Portrazza Disease Interactions

The use of certain EGFR inhibitors has been associated with progressive decreases in serum magnesium levels leading to severe cases of hypomagnesemia and accompanying electrolyte abnormalities, including hypocalcemia, and hypokalemia. The onset of hypomagnesemia and accompanying electrolyte abnormalities occurred days to months after initiation of these agents. Periodically monitor patients for hypomagnesemia, hypocalcemia, and hypokalemia, during and for at least 8 weeks following the completion of therapy. Caution is recommended when using these agents in patients predisposed to electrolyte imbalances and those with a history of coronary artery disease, congestive heart failure, or arrhythmias. Replete magnesium and other electrolytes as appropriate.

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.

Some epidermal growth factor receptor (EGFR) inhibitors should be administered cautiously in patients with ocular disorders such as primary keratitis, ulcerative keratitis, or conjunctivitis. It is recommended to interrupt or discontinue treatment with these agents if patients present with acute or worsening ocular disorders.

Venous and arterial thromboembolic events (VTE and ATE), some fatal, were observed with necitumumab in combination with gemcitabine and cisplatin. Caution is recommended when using necitumumab in patients with a reported history of VTE or ATE. Necitumumab should be discontinued in patients with serious or life threatening VTE or ATE.

No formal studies have been conducted to evaluate the effect of renal and hepatic impairment on the exposure to necitumumab. Renal function and mild or moderate hepatic impairment has no influence on the exposure to necitumumab based on the population pharmacokinetic analysis. No data is available for patients with severe hepatic impairment. Cation and monitoring is recommended for these patients.