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compositionComposition:NIVOLUMAB-40MG
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Prescription Medicine
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₹11096 with coupons & bank offers*

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Tishtha 40 mg Injection 4 ml used to treat various cancers, including Metastatic Melanoma, metastatic non-small cell lung cancer, Renal Cell Carcinoma, Hepatocellular carcinoma, Colorectal Cancer, Malignant pleural mesothelioma, Stomach Cancer, Squamous cell carcinoma of head and neck, and Urothelia carcinoma. It contains Nivolumab, which belongs to the class of monoclonal antibodies. It works by inhibiting the action of a programmed death receptor-1 (PD-1), thereby stopping the abnormal growth of cancer cells.

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Written By Dr. Lakshmithulasi Yarragunta , PharmD (PB)
Reviewed By Dr Aneela Siddabathuni , MPharma., PhD
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More about the Product

Composition :

NIVOLUMAB-40MG

Manufacturer/Marketer :

Zydus Lifesciences Ltd

Consume Type :

Parenteral

Expires on or after :

Jan-28

Return Policy :

Not Returnable

About Tishtha 40 mg Injection 4 ml

Tishtha 40 mg Injection 4 ml is a prescription immunotherapy medicine used to treat several types of advanced cancers, including melanoma, non-small cell lung cancer, kidney cancer, bladder cancer, head and neck cancer, and classical Hodgkin lymphoma. It works by helping your body's immune system recognise and attack cancer cells more effectively, slowing disease progression and improving treatment outcomes in eligible patients.

This medicine is administered as an intravenous (IV) infusion by a trained healthcare professional in a hospital or infusion centre. Depending on your condition and treatment plan, it is usually given every 2, 3, or 4 weeks. It is important to attend every scheduled appointment and complete your treatment as recommended by your doctor.

Your healthcare team will monitor you regularly throughout treatment with blood tests and clinical assessments. Unlike chemotherapy, Tishtha 40 mg Injection 4 ml stimulates the immune system, which can sometimes cause it to attack healthy organs. Contact your doctor immediately if you develop persistent diarrhoea, severe abdominal pain, a new or worsening cough, shortness of breath, yellowing of the skin or eyes, severe skin rash, vision changes, or unusual fatigue.

Before starting treatment, tell your doctor if you have an autoimmune disease, have received an organ transplant, or have lung, liver, kidney, or thyroid problems. Inform your healthcare provider about all medicines, herbal products, and dietary supplements you are taking before beginning treatment.

This medicine may harm an unborn baby. Women should use effective contraception during treatment and for at least 5 months after the last dose. Breastfeeding is not recommended during treatment and for at least 5 months after the final dose. Older adults generally tolerate this medicine similarly to younger adults but may require closer monitoring depending on their overall health.

Uses of Tishtha 40 mg Injection 4 ml

Your doctor may prescribe this medicine to help manage the following conditions:

  • Melanoma: Tishtha 40 mg Injection 4 ml helps treat advanced or metastatic melanoma and may also be used after surgery in certain patients to reduce the risk of the cancer returning.
  • Non-small cell lung cancer (NSCLC): It helps slow the growth of advanced lung cancer and may be used alone or in combination with other anticancer medicines depending on the stage of the disease.
  • Renal cell carcinoma (Kidney cancer): It helps control advanced kidney cancer and may be used alone or together with other targeted therapies.
  • Classical Hodgkin lymphoma: It is used to treat adults whose lymphoma has returned or has not responded to previous treatments.
  • Head and neck squamous cell carcinoma: It helps manage recurrent or metastatic head and neck cancer that has progressed despite previous treatment.
  • Urothelial carcinoma (Bladder cancer): It is used in selected patients with advanced or metastatic bladder cancer when other treatments are not suitable or have stopped working.

Key Benefits

When used as prescribed, Tishtha 40 mg Injection 4 ml offers several important benefits in the treatment of advanced cancers.

  • Helps the immune system fight cancer: Unlike traditional chemotherapy, Tishtha 40 mg Injection 4 ml works by strengthening your body's own immune response, allowing immune cells to recognise and attack cancer cells more effectively.
  • Slows cancer progression: By improving the immune system's ability to control cancer growth, this medicine can slow the spread of the disease and help keep it under control for longer periods.
  • Provides long-lasting responses in some patients: Some people experience durable responses that continue even after treatment has ended, making immunotherapy an effective option for selected cancers.
  • Improves quality of life: By controlling tumour growth, Tishtha 40 mg Injection 4 ml may reduce cancer-related symptoms such as pain, breathing difficulties, or fatigue, helping many patients maintain their daily activities and overall well-being.
Side effects of Tishtha 40 mg Injection 4 ml

Directions for Use

  • Follow your doctor's instructions on the dosage and timing of this medication.
  • Tishtha 40 mg Injection 4 ml will be administered by a nurse or doctor.
  • Do not self-administer.

How Tishtha 40 mg Injection 4 ml Works

Tishtha 40 mg Injection 4 ml contains nivolumab, a type of immunotherapy known as a programmed death receptor-1 (PD-1) inhibitor. Cancer cells can protect themselves from the immune system by activating the PD-1 pathway, which acts like a natural 'off switch' on T-cells. When this pathway is activated, immune cells are less able to recognise and destroy cancer cells. Nivolumab blocks the PD-1 receptor on T-cells, preventing cancer cells from switching off the immune response. This allows the immune system to recognise, attack, and destroy cancer cells more effectively. Because it works by stimulating your immune system rather than directly killing cancer cells, responses may take several weeks or months to become noticeable.
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Alcohol

Consult your doctor

It is unknown whether Tishtha 40 mg Injection 4 ml interacts with alcohol. Consult your doctor for more information.

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Pregnancy

Unsafe

Tishtha 40 mg Injection 4 ml is not recommended for use in pregnancy as it may cause embryo-fetal toxicity and harm your foetus. Hence, if you are pregnant or planning pregnancy, inform your doctor before receiving Tishtha 40 mg Injection 4 ml. You should not become pregnant while you are receiving Tishtha 40 mg Injection 4 ml for at least five months from the last dose of Tishtha 40 mg Injection 4 ml. Using effective birth control methods while on treatment is suggested.

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Breast Feeding

Unsafe

Tishtha 40 mg Injection 4 ml should not be taken if you are breastfeeding as it passes into breast milk and may harm your infant. Avoid nursing your child while on treatment with this medicine and for at least five months from the last dose of medicine.

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Driving

Not applicable

Tishtha 40 mg Injection 4 ml will be administered to hospitalized patients.

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Liver

Caution

If you have a pre-existing or a history of liver problems, tell your doctor before receiving this medicine. Inform your doctor if you experience severe nausea or vomiting, right-sided upper stomach pain, easy bruising or bleeding, dark urine, or jaundice (yellowing of the skin or eyes). Your doctor may suggest tests to monitor your liver function while on treatment with this medicine.

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Kidney

Caution

If you have a pre-existing or a history of kidney diseases, inform your doctor before receiving Tishtha 40 mg Injection 4 ml. Tell your doctor if you have little or no urination, swelling in your feet or ankles, or blood in your urine. Your doctor may adjust the dose of this medicine or prescribe a suitable alternative based on your condition.

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Children

Safe if prescribed

Tishtha 40 mg Injection 4 ml is not recommended for children below 12 years. It is safe for use in children above 12 years for the treatment of microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer. It will be administered only if the benefits outweigh the risks.

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Heart

Consult your doctor

Please consult your doctor before receiving Tishtha 40 mg Injection 4 ml if you have pre-existing heart problems. Your doctor will prescribe Tishtha 40 mg Injection 4 ml if the benefits outweigh the risks.

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Geriatrics

Consult your doctor

Please consult a doctor before administering Tishtha 40 mg Injection 4 ml to geriatric patients. Your doctor will prescribe Tishtha 40 mg Injection 4 ml if the benefits outweigh the risks.

What if I have taken an overdose of Tishtha 40 mg Injection 4 ml

An overdose is unlikely because this medicine is prepared and administered by trained healthcare professionals. However, if you develop severe or unusual symptoms during or after your infusion, notify your healthcare team immediately or seek emergency medical attention.

Diet & Lifestyle Advise

  • Eat a balanced diet: Choose nutritious meals rich in fruits, vegetables, whole grains, and lean protein to help support your body's recovery during cancer treatment.
  • Stay well-hydrated: Drink plenty of water unless your doctor advises otherwise. Good hydration helps support your overall health during treatment.
  • Protect your skin: Use fragrance-free moisturisers and sunscreen when outdoors, as skin dryness and rashes are common with immunotherapy.
  • Remain physically active: Gentle activities such as walking or stretching may help reduce fatigue and maintain strength. Adjust your activity level according to how you feel.
  • Report new symptoms promptly: Because this medicine can affect many organs, tell your healthcare provider immediately if you notice persistent diarrhoea, cough, shortness of breath, skin rash, vision changes, or unusual fatigue.
  • Keep all follow-up appointments: Regular blood tests and medical reviews help your doctor monitor for immune-related side effects and assess your response to treatment.

Health Queries

Is melanoma completely curable, or is it always fatal within 5 to 10 years, and what are the available treatment options?

Veda Maddala

Veda Maddala

M Pharmacy

Melanoma is highly curable, especially when detected early, and is certainly not always fatal. If caught in its early stages, simple surgery to remove the lesion is often the only treatment needed, offering excellent long-term survival. For advanced cases, treatments have dramatically improved in recent years. Available options include surgery, immunotherapy (such as pembrolizumab or nivolumab) to boost your immune system, targeted therapy (like dabrafenib) for specific gene mutations, radiation, and chemotherapy. The outlook depends on the cancer's stage, but modern therapies have significantly increased survival rates. Please consult an oncologist for a personalized evaluation.

I have been diagnosed with anorectal melanoma and have not yet started treatment. Can this condition be cured using Ayurvedic medicines?

Veda Maddala

Veda Maddala

M Pharmacy

I understand this diagnosis is overwhelming, but please know that anorectal melanoma is a highly aggressive cancer that cannot be cured by Ayurvedic medicines. There is no scientific evidence supporting Ayurveda as a primary cure for this condition. The standard and most effective treatments are conventional medical therapies, including surgery to remove the tumor, immunotherapy (such as pembrolizumab or nivolumab), or radiation. While Ayurvedic therapies can sometimes be used alongside standard care to help manage symptoms and improve well-being, they should never replace conventional treatment. I strongly encourage you to consult an oncologist immediately to plan your treatment. Starting standard care early is crucial for the best possible outcome.

After bladder cancer surgery, the report says there is no active disease and no chemotherapy is needed, so I am now confused why I am still being given costly vitamin medicines for 3 months, and whether I really need them or if simple generic supplements are enough, since the treatment was already completed with charity support. Can you please explain what is actually necessary in this situation?

Veda Maddala

Veda Maddala

M Pharmacy

If the surgery report shows no active bladder cancer and your doctors have said chemotherapy is not needed, that is generally a reassuring sign that the main treatment has been successful. The vitamin or nutritional medicines given afterwards are usually meant to support recovery, improve strength, help healing, and correct weakness or nutritional deficiencies that can happen after major illness or surgery. In many cases, these supplements are supportive rather than essential for cancer treatment itself. Expensive branded vitamins are not always medically superior to simpler generic supplements if the ingredients and doses are similar, but the exact need depends on your nutrition, weight, blood reports, appetite, and overall recovery. It is reasonable to discuss this openly with your treating doctor and ask whether a lower-cost generic alternative would be sufficient in your case. Focus on a good diet with enough protein, fluids, fruits, and vegetables, because recovery after cancer surgery also depends a lot on overall nutrition and physical strength. Regular follow-up remains important even when the disease is currently inactive.
health query

Have a query?

How Soon It Starts Working

The time required for Tishtha 40 mg Injection 4 ml to start to work: The time required for Tishtha 40 mg Injection 4 ml to show its action is not clinically established. The time for which the effects of Tishtha 40 mg Injection 4 ml last: The duration of action for Tishtha 40 mg Injection 4 ml is not clinically established.

What if you forget to take Tishtha 40 mg Injection 4 ml

If you miss your scheduled infusion appointment, contact your healthcare team immediately to arrange another appointment. Do not wait until your next scheduled dose or attempt to change your treatment schedule without consulting your doctor.

Storage

•Store unopened vials in a refrigerator between 2°C and 8°C (36°F and 46°F).
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Keep Refrigerated. Do not freeze.

Drug Warnings

  • Attend all scheduled blood tests: Regular monitoring helps your doctor detect immune-related side effects affecting the liver, kidneys, thyroid, lungs, and other organs before they become serious.
  • Report new symptoms immediately: Tell your doctor promptly if you develop persistent diarrhoea, severe abdominal pain, a new or worsening cough, shortness of breath, yellowing of the skin or eyes, severe skin rash, or vision changes.
  • Inform every healthcare provider that you are receiving immunotherapy: This is especially important before surgery, dental procedures, or starting any new medicines.
  • Avoid self-medicating with corticosteroids or immunosuppressants: These medicines should only be used under your doctor's supervision, as they may affect your treatment or are sometimes needed to manage immune-related side effects.
  • Avoid live vaccines during treatment: Consult your doctor before receiving any vaccination while you are being treated with Tishtha 40 mg Injection 4 ml.
  • Pregnancy warning: Use effective contraception during treatment and for at least 5 months after your final dose. Do not breastfeed during treatment or for 5 months after your last dose.
  • Do not ignore infusion reactions: Tell your nurse immediately if you experience fever, chills, flushing, itching, dizziness, chest tightness, or difficulty breathing during the infusion.
  • When to seek urgent medical care: Seek immediate medical attention if you develop severe breathing difficulty, confusion, severe allergic reactions, chest pain, or any rapidly worsening symptoms.

Drug-Drug Interactions

verifiedApollotooltip
  • Immunosuppressants (such as high-dose corticosteroids): These medicines may reduce the effectiveness of nivolumab when used before or during treatment. However, your doctor may prescribe corticosteroids to manage serious immune-related side effects caused by nivolumab.
  • Other anticancer medicines: When used together with chemotherapy, targeted therapy, or other immunotherapy medicines, the risk of side effects may increase. Your healthcare team will monitor you closely during combination treatment.
NivolumabThalidomide
Severe
NivolumabLenalidomide
Severe

Drug-Drug Interactions

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NivolumabThalidomide
Severe
How does the drug interact with Tishtha 40 mg Injection 4 ml:
Taking Thalidomide with Tishtha 40 mg Injection 4 ml may increase the risk of serious side effects.

How to manage the interaction:
Although taking thalidomide and Tishtha 40 mg Injection 4 ml together can possibly result in an interaction, it can be taken if your doctor has prescribed it. However, consult the doctor immediately if you experience symptoms such as fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, red or inflamed skin, body sores, and pain or burning during urination. Do not stop using any medications without consulting doctor.
NivolumabLenalidomide
Severe
How does the drug interact with Tishtha 40 mg Injection 4 ml:
These drugs together may raise the likelihood of adverse effects.

How to manage the interaction:
There may be a possibility of interaction between Lenalidomide and Tishtha 40 mg Injection 4 ml, but it can be taken if prescribed by a doctor. Do not stop using any medications without talking to your doctor.

Drug-Food Interactions

verifiedApollotooltip
  • There are no known clinically significant food interactions with nivolumab. You can continue your normal diet unless your doctor recommends dietary changes based on treatment-related side effects.
No Drug - Food interactions found in our database. Some may be unknown. Consult your doctor for what to avoid during medication.

Drug-Food Interactions

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All Substitutes & Brand Comparisons

Habit Forming

No

Therapeutic Class

[ANTINEOPLASTIC]

FAQs

Tishtha 40 mg Injection 4 ml is used to treat various cancers, including Metastatic Melanoma, metastatic non-small cell lung cancer, Renal Cell Carcinoma, Hepatocellular carcinoma, Colorectal Cancer, Malignant pleural mesothelioma, Stomach Cancer, Squamous cell carcinoma of head and neck, and Urothelia carcinoma.
Tishtha 40 mg Injection 4 ml contains Nivolumab, which works by inhibiting the action of a programmed death receptor-1 (PD-1) that causes the multiplication of cancerous cells.
Tishtha 40 mg Injection 4 ml is given as an intravenous (IV) infusion into a vein by a healthcare professional in a clinic or hospital. The process usually takes about 30 to 60 minutes. Talk to your doctor if you have questions about your schedule.
Most people can drive after their infusion, but you may feel unusually tired or weak after treatment. It is a good idea to have someone drive you to and from your first few appointments until you know how the medicine affects you. Talk to your doctor if you experience severe fatigue.
No, Tishtha 40 mg Injection 4 ml is not chemotherapy. It is an immunotherapy that helps your own immune system recognize and fight cancer cells, whereas chemotherapy directly targets and kills rapidly dividing cells. Talk to your doctor to learn more about how this treatment works.
Mild skin rashes can often be managed with fragrance-free moisturisers, but you must report any new or worsening skin reactions to your healthcare team immediately. Severe rashes can be a sign of a serious immune response. Talk to your doctor before applying any medicated creams.
You should avoid receiving live vaccines during your treatment, as they may cause serious infections. Non-live vaccines, like the annual flu shot, are generally safer, but you must always consult your healthcare team before getting any vaccination. Talk to your doctor for specific guidance.
There is no direct interaction between alcohol and Tishtha 40 mg Injection 4 ml, but alcohol can cause dehydration and worsen side effects like fatigue or nausea. It is best to limit alcohol intake during your treatment. Talk to your doctor or pharmacist for advice.
Early signs of lung inflammation include a new or worsening cough, chest pain, and shortness of breath. Because this can become serious quickly, you must report these symptoms to your doctor immediately. Talk to your doctor if you notice any changes in your breathing.

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Country of origin

India

Manufacturer/Marketer address

Zydus Corporate Park, 4Th Floor, B Wing, Plot No 103, Near Nirma University,S G Highway, Ahmedabad, 382481
Other Info - TIS0105
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