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Drug Interactions between A-G Profen and pegaspargase

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

ibuprofen pegaspargase

Applies to: A-G Profen (ibuprofen) and pegaspargase

MONITOR: Asparaginase therapy may lead to imbalances in coagulation factors predisposing the patient to bleeding or thrombosis. Theoretically, concurrent use of anticoagulants and asparaginase may increase the risk of bleeding. Hemorrhages grade 3 and above and CNS hemorrhages have been observed with asparaginase treatment. However, serious thromboembolic events have also been reported with the use of asparaginase. Some investigators have suggested that anticoagulants could be used prophylactically with asparaginase for the prevention of thromboembolic events.

MANAGEMENT: Coagulation parameters should be monitored at baseline and periodically during concomitant treatment with asparaginase and anticoagulants such as heparin, dipyridamole, aspirin and nonsteroidal anti-inflammatory drugs. Patients should be advised to promptly report any signs and symptoms of bleeding.

References

  1. "Product Information. Oncaspar (pegaspargase)." Rhone Poulenc Rorer PROD (2001):
  2. "Product Information. Elspar (asparaginase)." Merck & Co., Inc PROD (2001):
  3. Kieslich M, Porto L, Lanfermann H, Jacobi G, Schwabe D, Bohles H "Cerebrovascular complications of L-asparaginase in the therapy of acute lymphoblastic leukemia." J Pediatr Hematol Oncol 25 (2003): 484-7
  4. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  5. Cerner Multum, Inc. "Australian Product Information." O 0
  6. "Product Information. Erwinaze (asparaginase Erwinia chrysanthemi)." EUSA Pharma PROD
  7. "Product Information. Asparlas (calaspargase pegol)." Servier (2019):
  8. Duarte X, Esteves S, Neto AM, Pereira F "Incidence and risk factors for central nervous system thrombosis in paediatric acute lymphoblastic leukaemia during intensive asparaginase treatment: a single-centre study." Br J Haematol 174 (2016): 280-91
  9. Caruso V, Iacoviello L, Di Castelnuovo A, et al. "Thrombotic complications in childhood acute lymphoblastic leukemia: a meta-analysis of 17 prospective studies comprising 1752 pediatric patients." Blood 108 (2006): 2216-22
  10. Mitchell L, Andrew M, Hanna K, et al. "Trend to efficacy and safety using antithrombin concentrate in prevention of thrombosis in children receiving l-asparaginase for acute lymphoblastic leukemia. Results of the PAARKA study." Thromb Haemost 90 (2003): 235-44
  11. Elice F, Rodeghiero F "Hematologic malignancies and thrombosis." Thromb Res 129 (2012): 360-6
  12. Truelove E, Fielding AK, Hunt BJ "The coagulopathy and thrombotic risk associated with L-asparaginase treatment in adults with acute lymphoblastic leukaemia." Leukemia 27 (2013): 553-9
  13. Grace RF, DeAngelo DJ, Stevenson KE, et al. "The use of prophylactic anticoagulation during induction and consolidation chemotherapy in adults with acute lymphoblastic leukemia." J Thromb Thrombolysis 45 (2018): 306-14
View all 13 references

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Drug and food interactions

Moderate

ibuprofen food

Applies to: A-G Profen (ibuprofen)

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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