Ado-trastuzumab emtansine Disease Interactions
There are 5 disease interactions with ado-trastuzumab emtansine:
Ado-trastuzumab emtansine (applies to ado-trastuzumab emtansine) liver disease
Major Potential Hazard, Moderate plausibility.
Serious hepatotoxicity, predominantly in the form of asymptomatic, transient increases in the concentrations of serum transaminases including liver failure and death has been reported in patients treated with the antibody-drug conjugate, ado-trastuzumab emtansine (Kadcyla). Cases of nodular regenerative hyperplasia (NRH) of the liver, a rare condition characterized by widespread benign transformation of hepatic parenchyma into small regenerative nodules, have been reported in clinical trials. If NRH is confirmed, treatment must be permanently discontinued. Monitor serum transaminases and bilirubin before initiation of treatment and before each dose. It is recommended to reduce the dose or discontinue therapy with ado-trastuzumab emtansine as appropriate in cases of increased serum transaminases or total bilirubin. In patients with serum transaminases > 3 × ULN and concomitant total bilirubin > 2 × ULN, permanently discontinue treatment.
HER2 inhibitors (applies to ado-trastuzumab emtansine) pulmonary toxicity
Major Potential Hazard, Moderate plausibility. Applicable conditions: Pulmonary Impairment
Pulmonary toxicity, sometimes fatal has been reported with agents that block HER2 activity. Pulmonary toxicity includes dyspnea, interstitial pneumonitis, pulmonary infiltrates, pleural effusions, non-cardiogenic pulmonary edema, pulmonary insufficiency and hypoxia, acute respiratory distress syndrome, and pulmonary fibrosis. Patients with symptomatic intrinsic lung disease or with extensive tumor involvement of the lungs, resulting in dyspnea at rest may be at increased risk of pulmonary toxicity and appear to have more severe toxicity. Patients should be monitored for pulmonary symptoms. Permanently discontinue treatment with these agents in patients diagnosed with interstitial lung disease or pneumonitis and institute appropriate care.
HER2 inhibitors (applies to ado-trastuzumab emtansine) CHF
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Congestive Heart Failure, Hypertension, Myocardial Infarction, Arrhythmias, History - Myocardial Infarction, Post MI Syndrome
Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.
HER2 inhibitors (applies to ado-trastuzumab emtansine) peripheral neuropathy
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus
Peripheral neuropathy has been reported with the use of agents that block HER2 activity. Patients experiencing peripheral neuropathy may require temporary interruption, dose reduction, or treatment discontinuation of these agents. Withhold dosing temporarily for patients experiencing Grade 3 or 4 peripheral neuropathy until resolution. Close monitoring is recommended when using these agents in patients at risk, and all patients should be monitored on an ongoing basis for signs or symptoms of neurotoxicity.
HER2 inhibitors (applies to ado-trastuzumab emtansine) thrombocytopenia
Moderate Potential Hazard, Moderate plausibility.
Thrombocytopenia has been reported with the use of agents that block HER2 activity. Monitor platelet counts prior to initiation of therapy and prior to each dose. If appropriate modify the dose according to clinical guidelines. Patients with decreased platelet count and patients on anti-coagulant treatment should be closely monitored during treatment with these agents.
Ado-trastuzumab emtansine drug interactions
There are 233 drug interactions with ado-trastuzumab emtansine
Ado-trastuzumab emtansine alcohol/food interactions
There is 1 alcohol/food interaction with ado-trastuzumab emtansine
More about ado-trastuzumab emtansine
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
- En Español
- Drug class: HER2 inhibitors
Related treatment guides
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.|
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