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Bosutinib Disease Interactions

There are 6 disease interactions with bosutinib:

Moderate

Bcr-Abl Tyrosine Kinase Inhibitors (Includes Bosutinib) ↔ Cardiovascular Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Cardiovascular Disease

Cardiovascular events, including arterial vascular occlusive events, peripheral arterial occlusive events and ischemic cerebrovascular events have been reported in patients receiving tyrosine kinase inhibitors. If acute signs or symptoms of cardiovascular events occur, patients should seek immediate medical attention. The cardiovascular status and risk factors of patients should be evaluated prior to therapy and cardiovascular monitoring and management should take place during treatment.

Moderate

Bcr-Abl Tyrosine Kinase Inhibitors (Includes Bosutinib) ↔ Fluid Retention

Moderate Potential Hazard, Moderate plausibility

Applies to: Pleural Effusion, Congestive Heart Failure, Fluid Retention, Pulmonary Impairment

Fluid retention occurs with BCR-ABL tyrosine kinase inhibitors therapy and may manifest as pericardial effusion, pleural effusion, pulmonary edema, and/or peripheral edema. Caution should be taken when using these drugs in patients with preexisting fluid retention or congestive heart failure. Monitor and manage patients using standards of care. Interrupt, reduce dose or discontinue therapy as necessary.

Moderate

Bcr-Abl Tyrosine Kinase Inhibitors- Bone Marrow Suppression

Moderate Potential Hazard, Moderate plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

Thrombocytopenia, aplastic anemia, agranulocytosis and neutropenia occur with BCR-ABL tyrosine kinase inhibitors. Therapy with these drugs should be administered cautiously in patients with preexisting bone marrow suppression. A complete blood count should be performed every 1-2 weeks for the first month of therapy and then monthly thereafter, or as clinically indicated. To manage myelosuppression, withhold, reduce dose, or discontinue therapy as necessary.

Moderate

Bosutinib (Includes Bosutinib) ↔ Dehydration

Moderate Potential Hazard, Moderate plausibility

Applies to: Diarrhea, Vomiting, Dehydration

Adequate hydration might be necessary during therapy with bosutinib as diarrhea, nausea, vomiting, and abdominal pain occur with treatment. Monitor and manage patients using standards of care, including antidiarrheals, antiemetics, and fluid replacement. To manage gastrointestinal toxicity, withhold, dose reduce, or discontinue bosutinib as necessary.

Moderate

Bosutinib (Includes Bosutinib) ↔ Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Bosutinib is primarily metabolized by the CYP 450 3A4. Therapy with bosutinib should be administered cautiously in patients with hepatic impairment and the starting dose should be 200 mg daily in patients with baseline hepatic impairment. The manufacturer recommends to perform hepatic enzyme tests monthly for the first three months of bosutinib treatment and as clinically indicated. In patients with transaminase elevations, monitor liver enzymes more frequently. Withhold, reduce dose, or discontinue bosutinib as necessary.

Moderate

Bosutinib (Includes Bosutinib) ↔ Renal Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

An on-treatment decline in estimated glomerular filtration rate (eGFR) has occurred in patients treated with bosutinib. The manufacturer recommends reducing the bosutinib starting dose in patients with severe (CrCl) less than 30 mL/min) or moderate (CrCl 30 to 50 mL/min) renal impairment at baseline. Consider dose adjustment in patients with baseline and treatment emergent renal impairment. It is recommended to monitor patients for renal function at baseline and during therapy with bosutinib, with particular attention to those patients who have preexisting renal impairment or risk factors for renal dysfunction.

bosutinib drug Interactions

There are 496 drug interactions with bosutinib

bosutinib alcohol/food Interactions

There is 1 alcohol/food interaction with bosutinib

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 2000-2017 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.

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