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Nelarabine Disease Interactions

There are 6 disease interactions with nelarabine:

Major

Nelarabine (applies to nelarabine) neurotoxicity

Major Potential Hazard, Moderate plausibility. Applicable conditions: Neurologic Disorder

Severe neurologic adverse reactions have been reported with the use of nelarabine. Neurotoxicity is the dose-limiting toxicity of nelarabine. Patients treated previously or concurrently with intrathecal chemotherapy or previously with craniospinal irradiation may be at increased risk for neurologic adverse events. Close monitoring for neurologic adverse reactions is strongly recommended, when using nelarabine and therapy should be discontinued for neurologic adverse reactions of NCI Common Toxicity Criteria Grade 2 or greater.

Major

Nelarabine (applies to nelarabine) vaccination

Major Potential Hazard, Moderate plausibility.

Immunocompromised patients receiving nelarabine should avoid receiving live vaccines.

Moderate

Nelarabine (applies to nelarabine) bone marrow depression

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts

Leukopenia, thrombocytopenia, anemia, and neutropenia, including febrile neutropenia, have been associated with nelarabine therapy. Care should be instituted when using this agent in patients with hematologic complications. Complete blood counts including platelets should be monitored regularly.

Moderate

Nelarabine (applies to nelarabine) liver dysfunction

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

The influence of hepatic impairment on the pharmacokinetics of nelarabine has not been evaluated. Because the risk of adverse reactions to this drug may be greater in patients with severe hepatic impairment (total bilirubin greater than 3 times upper limit of normal), it is recommended to closely monitor patients with severe liver dysfunction when treated with nelarabine.

Moderate

Nelarabine (applies to nelarabine) renal impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

Nelarabine is a prodrug of the cytotoxic deoxyguanosine analogue, 9-beta-D-arabinofuranosylguanine (ara-G). The pharmacokinetics of nelarabine and ara-G have not been specifically studied in renally impaired or hemodialyzed patients. Nelarabine is excreted by the kidney to a small extent (5% to 10% of the administered dose). Ara-G is excreted by the kidney to a greater extent (20% to 30% of the administered nelarabine dose) and Ara-G clearance decreased as renal function decreased. Because the risk of adverse reactions to this drug may be greater in patients with moderate (CrCl 30 to 50 mL/min) or severe (CrCl less than 30 mL/min) renal impairment, it is recommended that these patients be closely monitored for toxicities when treated.

Moderate

Nelarabine (applies to nelarabine) tumor lysis syndrome

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hyperuricemia Secondary to Chemotherapy

Patients receiving nelarabine should receive intravenous hydration according to standard medical practice for the management of hyperuricemia in patients at risk for tumor lysis syndrome. Consideration should be given to the use of allopurinol in patients at risk of hyperuricemia.

Nelarabine drug interactions

There are 237 drug interactions with nelarabine

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.