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Pepaxto (melphalan flufenamide) Disease Interactions

There are 3 disease interactions with Pepaxto (melphalan flufenamide):

Major

Antineoplastics (Includes Pepaxto) infections

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

Melphalan flufenamide (Includes Pepaxto) bone marrow suppression

Moderate Potential Hazard, Moderate plausibility. Applies to: Bone Marrow Depression/Low Blood Counts

Bone marrow suppression is the most significant toxicity associated with melphalan flufenamide in most patients. It is recommended to perform the following tests at the start of therapy and prior to each subsequent dose of melphalan flufenamide: platelet count, hemoglobin, white blood cell count, and differential. Thrombocytopenia and/or neutropenia are indications to withhold further therapy until the blood counts have sufficiently recovered. Monitor blood counts frequently to determine optimal dosage and to avoid toxicity. Consider prophylactic therapy such as leukocyte growth factor as clinically appropriate. Dose adjustment on the basis of blood counts at the nadir and day of treatment should be considered.

Moderate

Melphalan flufenamide (Includes Pepaxto) renal dysfunction

Moderate Potential Hazard, Moderate plausibility. Applies to: Renal Dysfunction

No dose adjustment of melphalan flufenamide is recommended in patients with creatinine clearance (CrCl) 45 to 89 mL/min. Care should be exercised when using this agent in patients with CrCl 15 to 44 mL/min as the safety and efficacy has not been studied in these patients.

Pepaxto (melphalan flufenamide) drug interactions

There are 203 drug interactions with Pepaxto (melphalan flufenamide)

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.