Drug Interactions between asparaginase escherichia coli and Nexcede
This report displays the potential drug interactions for the following 2 drugs:
- asparaginase escherichia coli
- Nexcede (ketoprofen)
Interactions between your drugs
ketoprofen asparaginase Escherichia coli
Applies to: Nexcede (ketoprofen) and asparaginase escherichia coli
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
ketoprofen food
Applies to: Nexcede (ketoprofen)
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
asparaginase Escherichia coli food
Applies to: asparaginase escherichia coli
MONITOR: Concomitant use of asparaginase with other hepatotoxic agents may potentiate the risk of liver injury. Asparaginase-associated hepatotoxicity has been reported more commonly in adults than in children and has been strongly associated with obesity. Hepatomegaly, acute severe hepatotoxicity, and fatal liver failure have been reported with asparaginase treatment in adults. Also, asparaginase may increase the toxicity of drugs bound to plasma proteins or metabolized by the liver.
MANAGEMENT: The risk of additive hepatotoxicity should be considered when asparaginase is used with other hepatotoxic agents (e.g., alcohol, androgens, antituberculosis agents, azole antifungal agents, ACE inhibitors, macrolide antibiotics, nonsteroidal anti-inflammatory agents, nucleoside reverse transcriptase inhibitors, sulfonamides, thiazolidinediones, and statins). Liver function tests should be monitored at regular intervals during asparaginase treatment with or without other hepatotoxic drugs. Patients should be advised to seek medical attention if they experience potential symptoms of hepatotoxicity such as right upper quadrant pain, increasing abdominal size, fever, rash, itching, anorexia, nausea, vomiting, fatigue, malaise, dark urine, pale stools, and jaundice.
References
- (2001) "Product Information. Oncaspar (pegaspargase)." Rhone Poulenc Rorer
- (2001) "Product Information. Elspar (asparaginase)." Merck & Co., Inc
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- "Product Information. Erwinaze (asparaginase Erwinia chrysanthemi)." EUSA Pharma
- Cerner Multum, Inc (2015) "ANVISA Bulário Eletrônico."
- (2019) "Product Information. Asparlas (calaspargase pegol)." Servier
- Al-Nawakil C, Willems L, Mauprivez C, et al. (2014) "Successful treatment of l-asparaginase-induced severe acute hepatotoxicity using mitochondrial cofactors." Leuk Lymphoma, 55, p. 1670-4
- Christ TN, Stock W, Knoebel RW (2018) "Incidence of asparaginase-related hepatotoxicity, pancreatitis, and thrombotic events in adults with acute lymphoblastic leukemia treated with a pediatric-inspired regimen." J Oncol Pharm Pract, 24, p. 299-308
- Jenkins R, Perlin E (1987) "Severe hepatotoxicity from Escherichia coli L-asparaginase." J Natl Med Assoc, 79, p. 775-9
- Lu G, Karur V, Herrington JD, Walker MG (2016) "Successful treatment of pegaspargase-induced acute hepatotoxicity with vitamin B complex and L-carnitine" Proc (Bayl Univ Med Cent), 29, p. 46-7
- Bodmer M, Sulz M, Stadlmann S, Droll A, Terracciano L, Krahenbuhl S (2006) "Fatal liver failure in an adult patient with acute lymphoblastic leukemia following treatment with L-asparaginase." Digestion, 74, epub
- Burke PW, Aldoss I, Lunning MA, et al. (2013) "High-grade PEGylated asparaginase-related hepatotoxicity occurrence in a pediatric-inspired adult acute lymphoblastic leukemia regimen does not necessarily predict recurrent hepatotoxicity in subsequent cycles." Blood, 122, p. 2671
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
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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