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Sargramostim Disease Interactions

There are 8 disease interactions with sargramostim:

Major

Sargramostim (Includes Sargramostim) ↔ Arrhythmia

Severe Potential Hazard, Moderate plausibility

Applies to: Cardiovascular Disease

Transient supraventricular arrhythmia has been reported occasionally during sargramostim administration, particularly in patients with a history of cardiac arrhythmias. Therapy with sargramostim should be administered cautiously in patients with preexisting cardiac disease.

References

  1. "Product Information. Leukine (sargramostim)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Prokine (sargramostim)." Hoechst Marion-Roussel Inc, Kansas City, MO.
Major

Sargramostim (Includes Sargramostim) ↔ Fluid Retention

Severe Potential Hazard, Moderate plausibility

Applies to: Congestive Heart Failure, Fluid Retention

Sargramostim may cause fluid retention. Edema, capillary leak syndrome, and pleural and/or pericardial effusion have been reported. Therapy with sargramostim should be administered cautiously in patients with preexisting fluid retention or congestive heart failure. Fluid retention caused or worsened by sargramostim is often reversible following discontinuation of therapy or reduction in dosage, with or without diuretic administration.

References

  1. "Product Information. Prokine (sargramostim)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  2. Grant SM, Heel RC "Recombinant granulocyte-macrophage colony-stimulating factor (rGM- CSF). A review of its pharmacological properties and prospective role in the management of myelosuppression." Drugs 43 (1992): 516-60
  3. "Product Information. Leukine (sargramostim)." Immunex Corporation, Seattle, WA.
Major

Sargramostim (Includes Sargramostim) ↔ Hepatic Dysfunction

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

In patients with preexisting hepatic impairment, the administration of sargramostim may induce elevations of bilirubin and liver enzymes, which are generally reversible following a dosage reduction or therapy interruption. Monitoring of hepatic function before treatment initiation, and at least every other week during therapy is recommended.

References

  1. "Product Information. Leukine (sargramostim)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Prokine (sargramostim)." Hoechst Marion-Roussel Inc, Kansas City, MO.
Major

Sargramostim (Includes Sargramostim) ↔ Leukocytosis

Severe Potential Hazard, High plausibility

Applies to: Leukocytosis

Sargramostim is a growth factor for hematopoietic progenitor cells. Therefore, it should not be used in patients with leukocytosis. During sargramostim treatment, if the absolute neutrophil count (ANC) exceeds 20,000 cells/mm3 or white blood cell count (WBC) exceeds 50,000 cells/mm3, therapy should be interrupted or the dosage reduced by half, depending on the clinical condition of the patient. Blood counts generally return to normal or baseline levels within 3 to 7 days of stopping therapy.

References

  1. "Product Information. Leukine (sargramostim)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Prokine (sargramostim)." Hoechst Marion-Roussel Inc, Kansas City, MO.
Major

Sargramostim (Includes Sargramostim) ↔ Myeloid Tumors

Severe Potential Hazard, Moderate plausibility

Applies to: Myeloproliferative Disorder

Sargramostim primarily stimulates the proliferation of normal myeloid precursor cells but may also, theoretically, enhance tumor growth, particularly in myeloid malignancies. Therapy with sargramostim should be administered cautiously in patients with myeloid tumors. Additionally, if sargramostim is used for PBPC (peripheral blood progenitor cell) collection in such patients, tumor cells may be released from the marrow and collected in the leukapheresis product. The effect of reinfusion of tumor cells is uncertain at this time.

References

  1. "Product Information. Leukine (sargramostim)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Prokine (sargramostim)." Hoechst Marion-Roussel Inc, Kansas City, MO.
Major

Sargramostim (Includes Sargramostim) ↔ Renal Dysfunction

Severe Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

In patients with preexisting renal impairment, the administration of sargramostim may induce elevations of serum creatinine, which are generally reversible following a dosage reduction or therapy interruption. Monitoring of renal function at least every other week during therapy is recommended.

References

  1. "Product Information. Leukine (sargramostim)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Prokine (sargramostim)." Hoechst Marion-Roussel Inc, Kansas City, MO.
Major

Sargramostim (Includes Sargramostim) ↔ Respiratory Symptoms

Severe Potential Hazard, Moderate plausibility

Applies to: Pulmonary Impairment, Asphyxia

Sargramostim may cause an influx of granulocytes in the pulmonary circulation. Dyspnea has been reported occasionally during or after treatment. Therapy with sargramostim should be administered cautiously in patients with lung disease or hypoxia. Respiratory status should be monitored during and immediately after therapy, and the infusion rate reduced by half if dyspnea occurs during IV administration. In patients who do not respond to the rate reduction or experience a worsening of symptoms, the infusion should be discontinued. For subsequent infusions, the standard rate schedule may be resumed (with careful monitoring), since respiratory symptoms often do not recur within the same treatment cycle.

References

  1. Rosenfeld CS, Sulecki M, Evans C, Shadduck RK "Comparison of intravenous versus subcutaneous recombinant human GM-CSF in patients with primary myelodysplasia." Exp Hematol 19 (1991): 273-7
  2. "Product Information. Prokine (sargramostim)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  3. Nemunaitis J, Buckner CD, Appelbaum FR, Higano CS, Mori M, Bianco J, Epstein C, Lipani J, Hansen J, Storb R, et al "Phase I/II trial of recombinant human granulocyte-macrophage colony- stimulating factor following allogeneic bone marrow transplantation." Blood 77 (1991): 2065-71
View all 5 references
Moderate

Sargramostim (Includes Sargramostim) ↔ Prematurity

Moderate Potential Hazard, Moderate plausibility

Applies to: Prematurity/Underweight in Infancy

The use of Leukine (brand of sargramostim) liquid or lyophilized powder reconstituted with Bacteriostatic Water for Injection is considered by the drug manufacturer to be contraindicated in neonates, particularly premature infants and infants of low birth weight. These preparations contain benzyl alcohol which, in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions, has been associated with fatalities and severe respiratory and metabolic complications in low-birth-weight premature infants. However, many experts feel that, in the absence of benzyl alcohol- free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. Continuous infusions of high dosages of medications containing benzyl alcohol may, however, cause toxicity and should be avoided if possible.

References

  1. ""Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics Committee on Drugs. Available from: URL: http://www.aap.org/policy/re9706.html." Pediatrics 99 (1997): 268-78
  2. "Product Information. Leukine (sargramostim)." Immunex Corporation, Seattle, WA.
  3. "Product Information. Prokine (sargramostim)." Hoechst Marion-Roussel Inc, Kansas City, MO.

sargramostim drug Interactions

There are 127 drug interactions with sargramostim

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

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