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Cladribine Novaplus (cladribine) Disease Interactions

There are 5 disease interactions with Cladribine Novaplus (cladribine):

Major

Antineoplastics (Includes Cladribine Novaplus) ↔ Infections

Severe Potential Hazard, High 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. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  5. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  6. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  7. "Product Information. Matulane (procarbazine)." Roche Laboratories, Nutley, NJ.
  8. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb, Princeton, NJ.
  9. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  10. "Product Information. Taxotere (docetaxel)." Rhone-Poulenc Rorer, Collegeville, PA.
  11. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  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. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
  14. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb, Princeton, NJ.
  15. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
  16. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
  17. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
  18. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn, Kalamazoo, MI.
  19. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories, Wayne, NJ.
  20. "Product Information. Xeloda (capecitabine)." Roche Laboratories, Nutley, 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. Nipent (pentostatin)." Parke-Davis, Morris Plains, NJ.
  23. "Product Information. DTIC-Dome (dacarbazine)." Bayer, West Haven, CT.
  24. 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
  25. "Product Information. Tabloid (thioguanine)." Glaxo Wellcome, Research Triangle Park, NC.
  26. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.
  27. "Product Information. Thiotepa (thiotepa)." Lederle Laboratories, Wayne, NJ.
  28. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  29. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
  30. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation, Eatontown, 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

Cladribine (Includes Cladribine Novaplus) ↔ Myelosuppression

Severe Potential Hazard, High plausibility

Applies to: Bleeding, Fever, Bone Marrow Depression/Low Blood Counts

Cladribine induces myelosuppression, primarily affecting lymphocytes and monocytes, however, neutropenia, anemia, and thrombocytopenia have been reported during cladribine therapy. Myelosuppressive effects are most notable the first month following therapy and may require red blood cell and/or platelet transfusions. Therapy with cladribine should be administered cautiously in patients whose bone marrow reserve may be severely depressed by prior chemotherapy or whose marrow function is recovering from previous cytotoxic therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.

References

  1. Juliusson G, Liliemark J "Rapid recovery from cytopenia in hairy cell leukemia after treatment with 2-chloro-2'-deoxyadenosine (CdA): relation to opportunistic infections." Blood 79 (1992): 888-94
  2. Fleischman RA, Croy D "Acute onset of severe autoimmune hemolytic anemia after treatment with 2-chlorodeoxyadenosine for chronic lymphocytic leukemia." Am J Hematol 48 (1995): 293
  3. Betticher DC, Fey MF, Rabaglio M, Cerny T, Hess U, Meier V, Stalder M, Zulian G "Cladribine and severe myelotoxicity." Lancet 342 (1993): 1369
  4. Bryson HM, Sorkin EM "Cladribine. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in haematological malignancies." Drugs 46 (1993): 872-94
View all 4 references
Major

Cladribine (Includes Cladribine Novaplus) ↔ Neurological Disorders

Severe Potential Hazard, Low plausibility

Applies to: Neurologic Disorder

Severe unspecified neurological toxicity has been reported rarely during cladribine therapy administered at therapeutic doses. Serious neurological toxicity such as irreversible paraparesis and quadriparesis has been reported in patients receiving four to nine times the recommended dosage of cladribine for hairy cell leukemia. Therapy with cladribine should be administered cautiously to patients with or predisposed to neurological impairment.

References

  1. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
Moderate

Cladribine (Includes Cladribine Novaplus) ↔ Hepatic Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

The pharmacokinetic disposition of cladribine has not be fully assessed. The effect of hepatic impairment on the elimination of cladribine is not known. Therapy with cladribine should be administered cautiously in patient with existing or predisposition to compromised hepatic function. Clinical monitoring of hepatic function is recommended.

References

  1. Bryson HM, Sorkin EM "Cladribine. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in haematological malignancies." Drugs 46 (1993): 872-94
  2. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
Moderate

Cladribine (Includes Cladribine Novaplus) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

The effect of renal impairment on the elimination of cladribine has not been assessed in humans. Renal toxicity such as acidosis, anuria, elevated serum creatinine has been reported with doses four to nine times the recommended dosage of cladribine for hairy cell leukemia. Therapy with cladribine should be administered cautiously in patient with compromised renal function. Clinical monitoring of renal function is recommended.

References

  1. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.

Cladribine Novaplus (cladribine) drug Interactions

There are 348 drug interactions with Cladribine Novaplus (cladribine)

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.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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