Can you take Acalabrutinib with Chloramphenicol / hydrocortisone / polymyxin b ophthalmic?
1 drug interaction and 12 additional warnings found for the following 2 drugs:
- acalabrutinib
- chloramphenicol/hydrocortisone/polymyxin b ophthalmic
Drug interactions
Moderate drug interactions
Moderate:
chloramphenicol ophthalmic acalabrutinib
Applies to: chloramphenicol / hydrocortisone / polymyxin b ophthalmic and acalabrutinib
After using chloramphenicol ophthalmic, some of the medication may be absorbed into the bloodstream and may increase the risk of side effects that affect your bone marrow function, resulting in low numbers of different types of blood cells. Using chloramphenicol ophthalmic together with acalabrutinib may further increase those risks. You may be more likely to develop anemia, bleeding problems or infections due to low blood cell counts. Although serious side effects are not very common with medications administered to the eyes, ears, or vagina because only limited amounts of the medication generally get absorbed into the bloodstream, they can sometimes occur. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need more frequent monitoring to safely use both medications. You should seek medical attention if you develop paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Major food/lifestyle interactions
Major:
acalabrutinib Food/Lifestyle
Applies to: acalabrutinib
Acalabrutinib may be taken with or without food. However, consumption of grapefruit and grapefruit juice can increase the blood levels of acalabrutinib. This may increase side effects such as nausea, vomiting, diarrhea, abdominal pain, hemorrhage, development of other cancers, abnormal heart rhythm, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. You should avoid the consumption of grapefruit and grapefruit juice during treatment with acalabrutinib. Be sure to take the medication at approximately the same time(s) every day to maintain consistent blood levels and effects. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
11 potential interactions Applies to: 10 conditions, including Arrhythmia, Eye Conditions, Cataract, Liver Disease, and Infection.
Arrhythmia
Moderate:
acalabrutinib
Acalabrutinib has a moderate potential interaction with Arrhythmia.
Atrial fibrillation and atrial flutter have been observed in patients treated with acalabrutinib. It is recommended to monitor patients with abnormal heart rhythm for atrial fibrillation and atrial flutter and manage as clinically appropriate.
Bleeding Disorder
Moderate:
acalabrutinib
Acalabrutinib has a moderate potential interaction with Bleeding Disorder.
Serious hemorrhagic events, including fatal events, have occurred in patients treated with acalabrutinib. Care should be exercised when using acalabrutinib in patients with bleeding disorders. It is recommended to monitor for signs of bleeding and to consider the benefit-risk of withholding therapy for 3-7 days pre- and post-surgery depending upon the type of surgery and the risk of bleeding.
Bone Marrow Depression/Low Blood Counts
Major:
chloramphenicol / hydrocortisone / polymyxin b ophthalmic
The chloramphenicol ophthalmic in chloramphenicol / hydrocortisone / polymyxin b ophthalmic has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
Chloramphenicol may cause bone marrow depression and other hematologic toxicities, which can be irreversible or reversible. The former type is independent of dose and results in aplastic anemia with a high rate of mortality, generally from hemorrhage or infection. It has been reported following both systemic and topical administration of chloramphenicol and has an estimated incidence of 1 in 25,000 to 1 in 40,000 courses of therapy. Bone marrow aplasia or hypoplasia may occur after a single dose but more often develops weeks or months after the drug has been discontinued. A reversible myelosuppression occurs much more frequently and is characterized by anemia, vacuolation of red blood cells, decreased reticulocyte count, leukopenia, thrombocytopenia, increased serum iron concentrations, and increased serum iron-binding capacity. It is dose-dependent, occurring regularly at chloramphenicol dosages exceeding 4 g/day (in adults) or at plasma drug concentrations >= 25 mcg/mL, and usually responds to withdrawal of the drug. Therapy with chloramphenicol should be administered cautiously, if at all, in patients with preexisting blood dyscrasias and/or bone marrow depression. Complete blood counts and differential reticulocyte counts should be performed in all patients prior to initiating therapy and approximately every 2 days during therapy. Marked depression of blood counts and/or development of other hematologic abnormalities may be indication for withdrawal of chloramphenicol therapy.
Moderate:
acalabrutinib
Acalabrutinib has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.
Serious infections (bacterial, viral or fungal), including fatal events and opportunistic infections have occurred in patients treated with acalabrutinib. Care should be exercised in patients at risk as in those at increased susceptibility to infection, such as neutropenic patients or those with a prior history of hepatitis B virus infection. It is recommended to monitor patients for signs and symptoms of infection and treat as medically appropriate. Consider prophylaxis in patients who are at increased risk for opportunistic infections.
Cataract
Major:
chloramphenicol / hydrocortisone / polymyxin b ophthalmic
The hydrocortisone ophthalmic in chloramphenicol / hydrocortisone / polymyxin b ophthalmic has a major potential interaction with Cataract.
Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with ophthalmic corticosteroids should be administered cautiously in patients with a history of cataracts, glaucoma, or increased intraocular pressure. If these agents are used for more than 10 days, the manufacturers recommend that intraocular pressure be routinely monitored, including in children. The equatorial and posterior subcapsular portions of the lens should be examined for changes.
Eye Conditions
Major:
chloramphenicol / hydrocortisone / polymyxin b ophthalmic
The hydrocortisone ophthalmic in chloramphenicol / hydrocortisone / polymyxin b ophthalmic has a major potential interaction with Eye Conditions.
The use of ophthalmic corticosteroids is contraindicated in most viral diseases of the cornea and conjunctiva, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella; fungal diseases of ocular structures; mycobacterial infections, including tuberculosis, of the eye; and any acute, purulent, untreated ocular infections. Corticosteroids may decrease host resistance to infectious agents, thus prolonging the course and/or exacerbating the severity of the infection while encouraging the development of new or secondary infection. In addition, administration of ophthalmic corticosteroids in severe ocular disease, especially acute herpes simplex keratitis, may lead to excessive corneal and scleral thinning, increasing the risk for perforation. In less serious ocular infections, therapy with ophthalmic corticosteroids may be administered but only with caution and accompanied by appropriate antimicrobial agents. Besides compromising host immune response, corticosteroids may also mask the symptoms of infection, thus hindering the recognition of potential ineffectiveness of the antibiotic therapy. If infection does not improve or becomes worse during administration of an ophthalmic corticosteroid, the drug should be discontinued and other appropriate therapy initiated.
Glaucoma/Intraocular Hypertension
Major:
chloramphenicol / hydrocortisone / polymyxin b ophthalmic
The hydrocortisone ophthalmic in chloramphenicol / hydrocortisone / polymyxin b ophthalmic has a major potential interaction with Glaucoma/Intraocular Hypertension.
Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with ophthalmic corticosteroids should be administered cautiously in patients with a history of cataracts, glaucoma, or increased intraocular pressure. If these agents are used for more than 10 days, the manufacturers recommend that intraocular pressure be routinely monitored, including in children. The equatorial and posterior subcapsular portions of the lens should be examined for changes.
Immunodeficiency
Moderate:
acalabrutinib
Acalabrutinib has a moderate potential interaction with Immunodeficiency.
Serious infections (bacterial, viral or fungal), including fatal events and opportunistic infections have occurred in patients treated with acalabrutinib. Care should be exercised in patients at risk as in those at increased susceptibility to infection, such as neutropenic patients or those with a prior history of hepatitis B virus infection. It is recommended to monitor patients for signs and symptoms of infection and treat as medically appropriate. Consider prophylaxis in patients who are at increased risk for opportunistic infections.
Infection
Moderate:
acalabrutinib
Acalabrutinib has a moderate potential interaction with Infection.
Serious infections (bacterial, viral or fungal), including fatal events and opportunistic infections have occurred in patients treated with acalabrutinib. Care should be exercised in patients at risk as in those at increased susceptibility to infection, such as neutropenic patients or those with a prior history of hepatitis B virus infection. It is recommended to monitor patients for signs and symptoms of infection and treat as medically appropriate. Consider prophylaxis in patients who are at increased risk for opportunistic infections.
Liver Disease
Moderate:
acalabrutinib
Acalabrutinib has a moderate potential interaction with Liver Disease.
Acalabrutinib is metabolized in the liver. Based on the population pharmacokinetic analysis, no clinically relevant difference was observed in subjects with mild or moderate hepatic impairment. The pharmacokinetic of acalabrutinib has not been evaluated in patients with severe hepatic impairment. Close monitoring of liver function is recommended in these patients.
Renal Dysfunction
Moderate:
acalabrutinib
Acalabrutinib has a moderate potential interaction with Renal Dysfunction.
Acalabrutinib undergoes minimal renal elimination. Based on the population pharmacokinetic analysis, no clinically relevant difference was observed in patients with mild or moderate renal impairment. The pharmacokinetic of acalabrutinib has not been evaluated in patients with severe renal impairment or renal impairment requiring dialysis. Close monitoring of renal function is recommended in these patients.
More resources
acalabrutinib
A total of 529 drugs are known to interact with acalabrutinib.
- Acalabrutinib is in the drug class BTK inhibitors.
- Acalabrutinib is used to treat the following conditions:
chloramphenicol / hydrocortisone / polymyxin b ophthalmic
A total of 401 drugs are known to interact with chloramphenicol / hydrocortisone / polymyxin b ophthalmic.
- Chloramphenicol / hydrocortisone / polymyxin b ophthalmic is in the drug class ophthalmic steroids with anti-infectives.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
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