks a different checkpoint, PD-1), the two medicines release two different immune brakes at the same time. This dual checkpoint inhibition produces a much stronger anti-tumour immune response than either medicine alone, often resulting in higher response rates and longer remissions, particularly for melanoma. Clinical evidence shows about 2 in 3 people with resectable melanoma have a major response with this combination.
How to take it
Ipilimumab (Yervoy) is given as an IV infusion at a hospital or cancer day unit. It is not a take-home medicine.
When used in combination with nivolumab before surgery for melanoma:
- Usually given together with nivolumab every 3 weeks for up to 4 cycles (doses) before surgery
- Each ipilimumab infusion takes approximately 30–90 minutes
- Nivolumab is usually given first, followed by ipilimumab
Common side effects
Because ipilimumab activates the immune system, its side effects are immune-related rather than typical chemotherapy side effects. The combination of ipilimumab + nivolumab produces more side effects than nivolumab alone.
Common (affecting many patients):
- Fatigue
- Rash and/or itching
- Diarrhoea
- Nausea
- Decreased appetite
- Abdominal (tummy) pain
- Joint and muscle aches
Serious side effects to watch for
Ipilimumab + nivolumab combination carries a higher risk of serious immune-related adverse events (irAEs) than nivolumab alone. These can affect almost any organ and can be life-threatening if not treated promptly. Report any new or worsening symptoms to your oncologist immediately.
Seek urgent medical attention for:
- Severe diarrhoea or colitis — more than 3–4 loose stools per day, blood or mucus in stools, severe cramps
- Liver inflammation (hepatitis) — yellowing of skin/eyes, dark urine, right-sided abdominal pain, elevated liver tests
- Lung inflammation (pneumonitis) — new or worsening cough, breathlessness, chest pain
- Pituitary or adrenal gland inflammation (hypophysitis/adrenalitis) — severe persistent headache, vision changes, extreme fatigue, dizziness
- Thyroid problems — symptoms of overactive or underactive thyroid
- Severe skin reaction — blistering, widespread painful rash
- Neurological problems — muscle weakness, numbness, confusion, peripheral neuropathy
Important drug interactions
- Corticosteroids (prednisone, dexamethasone) — high-dose corticosteroids are used to treat serious immune reactions from ipilimumab, but long-term use may reduce treatment effectiveness
- Other immunosuppressants — may reduce ipilimumab’s effectiveness
- Live vaccines — not recommended during treatment
Things to avoid while taking it
- Live vaccines — immune system activation makes live vaccines unsafe
- Corticosteroids or immunosuppressants without specialist instruction — can reduce treatment effectiveness (though they are essential if you develop serious immune reactions)
- Ignoring new symptoms — immune reactions can occur weeks or months after the last infusion; always report new symptoms promptly to your oncology team
NZ-specific information
Brand name in NZ: Yervoy
Funded: Yes — from 1 May 2026, nivolumab + ipilimumab is funded for resectable stage 3B–4 melanoma (neoadjuvant/pre-surgery). Also funded in combination for some other melanoma and cancer indications
How it is given: IV infusion at hospital oncology centre
Special Authority: Required — your oncologist will apply
Prescription type: Hospital specialist (oncologist)
The availability of nivolumab + ipilimumab before surgery for resectable melanoma is a significant advancement for NZ melanoma patients. Clinical studies show that around two in three patients achieve a major pathological response — meaning very little or no active disease remains at the time of surgery. For these patients, further treatment after surgery may not be needed, reducing the total treatment burden. Pharmac estimates this will also save around 1,000 infusion hours per year for the health system.
Frequently asked questions
What is the difference between ipilimumab and nivolumab?
Both are immune checkpoint inhibitors, but they target different checkpoints. Nivolumab blocks PD-1 (a brake that is active in the tumour environment), while ipilimumab blocks CTLA-4 (a brake that is active during the initial immune activation process). Used together, they provide a much stronger anti-tumour immune response than either alone.
Is the combination more toxic than either medicine alone?
Yes — the nivolumab + ipilimumab combination causes more immune-related side effects than nivolumab alone, and they tend to be more severe. This is why close monitoring is essential, and why this combination is only used in specialist oncology settings.
Will I definitely need surgery after immunotherapy?
Yes — ipilimumab + nivolumab is used before (neoadjuvant) surgery for resectable melanoma. Surgery is still planned. The hope is that immunotherapy before surgery improves the surgical outcome and may reduce or eliminate the need for further treatment afterwards.
How long do immune side effects last?
Most immune-related side effects resolve with corticosteroid treatment, but some (particularly thyroid or other gland problems) may be permanent and require ongoing management.
Related medications
- Nivolumab (Opdivo) — given in combination with ipilimumab for melanoma