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Lapatinib Disease Interactions

There are 7 disease interactions with lapatinib:

Major

Egfr Inhibitors (Includes Lapatinib) ↔ Dermatologic Toxicities

Severe Potential Hazard, Moderate plausibility

Applies to: Dermatitis - Drug-Induced

Cutaneous reactions, in some cases severe, have been reported with the use of EGFR inhibitors. Monitor patients who develop dermatologic or soft tissue toxicities while receiving these agents for the development of inflammatory or infectious sequelae. It is recommended to withhold treatment, and appropriate measures should be instituted as appropriate or discontinue the use of these agents for dermatologic or soft tissue toxicity associated with severe or life-threatening inflammatory or infectious complications. Advise patients to wear sunscreen and hats and limit sun exposure while receiving therapy with these agents as exposure to sunlight can exacerbate dermatologic toxicities.

Major

Egfr Inhibitors (Includes Lapatinib) ↔ Cardiomyopathy

Severe Potential Hazard, Moderate plausibility

Applies to: Congestive Heart Failure, Cardiomyopathy, Pulmonary Edema

Cardiomyopathy was observed in clinical trials of certain EGFR inhibitors. Assess Left Ventricular Ejection Fraction (LVEF) by echocardiogram or multigated acquisition (MUGA) scan before initiation of these agents and then at 3 month intervals while on treatment. Caution is recommended when prescribing these agents to patients with conditions that could impair left ventricular function and it is recommended to withhold treatment with these agents if ejection fraction drops below the established lower limit of normal. For symptomatic congestive heart failure or persistent, asymptomatic LV dysfunction that does not resolve within 4 weeks, permanently discontinue these agents.

Major

Egfr Inhibitors (Includes Lapatinib) ↔ Pulmonary Toxicity

Severe Potential Hazard, Moderate plausibility

Applies to: Pulmonary Impairment, Fever

The use of certain EGFR inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, permanently discontinue these agents and institute appropriate measures.

Major

Egfr Inhibitors (Includes Lapatinib) ↔ Qt Prolongation

Severe Potential Hazard, Moderate plausibility

Applies to: Arrhythmias, Congestive Heart Failure, Long QT Syndrome

QT prolongation was observed in patients treated with certain EGFR inhibitors. These agents should be administered with caution in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those who are taking medications known to prolong the QTc interval. Serum electrolytes should be corrected prior to initiating therapy with these agents. Periodic monitoring of ECGs and electrolytes is recommended in these patients. Permanently discontinue the use of these agents in patients who develop QTc interval prolongation with signs/symptoms of life-threatening arrhythmia.

Major

Her2 Inhibitors (Includes Lapatinib) ↔ Pulmonary Toxicity

Severe Potential Hazard, Moderate plausibility

Applies to: Pulmonary Impairment

Pulmonary toxicity, sometimes fatal has been reported with agents that block HER2 activity. Pulmonary toxicity includes dyspnea, interstitial pneumonitis, pulmonary infiltrates, pleural effusions, non-cardiogenic pulmonary edema, pulmonary insufficiency and hypoxia, acute respiratory distress syndrome, and pulmonary fibrosis. Patients with symptomatic intrinsic lung disease or with extensive tumor involvement of the lungs, resulting in dyspnea at rest may be at increased risk of pulmonary toxicity and appear to have more severe toxicity. Patients should be monitored for pulmonary symptoms. Permanently discontinue treatment with these agents in patients diagnosed with interstitial lung disease or pneumonitis and institute appropriate care.

Moderate

Her2 Inhibitors (Includes Lapatinib) ↔ Chf

Moderate Potential Hazard, Moderate plausibility

Applies to: Arrhythmias, Congestive Heart Failure, Hypertension, Myocardial Infarction, History - Myocardial Infarction, Post MI Syndrome

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with prior history of heart conditions. Evaluate cardiac function before, during and upon completion of treatment. Discontinue treatment with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further, unless the benefits for the individual patient outweigh the risks.

Moderate

Her2 Inhibitors (Includes Lapatinib) ↔ Thrombocytopenia

Moderate Potential Hazard, Moderate plausibility

Applies to: Thrombocytopenia

Thrombocytopenia has been reported with the use of agents that block HER2 activity. Monitor platelet counts prior to initiation of therapy and prior to each dose. If appropriate modify the dose according to clinical guidelines. Patients with decreased platelet count and patients on anti-coagulant treatment should be closely monitored during treatment with these agents.

lapatinib drug Interactions

There are 627 drug interactions with lapatinib

lapatinib alcohol/food Interactions

There are 2 alcohol/food interactions with lapatinib

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 2000-2016 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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