Interactions between zyloprim(allopurinol) and Bortezomib (bortezomib)
allopurinol and bortezomib (Moderate Drug-Drug)
MONITOR: Bortezomib can cause peripheral neuropathy, and concurrent use of other agents that are also associated with this adverse effect can potentiate the risk. Bortezomib treatment causes a peripheral neuropathy that is predominantly sensory, although cases of mixed sensorimotor neuropathy have also been reported. During clinical trials, 37% of the patients experienced treatment emergent neuropathy. Of these, more than 70% had previously been treated with neurotoxic agents and more than 80% of these patients had signs or symptoms of peripheral neuropathy at baseline. The incidence of grade 3 neuropathy (i.e., that which interferes with activities of daily life) was 5% in patients without baseline neuropathy.
MANAGEMENT: Caution is advised if bortezomib is used in combination with other neurotoxic agents. Patients should be monitored closely for symptoms of neuropathy such as visual disturbances or burning, tingling, or numbness in the hands and feet. Patients experiencing new or worsening peripheral neuropathy may require a change in the dosage and schedule of bortezomib in accordance with product labeling. Symptoms may improve or return to baseline in some patients upon discontinuation of bortezomib, although the complete time-course of this toxicity has not been fully characterized.