Skip to Content

Oforta (fludarabine) Disease Interactions

There are 6 disease interactions with Oforta (fludarabine):

Major

Antineoplastics (applies to Oforta) infections

Major Potential Hazard, High plausibility. Applicable conditions: 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. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Doxil (doxorubicin liposomal)." Sequis Pharmaceuticals Inc, Menlo Park, CA.
  4. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  5. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  6. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  7. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
  8. "Product Information. Matulane (procarbazine)." Roche Laboratories, Nutley, NJ.
  9. 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
  10. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb, Princeton, NJ.
  11. "Product Information. Tabloid (thioguanine)." Prasco Laboratories, Cincinnati, OH.
  12. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  13. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  14. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
  15. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
  16. 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
  17. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn, Kalamazoo, MI.
  18. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories, Wayne, NJ.
  19. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
  20. "Product Information. Xeloda (capecitabine)." Roche Laboratories, Nutley, NJ.
  21. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
  22. 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
  23. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
  24. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  25. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.
  26. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation, Eatontown, NJ.
  27. "Product Information. Taxotere (docetaxel)." Rhone-Poulenc Rorer, Collegeville, PA.
  28. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb, Princeton, NJ.
  29. "Product Information. Nipent (pentostatin)." Hospira Inc, Lake Forest, IL.
  30. "Product Information. DTIC-Dome (dacarbazine)." Bayer, West Haven, CT.
  31. "Product Information. Thiotepa (thiotepa)." Hikma USA (formerly West-Ward Pharmaceutical Corporation), Eatontown, NJ.
View all 31 references
Major

Fludarabine (applies to Oforta) hemolytic anemia

Major Potential Hazard, Moderate plausibility.

Life-threatening and sometimes fatal autoimmune hemolytic anemia has been reported in patients with and without previous history of autoimmune hemolytic anemia or a positive Coombs' test during fludarabine therapy. Risk factors that predispose patients to this complication have not been identified. Patients should be instructed to immediately report signs and symptoms suggesting anemia such as fatigue, weakness, and/or bloody urine. Therapy with fludarabine should be administered cautiously in patients with anemia and those with a history of or a predisposition to hemolytic syndromes. Close clinical monitoring of hematopoietic function for hemolysis and anemia is recommended.

References

  1. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
  2. Maclean R, Meiklejohn D, Soutar R "Fludarabine-related autoimmune haemolytic anaemia in patients with chronic lymphocytic leukaemia." Br J Haematol 92 (1996): 768-9
Major

Fludarabine (applies to Oforta) myelosuppression

Major Potential Hazard, High plausibility. Applicable conditions: Bleeding, Fever, Bone Marrow Depression/Low Blood Counts

Fludarabine can severely suppress bone marrow function. Leukopenia, thrombocytopenia, and anemia have been reported during fludarabine 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. Therapy with fludarabine should be administered cautiously in patients with bone marrow suppression. Close clinical monitory of hematopoietic function is recommended.

References

  1. Keating MJ, Estey E, O'Brien S, Kantarjian H, Robertson LE, Plunkett W "Clinical experience with fludarabine in leukaemia." Drugs 47 Suppl 6 (1994): 39-49
  2. Woodcock BE "Cytopenia and fludarabine." Lancet 342 (1993): 1049
  3. Leporrier M, Reman O, Troussard X "Pure red-cell aplasia with fludarabine for chronic lymphocytic leukaemia." Lancet 342 (1993): 555
  4. Zinzani PL, Tabanelli M, Bendandi M, Tura S "Prolonged bone marrow aplasia of refractory prolymphocytoid variant of B-cell chronic lymphocytic leukemia related to fludarabine treatment." Eur J Haematol 53 (1994): 56-8
  5. 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
  6. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
  7. 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
  8. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
View all 8 references
Moderate

Fludarabine (applies to Oforta) peripheral neuropathy

Moderate Potential Hazard, Low plausibility.

Peripheral neuropathy has been reported in patients during fludarabine therapy. Therapy with fludarabine should be administered cautiously in patients with a history of or predisposition to neuropathy.

References

  1. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
Moderate

Fludarabine (applies to Oforta) renal dysfunction

Moderate Potential Hazard, Moderate plausibility.

Fludarabine is primarily eliminated by the kidney and it should be administered cautiously in patients with renal insufficiency. Patients with moderate impairment of renal function (creatinine clearance 30 to 70 mL/min/1.73 m2) should have their fludarabine dose reduced by 20% and be monitored closely. Fludarabine is not recommended for patients with severely impaired renal function (creatinine clearance less than 30 mL/min/1.73 m2).

References

  1. Malspeis L, Grever MR, Staubus AE, Young D "Pharmacokinetics of 2-F-ara-A (9-B-D-Arabinofuranosyl-2-fluoroadenine) in cancer patients during the phase I clinical investigation of fludarabine phosphate." Semin Oncol 17 (1990): 18-32
  2. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
Moderate

Fludarabine (applies to Oforta) transfusion/graft-vs-host disease

Moderate Potential Hazard, High plausibility. Applicable conditions: Blood Transfusion

Transfusion- associated graft-versus-host disease has been observed rarely after transfusion of non-irradiated blood in fludarabine treated patients. Consideration should, therefore, be given to the use of irradiated blood products in those patients requiring transfusions while undergoing treatment with fludarabine.

References

  1. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.

Oforta (fludarabine) drug interactions

There are 243 drug interactions with Oforta (fludarabine)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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 interaction information available.

Further information

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