Skip to Content

Atezolizumab Disease Interactions

There are 10 disease interactions with atezolizumab:

Major

Atezolizumab (Includes Atezolizumab) ↔ Endocrinopathies

Severe Potential Hazard, Moderate plausibility

Applies to: Thyroid Disease, Adrenal Insufficiency, Diabetes Mellitus

Immune-related thyroid disorders, adrenal insufficiency, and type 1 diabetes mellitus, including diabetic ketoacidosis, have been reported in patients receiving atezolizumab. It is recommended to monitor patients for clinical signs and symptoms of endocrinopathies and to institute appropriate measures as necessary. Monitor as clinically indicated prior to and periodically during treatment and withhold, reduce dose, or discontinue therapy as necessary.

Major

Atezolizumab (Includes Atezolizumab) ↔ Hepatitis

Severe Potential Hazard, Moderate plausibility

Applies to: Autoimmune Hepatitis

Immune-mediated hepatitis occurred in patients receiving atezolizumab treatment with reported liver test abnormalities. Monitor patients for liver function test and for symptoms of hepatitis. Monitor bilirubin prior to and periodically during treatment. Therapy with atezolizumab should be administered cautiously in these patients. It is recommended to withhold atezolizumab for Grade 2 immune-mediated hepatitis and institute appropriate measures and to permanently discontinue therapy for Grade or 4 immune-mediated hepatitis

Major

Atezolizumab (Includes Atezolizumab) ↔ Infections

Severe Potential Hazard, Moderate plausibility

Applies to: Infection - Bacterial/Fungal/Protozoal/Viral

Severe infections, including urinary tract infections, pneumonia, sepsis, herpes encephalitis, and mycobacterial infection leading to retroperitoneal hemorrhage occurred in patients treated with atezolizumab. It is recommended to monitor patients for signs and symptoms of infection and to treat with antibiotics for suspected or confirmed bacterial infections. Withhold therapy for greater than or equal to Grade 3 infections.

Major

Atezolizumab (Includes Atezolizumab) ↔ Meningitis

Severe Potential Hazard, Moderate plausibility

Applies to: Acute Disseminated Encephalomyelitis

Immune-related meningoencephalitis has been reported with the use of atezolizumab therapy. Monitor patients for clinical signs and symptoms of meningitis or encephalitis. Permanently discontinue therapy for any grade of meningitis or encephalitis.

Major

Atezolizumab (Includes Atezolizumab) ↔ Neuropathy

Severe Potential Hazard, Moderate plausibility

Applies to: Myasthenia Gravis, Guillain-Barre Syndrome, Autonomic Neuropathy, Peripheral Neuropathy

Immune-related myasthenic syndrome/myasthenia gravis, Guillain-Barré, and ocular inflammatory toxicity have been reported with the use of atezolizumab therapy. Monitor patients for symptoms of motor and sensory neuropathy. Permanently discontinue therapy for any grade of myasthenic syndrome/myasthenia gravis or Guillain-Barré syndrome and institute medical intervention as appropriate.

Major

Atezolizumab (Includes Atezolizumab) ↔ Pancreatitis

Severe Potential Hazard, Moderate plausibility

Applies to: Pancreatitis

Immune-related pancreatitis, including increases in serum amylase and lipase levels have been reported with the use of atezolizumab therapy. Caution is recommended and patients should be monitored for signs and symptoms of acute pancreatitis. Withhold atezolizumab for greater than or equal to Grade 3 serum amylase or lipase levels (> 2.0 ULN), or Grade 2 or 3 pancreatitis and permanently discontinue therapy for Grade 4 or any grade of recurrent pancreatitis.

Moderate

Atezolizumab (Includes Atezolizumab) ↔ Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Colitis/Enteritis (Noninfectious)

Immune-mediated colitis or diarrhea have been reported during atezolizumab therapy, in some cases with fatal outcomes. Monitor patients for signs and symptoms of diarrhea or colitis. It is recommended to withhold treatment with atezolizumab for Grade 2 diarrhea or colitis and if symptoms persist for longer than 5 days or recur, it is recommended to administer 1 to 2 mg/kg prednisone or equivalent per day. Withhold treatment for Grade 3 diarrhea or colitis and treat with IV methylprednisolone 1 to 2 mg/kg per day and convert to oral steroids once the patient has improved. For both Grade 2 and Grade 3 diarrhea or colitis, when symptoms improve to Grade 0 or Grade 1, taper steroids over greater than or equal to 1 month. Resume treatment if the event improves to Grade 0 or 1 within 12 weeks and corticosteroids have been reduced to the equivalent of less than or equal to 10 mg oral prednisone per day. Permanently discontinue atezolizumab for Grade 4 diarrhea or colitis.

Moderate

Atezolizumab (Includes Atezolizumab) ↔ Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Population pharmacokinetic analyses suggest that no dose adjustment of atezolizumab is needed for patients with mild hepatic impairment. No clinical studies were conducted with atezolizumab in patients with moderate or severe hepatic impairment. Caution is recommended when using this agent.

Moderate

Atezolizumab (Includes Atezolizumab) ↔ Pneumonitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Pulmonary Impairment

Immune-mediated pneumonitis, sometimes fatal, or interstitial lung disease have been reported during atezolizumab therapy. Patients should be monitored with radiographic imaging and for symptoms of pneumonitis. Therapy with atezolizumab should be administered cautiously in patients with or predisposed to pulmonary dysfunction. It is recommended to withhold atezolizumab until resolution for Grade 2 pneumonitis and to permanently discontinue therapy for Grade 3 or 4 pneumonitis.

Moderate

Atezolizumab (Includes Atezolizumab) ↔ Renal Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Population pharmacokinetic analyses suggest that no dose adjustment of atezolizumab is required for patients with renal impairment. The effect of severe renal impairment on the pharmacokinetics of atezolizumab is unknown. Caution is recommended with these patients.

atezolizumab drug Interactions

There are 94 drug interactions with atezolizumab

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.
Unknown No information available.

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 2000-2017 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.

Hide