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Ado-trastuzumab emtansine Disease Interactions

There are 5 disease interactions with ado-trastuzumab emtansine:

Major

Ado-Trastuzumab Emtansine (Includes Ado-trastuzumab emtansine) ↔ Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

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.

Major

Her2 Inhibitors (Includes Ado-trastuzumab emtansine) ↔ Pulmonary Toxicity

Severe Potential Hazard, Moderate plausibility

Applies to: 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.

Moderate

Her2 Inhibitors (Includes Ado-trastuzumab emtansine) ↔ Chf

Moderate Potential Hazard, Moderate plausibility

Applies to: 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 prior history of heart conditions. Evaluate cardiac function before, during and upon completion of treatment. Discontinue treatment 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, unless the benefits for the individual patient outweigh the risks.

Moderate

Her2 Inhibitors (Includes Ado-trastuzumab emtansine) ↔ Peripheral Neuropathy

Moderate Potential Hazard, Moderate plausibility

Applies to: Peripheral Neuropathy, 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.

Moderate

Her2 Inhibitors (Includes Ado-trastuzumab emtansine) ↔ Thrombocytopenia

Moderate Potential Hazard, Moderate plausibility

Applies to: Thrombocytopenia

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 185 drug interactions with ado-trastuzumab emtansine

ado-trastuzumab emtansine alcohol/food Interactions

There is 1 alcohol/food interaction with ado-trastuzumab emtansine

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

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.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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