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Orthoclone OKT3 Disease Interactions

There are 4 disease interactions with Orthoclone OKT3 (muromonab-cd3).

Major

Muromonab-CD3 (applies to Orthoclone OKT3) cardiovascular dysfunction

Major Potential Hazard, High plausibility. Applicable conditions: Congestive Heart Failure, Arrhythmias, Ischemic Heart Disease

The use of muromonab-CD3 is contraindicated in patients with uncompensated heart failure. Cardiovascular collapse, cardiac arrest, severe hypotension, shock, left ventricular dysfunction, and arrhythmias have occurred in patients administered muromonab-CD3. Patients with cardiovascular impairments are at increased risk for more serious cardiorespiratory complications (respiratory arrest, failure, distress, and/or cardiovascular collapse, cardiac arrest, angina, or myocardial infarction) from muromonab-CD3-associated Cytokine Release Syndrome.

References

  1. Hollenbeck M, Westhoff A, Bach D, Grabensee B, Kolvenbach R, Kniemeyer HW "Doppler sonography and renal graft vessel thromboses after OKT3 treatment." Lancet 340 (1992): 619-20
  2. Abramowicz D, Pradier O, Marchant A, Florquin S, De Pauw L, Vereerstraeten P, Kinnaert P, Vanherweghem JL, Goldman M "Induction of thromboses within renal grafts by high-dose prophylactic OKT3." Lancet 339 (1992): 777-8
  3. Spieker C, Zidek W, Barenbrock M, Wieneke R, Buchholz B, Rahn KH "Acute hypertension after renal allograft rejection therapy with OKT3 monoclonal antibody." J Int Med Res 19 (1991): 419-23
  4. Pradier O, Marchant A, Abramowicz D, De Pauw L, Vereerstraeten P, Kinnaert P, Vanherweghem JL, Capel P, Goldman M "Procoagulant effect of the OKT3 monoclonal antibody: involvement of tumor necrosis factor." Kidney Int 42 (1992): 1124-9
  5. Costanzo-Nordin MR "Cardiopulmonary effects of OKT3: determinants of hypotension, pulmonary edema, and cardiac dysfunction." Transplant Proc 25 (1993): 21-4
  6. Spieker C, Barenbrock M, Buchholz B, Heidenreich S, Zidek W "Cardiovascular effects of ATG and OKT3 in renal allograft recipients." Transplant Proc 24 (1992): 2594-5
  7. "Product Information. Orthoclone OKT3 (muromonab-CD3)." Ortho McNeil Pharmaceutical
  8. Sgro C "Side-effects of a monoclonal antibody, muromonab CD3 orthoclone OKT3: bibliographic review." Toxicology 105 (1995): 23-9
View all 8 references
Major

Muromonab-CD3 (applies to Orthoclone OKT3) neuro/psychiatric dysfunction

Major Potential Hazard, High plausibility. Applicable conditions: Cerebral Vascular Disorder, Seizures, Head Injury

The use of muromonab-CD3 is contraindicated in patients with or predisposed to seizures. Seizures, cerebral edema, confusion, auditory/visual hallucinations, mental status changes, psychosis, mania, lethargy, stupor, or coma have occurred in patients administered muromonab-CD3. Patient with CNS disorders, cerebrovascular disease, neurological disturbances are at increased risk for neuro/psychiatric events.

References

  1. Coleman AE, Norman DJ "OKT3 Encephalopathy." Ann Neurol 28 (1990): 837
  2. Capone PM, Cohen ME "Seizures and cerebritis associated with administration of OKT3." Pediatr Neurol 7 (1991): 299-301
  3. Shihab FS, Barry JM, Norman DJ "Encephalopathy following the use of OKT3 in renal allograft transplantation." Transplant Proc 25 (1993): 31-4
  4. Jeffrey RF, Johnson MH, Bamford JM, Giles GR, Brownjohn AM, Will EJ "Prolonged neurological disability following OKT3 therapy for acute renal transplant rejection." Transplantation 55 (1993): 677-9
  5. "Product Information. Orthoclone OKT3 (muromonab-CD3)." Ortho McNeil Pharmaceutical
  6. Kehinde EO, Scriven SD, Feehally J, Veitch PS, Varty K, Bell PRF "Adverse effects of OKT3 therapy: increased risk with impaired renal function." Transplant Proc 26 (1994): 1945-7
  7. Sgro C "Side-effects of a monoclonal antibody, muromonab CD3 orthoclone OKT3: bibliographic review." Toxicology 105 (1995): 23-9
View all 7 references
Major

Muromonab-CD3 (applies to Orthoclone OKT3) volume overload

Major Potential Hazard, High plausibility. Applicable conditions: Fluid Retention

The use of muromonab-CD3 is contraindicated in patients with fluid overload as evidences by chest X-ray or a 3% or more weight gain in the week prior to muromonab-CD3 therapy. Patients with fluid overload are at increased risk for more serious cardiopulmonary complications (respiratory arrest, failure, distress, and/or cardiovascular collapse, cardiac arrest, angina, or myocardial infarction) from muromonab-CD3-associated Cytokine Release Syndrome.

References

  1. Todd PA, Brogden RN "Muromonab CD3. A review of its pharmacology and therapeutic potential." Drugs 37 (1989): 871-99
  2. "Product Information. Orthoclone OKT3 (muromonab-CD3)." Ortho McNeil Pharmaceutical
  3. Sgro C "Side-effects of a monoclonal antibody, muromonab CD3 orthoclone OKT3: bibliographic review." Toxicology 105 (1995): 23-9
Moderate

Muromonab-CD3 (applies to Orthoclone OKT3) fever

Moderate Potential Hazard, Moderate plausibility.

Muromonab-CD3 should not be administered in the presence of a body temperature of 100 degrees F (38.7 degrees C) or greater. Spiking fever (to 107 degrees F) associated with the Cytokine Release Syndrome have occurred. Antipyretics may be administered to reduce body temperature in this setting.

References

  1. Shield CF II, Kahana L, Pirsch J, et al. "Use of indomethacin to minimize the adverse reactions associated with orthoclone OKT3 treatment of kidney allograft rejection." Transplantation 54 (1992): 164-6
  2. Todd PA, Brogden RN "Muromonab CD3. A review of its pharmacology and therapeutic potential." Drugs 37 (1989): 871-99
  3. Agarwal RK, Ostaszewski ML, Feld LG, Springate JE, Moxey-Mims MM, O'Neil KM "Tumor necrosis factor and interleukin-6 in cerebrospinal fluid of a patient with recurrent adverse central nervous system events following OKT3." Transplant Proc 25 (1993): 2143-4
  4. Radhakrishnan J, Cohen DJ "Cytokine-release syndrome: general risk-factor modification-- preparation of high-risk patients for use of OKT3." Transplant Proc 25 (1993): 60-2
  5. First MR, Schroeder TJ, Hariharan S, Weiskittel P "Reduction of the initial febrile response to OKT3 with indomethacin." Transplant Proc 25 (1993): 52-4
  6. Chatenoud L "OKT3-induced cytokine-release syndrome: prevention effect of anti-tumor necrosis factor monoclonal antibody." Transplant Proc 25 (1993): 47-51
  7. Doutrelepont JM, Abramowicz D, Borre B, Lemoine A, De Pauw L, Kinnaert P, Vereerstraeten P, Vanherweghem JL, Goldman M "Prophylactic OKT3: practical considerations for the prevention of first-dose reactions." Transplant Proc 25 (1993): 45-6
  8. Norman DJ, Kimball JA, Barry JM "Cytokine-release syndrome: differences between high and low doses of OKT3." Transplant Proc 25 (1993): 35-8
  9. Jeyarajah DR, Thistlethwaite JR, Jr "General aspects of cytokine-release syndrome: timing and incidence of symptoms." Transplant Proc 25 (1993): 16-20
  10. Shihab F, Barry JM, Bennett WM, Meyer MM, Norman DJ "Cytokine-related encephalopathy induced by OKT3: incidence and predisposing factors." Transplant Proc 25 (1993): 564-5
  11. First MR, Schroeder TJ, Hariharan S, Alexander JW, Weiskittel P "The effect of indomethacin on the febrile response following OKT3 therapy." Transplantation 53 (1992): 91-4
  12. Hall KA, Dole EJ, Hunter GC, Zukoski CF, Putnam CW "Hyperpyrexia-related ventricular tachycardia during OKT3 induction therapy." Transplantation 54 (1992): 1112-3
  13. "Product Information. Orthoclone OKT3 (muromonab-CD3)." Ortho McNeil Pharmaceutical
  14. Devault GA, Kohan DE, Nelson EW, Holman JM "The effects of oral pentoxifylline on the cytokine release syndrome during inductive OKT3." Transplantation 57 (1994): 532-40
  15. Sgro C "Side-effects of a monoclonal antibody, muromonab CD3 orthoclone OKT3: bibliographic review." Toxicology 105 (1995): 23-9
View all 15 references

Orthoclone OKT3 drug interactions

There are 163 drug interactions with Orthoclone OKT3 (muromonab-cd3).

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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.

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