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Pomalidomide Disease Interactions

There are 7 disease interactions with pomalidomide:

Major

Pomalidomide (applies to pomalidomide) thromboembolism

Major Potential Hazard, Moderate plausibility. Applicable conditions: Thrombotic/Thromboembolic Disorder, History - Thrombotic/Thromboembolic Disorder

Pomalidomide may cause venous thromboembolic events (deep venous thrombosis and pulmonary embolism) and arterial thromboembolic events (myocardial infarction and stroke). It is recommended to initiate precautionary actions to try to minimize all modifiable factors (e.g., hyperlipidemia, hypertension, smoking) in patients with known risk factors, including those with prior thrombosis. Thromboprophylaxis is recommended, and the choice of regimen should be based on the assessment of the patient's underlying risk factors.

Moderate

Pomalidomide (applies to pomalidomide) hematologic toxicities

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

The use of pomalidomide has been associated with hematological toxicities, followed by anemia and thrombocytopenia. It is recommended to monitor patients for hematologic toxicities, especially neutropenia. Monitor complete blood counts weekly for the first 8 weeks and monthly thereafter and depending on findings, patients may require dose interruption and/or modification. Close monitoring is recommended.

Moderate

Pomalidomide (applies to pomalidomide) hepatic impairment

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

Pomalidomide is primarily metabolized in the liver by CYP450 1A2 and CYP450 3A4. Hepatic failure, including fatal cases, has occurred in patients treated with pomalidomide. Elevated levels of alanine aminotransferase and bilirubin have also been observed. Reduce the starting dose of pomalidomide by 25% (3 mg daily) in patients with mild to moderate hepatic impairment and by 50% (2 mg daily) in those patients with severe hepatic impairment. It is recommended to monitor liver function tests monthly and to stop treatment with pomalidomide upon elevation of liver enzymes. After return to baseline values, treatment at a lower dose may be considered.

Moderate

Pomalidomide (applies to pomalidomide) neuropathy

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Peripheral Neuropathy

The use of pomalidomide has been associated with the development of neuropathy. Therapy with pomalidomide should be administered cautiously in patients with or at risk for neuropathy. Monitor closely for signs and symptoms associated with neuropathy and evaluate patients accordingly.

Moderate

Pomalidomide (applies to pomalidomide) renal impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: hemodialysis

Pomalidomide pharmacokinetic parameters were not significantly affected in patients with moderate or severe renal impairment. Pomalidomide should be used with caution in patients with severe renal impairment requiring dialysis and it should be administered after the completion of hemodialysis on dialysis days as the exposure of the drug could be significantly increased. Dose modification, 25% dose reduction (3 mg daily) is recommended at the start of therapy in patients with severe renal impairment requiring dialysis. Close monitoring is recommended.

Moderate

Pomalidomide (applies to pomalidomide) smoking

Moderate Potential Hazard, Moderate plausibility.

Cigarette smoking reduces pomalidomide AUC by 32% due to CYP450 1A2 induction. Advise patients that smoking may reduce the efficacy of pomalidomide.

Moderate

Pomalidomide (applies to pomalidomide) tumor lysis syndrome

Moderate Potential Hazard, Moderate plausibility.

Tumor lysis syndrome (TLS) may occur in patients receiving pomalidomide. Patients with high tumor burden and those with high circulating lymphocyte counts of greater than 25 X 10^9/L have a higher risk of developing TLS. Monitor for signs and symptoms of TLS. Temporary interruption or discontinuation of therapy might be required.

Pomalidomide drug interactions

There are 299 drug interactions with pomalidomide

Pomalidomide alcohol/food interactions

There is 1 alcohol/food interaction with pomalidomide

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.