Drug Interactions between Advil PM and asparaginase erwinia chrysanthemi
This report displays the potential drug interactions for the following 2 drugs:
- Advil PM (diphenhydramine/ibuprofen)
- asparaginase erwinia chrysanthemi
Interactions between your drugs
ibuprofen asparaginase Erwinia chrysanthemi
Applies to: Advil PM (diphenhydramine / ibuprofen) and asparaginase erwinia chrysanthemi
MONITOR: Asparaginase therapy may lead to imbalances in coagulation factors predisposing the patient to bleeding or thrombosis. Theoretically, concurrent use of anticoagulants and asparaginase may increase the risk of bleeding. Hemorrhages grade 3 and above and CNS hemorrhages have been observed with asparaginase treatment. However, serious thromboembolic events have also been reported with the use of asparaginase. Some investigators have suggested that anticoagulants could be used prophylactically with asparaginase for the prevention of thromboembolic events.
MANAGEMENT: Coagulation parameters should be monitored at baseline and periodically during concomitant treatment with asparaginase and anticoagulants such as heparin, dipyridamole, aspirin and nonsteroidal anti-inflammatory drugs. Patients should be advised to promptly report any signs and symptoms of bleeding.
References
- (2001) "Product Information. Oncaspar (pegaspargase)." Rhone Poulenc Rorer
- (2001) "Product Information. Elspar (asparaginase)." Merck & Co., Inc
- Kieslich M, Porto L, Lanfermann H, Jacobi G, Schwabe D, Bohles H (2003) "Cerebrovascular complications of L-asparaginase in the therapy of acute lymphoblastic leukemia." J Pediatr Hematol Oncol, 25, p. 484-7
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- "Product Information. Erwinaze (asparaginase Erwinia chrysanthemi)." EUSA Pharma
- (2019) "Product Information. Asparlas (calaspargase pegol)." Servier
- Duarte X, Esteves S, Neto AM, Pereira F (2016) "Incidence and risk factors for central nervous system thrombosis in paediatric acute lymphoblastic leukaemia during intensive asparaginase treatment: a single-centre study." Br J Haematol, 174, p. 280-91
- Caruso V, Iacoviello L, Di Castelnuovo A, et al. (2006) "Thrombotic complications in childhood acute lymphoblastic leukemia: a meta-analysis of 17 prospective studies comprising 1752 pediatric patients." Blood, 108, p. 2216-22
- Mitchell L, Andrew M, Hanna K, et al. (2003) "Trend to efficacy and safety using antithrombin concentrate in prevention of thrombosis in children receiving l-asparaginase for acute lymphoblastic leukemia. Results of the PAARKA study." Thromb Haemost, 90, p. 235-44
- Elice F, Rodeghiero F (2012) "Hematologic malignancies and thrombosis." Thromb Res, 129, p. 360-6
- Truelove E, Fielding AK, Hunt BJ (2013) "The coagulopathy and thrombotic risk associated with L-asparaginase treatment in adults with acute lymphoblastic leukaemia." Leukemia, 27, p. 553-9
- Grace RF, DeAngelo DJ, Stevenson KE, et al. (2018) "The use of prophylactic anticoagulation during induction and consolidation chemotherapy in adults with acute lymphoblastic leukemia." J Thromb Thrombolysis, 45, p. 306-14
Drug and food interactions
ibuprofen food
Applies to: Advil PM (diphenhydramine / ibuprofen)
GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.
MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.
References
- (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn
diphenhydrAMINE food
Applies to: Advil PM (diphenhydramine / ibuprofen)
GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.
MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.
References
- Linnoila M (1973) "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol, 6, p. 107-12
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Report options
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
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