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Drug Interactions between daclizumab and Tysabri

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

daclizumab natalizumab

Applies to: daclizumab and Tysabri (natalizumab)

GENERALLY AVOID: Concomitant or recent use of immunosuppressant, immunomodulating, or antineoplastic agents in patients treated with natalizumab may increase the risk of infections including progressive multifocal leukoencephalopathy (PML), a severely disabling, potentially fatal opportunistic viral infection of the brain caused by John Cunningham Virus (JCV). In clinical trials, PML occurred in two of 1869 patients with multiple sclerosis treated with natalizumab for a median of 120 weeks and one of 1043 patients with Crohn's disease after eight doses of natalizumab. Both of the MS patients were receiving concomitant interferon beta therapy, and the third patient was immunocompromised due to recent treatment with azathioprine. In the postmarketing setting, additional cases of PML have been reported in patients who were receiving no concomitant immunomodulatory therapy. Longer treatment duration of natalizumab, especially beyond 2 years, and the presence of anti-JCV antibodies are additional risk factors for the development of PML. Other potentially serious or life-threatening infections that may occur include herpes encephalitis or meningitis and opportunistic infections such as pneumocystis carinii pneumonia, pulmonary mycobacterium avium intracellulare, bronchopulmonary aspergillosis, and Burkholderia cepacia.

MANAGEMENT: The safety and efficacy of natalizumab in combination with immunosuppressant, immunomodulating, antineoplastic, or other myelosuppressive agents have not been established. In general, patients receiving chronic therapy with such agents should not be treated with natalizumab due to potentially increased risk of PML and other serious infections. For patients with Crohn's disease who start natalizumab while on chronic corticosteroid therapy, begin steroid withdrawal as soon as a therapeutic benefit is achieved. Natalizumab should be discontinued if patient is unable to stop using systemic corticosteroids within six months. All patients treated with natalizumab should be monitored closely during and for at least six months following discontinuation of treatment. The drug should be discontinued immediately at the first sign or symptom suggestive of PML, although it is not known if early detection of PML and discontinuation of natalizumab will mitigate the disease. Typical symptoms associated with PML are diverse, progress over days to weeks, and include progressive weakness on one side of the body, clumsiness of limbs, disturbance of vision, and changes in thinking, memory, and orientation leading to confusion and personality changes. Due to the long half-life of natalizumab, immune effects are possible for up to 2 to 3 months following its discontinuation.

References

  1. "Product Information. Tysabri (natalizumab)." Elan Pharmaceutical/Athena Neurosciences Inc (2004):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0
  4. Agencia EspaƱola de Medicamentos y Productos Sanitarios Healthcare "Centro de informaciĆ³n online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html" (2008):
  5. "Product Information. Tysabri (natalizumab)." Biogen (2023):
View all 5 references

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Immunomodulators for multiple sclerosis

Therapeutic duplication

The recommended maximum number of medicines in the 'immunomodulators for multiple sclerosis' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'immunomodulators for multiple sclerosis' category:

  • daclizumab
  • Tysabri (natalizumab)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.