Interactions between bismuth-subsalicylate(bismuth subsalicylate) and In 111 zevalin (ibritumomab)
bismuth subsalicylate and ibritumomab (Major Drug-Drug)
MONITOR CLOSELY: Coadministration of ibritumomab and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Ibritumomab commonly causes severe and prolonged thrombocytopenia, and the risk is increased further in patients with mild thrombocytopenia at the initiation of therapy. Hemorrhage, including fatal cerebral hemorrhage, has occurred in a minority of patients in clinical studies. The median time to thrombocyte nadir was 7 to 9 weeks, and the median duration of thrombocytopenia was 22 to 35 days. However, in less than 5% of the cases, patients experienced severe cytopenia that extended beyond 12 weeks following administration of the ibritumomab therapeutic regimen. Platelet transfusions were given to 22% of patients in clinical trials.
MANAGEMENT: Caution is advised if ibritumomab is used in combination with drugs that interfere with platelet function or coagulation. Close clinical and laboratory observation for bleeding complications is recommended during and after ibritumomab therapy.
