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Blinatumomab Disease Interactions

There are 9 disease interactions with blinatumomab:

Major

Antineoplastics (Includes Blinatumomab) ↔ Infections

Severe Potential Hazard, Moderate plausibility

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

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Doxil (doxorubicin liposomal)." Sequis Pharmaceuticals Inc, Menlo Park, CA.
  3. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
  4. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  5. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  6. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  7. "Product Information. Matulane (procarbazine)." Roche Laboratories, Nutley, NJ.
  8. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  9. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb, Princeton, NJ.
  10. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  11. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
  12. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
  13. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
  14. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
  15. "Product Information. Taxotere (docetaxel)." Rhone-Poulenc Rorer, Collegeville, PA.
  16. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn, Kalamazoo, MI.
  17. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
  18. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb, Princeton, NJ.
  19. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
  20. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories, Wayne, NJ.
  21. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  22. "Product Information. Xeloda (capecitabine)." Roche Laboratories, Nutley, NJ.
  23. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.
  24. "Product Information. Tabloid (thioguanine)." Glaxo Wellcome, Research Triangle Park, NC.
  25. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  26. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation, Eatontown, NJ.
  27. "Product Information. Nipent (pentostatin)." Parke-Davis, Morris Plains, NJ.
  28. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
  29. "Product Information. DTIC-Dome (dacarbazine)." Bayer, West Haven, CT.
  30. "Product Information. Thiotepa (thiotepa)." Lederle Laboratories, Wayne, NJ.
  31. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
View all 31 references
Major

Monoclonal Antibodies (Includes Blinatumomab) ↔ Infusion Reactions

Severe Potential Hazard, Moderate plausibility

Applies to: Pulmonary Impairment, Urticaria, Angioedema, Hypotension, Hypertension

The use of monoclonal antibodies administered via IV infusion may cause serious infusion reactions, including bronchospasm, hypoxia, dyspnea, fluctuations in blood pressure, laryngeal edema and pulmonary edema. Caution should be taken in patients with a history of cardiopulmonary disease as they may require additional post-infusion medications to manage respiratory complications. It is recommended to administer required intravenous hydration and premedication with antihistamines, analgesics, and antipyretics before administration. Monitor closely for signs and symptoms of infusion reactions during and for at least 4 hours following completion of each infusion in a setting where cardiopulmonary resuscitation medication and equipment are available. Immediately interrupt or permanently discontinue treatment and institute supportive management for severe or prolonged infusion reactions as appropriate.

Major

Monoclonal Antibodies (Includes Blinatumomab) ↔ Tumor Lysis Syndrome

Severe Potential Hazard, Moderate plausibility

Applies to: Tumor Lysis Syndrome

Tumor lysis syndrome (TLS) has occurred in patients receiving certain monoclonal antibodies. Patients with high tumor burden and those with high circulating lymphocyte counts of greater than 25 X 10^9/L have a higher risk of developing TLS. Consider tumor lysis prophylaxis prior to the infusion with anti-hyperuricemics and hydration beginning 12 to 24 hours prior to infusion. It is recommended to correct electrolytes abnormalities, and monitor renal function in patients who develop TLS. Monitor for signs and symptoms of TLS and temporary interruption or discontinuation of therapy might be required.

Moderate

Blinatumomab (Includes Blinatumomab) ↔ Liver Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

The use of blinatumomab has been associated with transient elevations in liver enzymes. Care should be exercised when using this agent in patients with liver impairment. It is recommended to monitor liver enzymes before the start of therapy and periodically as clinically appropriate. Interrupt treatment if the transaminases levels rise to greater than 5 times the upper limit of normal or if bilirubin rises to more than 3 times the upper limit normal.

Moderate

Blinatumomab (Includes Blinatumomab) ↔ Neurologic Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Neurologic Disorder

Serious neurological toxicity such as encephalopathy, convulsions, speech disorders, disturbances in consciousness, confusion and disorientation, and coordination and balance disorders have been reported with the use of blinatumomab therapy. Monitor therapy closely if administered to patients with or predisposed to neurological impairment and interruption or discontinuation of therapy might be appropriate in some cases.

Moderate

Blinatumomab (Includes Blinatumomab) ↔ Neutropenia

Moderate Potential Hazard, Moderate plausibility

Applies to: Neutropenia

The use of blinatumomab may cause life-threatening neutropenia, and febrile neutropenia. It is recommended to monitor complete blood counts during the infusion. Therapy interruption is recommended for prolonged neutropenia. Care and close monitoring is recommended, in particular for any episodes of fever.

Moderate

Blinatumomab (Includes Blinatumomab) ↔ Pancreatitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Pancreatitis

Fatal pancreatitis has been observed in patients treated with blinatumomab in combination with dexamethasone. Care should be exercised when using blinatumomab in combination with dexamethasone in patients with pancreatic disorders. Management of pancreatitis may require either temporary interruption or discontinuation of these agents.

Moderate

Blinatumomab (Includes Blinatumomab) ↔ Vaccination

Moderate Potential Hazard, Moderate plausibility

Applies to: Vaccination

The administration of live vaccines should be avoided during therapy with blinatumomab. Vaccination with live virus vaccines is not recommended for at least 2 weeks prior to start of therapy, during treatment, and until the immune system has recovered following last cycle of blinatumomab. It is recommended to be up-to-date with all required immunizations, as recommended by current immunization guidelines, before initiating therapy.

Moderate

Blinatumomab (Includes Blinatumomab) ↔ Renal Impairment

Minor Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

No formal pharmacokinetic studies of blinatumomab have been conducted in patients with renal impairment. Pharmacokinetic analyses showed an approximately 2-fold difference in mean blinatumomab clearance values between patients with moderate renal impairment (CrCl ranging from 30 to 59 mL/min, N = 21) and normal renal function. However, high interpatient variability was observed (CV% up to 96.8%), and clearance values in renal impaired patients were essentially within the range observed in patients with normal renal function. Close monitoring is recommended in patients with severe renal impairment (CrCl less than 30 mL/min) or patients on hemodialysis as there is no information available.

blinatumomab drug Interactions

There are 224 drug interactions with blinatumomab

blinatumomab alcohol/food Interactions

There is 1 alcohol/food interaction with blinatumomab

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.

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