Drug interactions between Herceptin and Miradon
| Results for the following 2 drugs: |
|---|
| Herceptin (trastuzumab) |
| Miradon (anisindione) |
Interactions between your selected drugs
anisindione ↔ trastuzumab
Applies to:Miradon (anisindione) and Herceptin (trastuzumab)
MONITOR: Trastuzumab may potentiate the hypoprothrombinemic effect of warfarin, although data are limited and the mechanism is unknown. There have been isolated post-marketing case reports of patients stabilized on warfarin whose INR increased several weeks following the addition of trastuzumab, accompanied by signs of excessive anticoagulation such as epistaxis, bruisability, and prolonged bleeding from cuts. A search on a large patient database conducted by the manufacturer of trastuzumab found several bleeding events among 469 women with HER2-overexpressing metastatic breast cancer who were randomized to receive chemotherapy with or without trastuzumab. Although trastuzumab patients had a higher crude incidence of bleeding events, which were generally mild to moderate in severity (with nosebleeds being the most common), they were also seen more frequently and received treatment significantly longer than controls. After adjusting for time on study, the incidence rates were similar for both groups, with or without anticoagulants.
MANAGEMENT: Given the potential for interaction and the high degree of interpatient variability with respect to warfarin metabolism, patients should be closely monitored during concomitant therapy with trastuzumab. The INR should be checked frequently and warfarin dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of trastuzumab in patients who are stabilized on their warfarin regimen. The same precaution may be applicable during therapy with other oral anticoagulants, although clinical data are lacking. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| 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. |
Do not stop taking any medications without consulting your healthcare provider.
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