Can you take Actos with Brentuximab?

The pioglitazone in Actos has a minor potential interaction with Anemia.

Thiazolidinediones can cause slight decreases in hemoglobin and hematocrit. In clinical studies, hemoglobin levels were reduced primarily within the first 4 to 12 weeks of therapy but remained relatively constant thereafter. These changes may be related to increased plasma volume and have rarely been associated with any significant hematologic clinical effects. Nevertheless, caution may be advisable when thiazolidinediones are prescribed to patients with certain anemias.

The pioglitazone in Actos has a moderate potential interaction with Bladder Cancer.

There are insufficient data to determine if pioglitazone has an effect on preexisting bladder tumors or if it can cause bladder cancer. However, the manufacturer does not recommend the use of pioglitazone in patients with active bladder cancer. In patients with history of bladder cancer the benefit of treatment versus the risk of cancer recurrence during treatment should be considered.

The pioglitazone in Actos has a major potential interaction with Diabetes, Type 1.

Thiazolidinediones exert their hypoglycemic effect only in the presence of insulin. Therefore, these agents should not be used in patients with type I diabetes or for the treatment of diabetic ketoacidosis.

The pioglitazone in Actos has a moderate potential interaction with Diabetes Mellitus.

New onset or worsening diabetic macular edema with decreased visual acuity have been reported in postmarketing reports in some diabetic patients who were taking thiazolidinedione drugs. Some patients presented with blurred vision or decreased visual acuity, but some patients appear to have been diagnosed on routine ophthalmologic examination. Most patients had peripheral edema at the time macular edema was diagnosed. Some patients had improvement in their macular edema after discontinuation of their thiazolidinedione. Patients with diabetes should have regular eye exams by an ophthalmologist according to current standards of care. Additionally, any diabetic who reports any kind of visual symptom should be promptly referred to an ophthalmologist, regardless of the patient's underlying medications or other physical findings.

The brentuximab vedotin in brentuximab has a moderate potential interaction with Diabetes Mellitus.

Serious events of hyperglycemia (e.g., new-onset hyperglycemia, exacerbation of preexisting diabetes mellitus, ketoacidosis [including fatalities]) have been reported in brentuximab vedotin-treated patients. Hyperglycemia occurred more frequently in patients with high body mass index or diabetes. Serum glucose should be monitored and if hyperglycemia develops, antihyperglycemic agents should be administered as clinically indicated.

The pioglitazone in Actos has a major potential interaction with Diabetic Ketoacidosis.

Thiazolidinediones exert their hypoglycemic effect only in the presence of insulin. Therefore, these agents should not be used in patients with type I diabetes or for the treatment of diabetic ketoacidosis.

The pioglitazone in Actos has a moderate potential interaction with Diabetic Macular Edema.

New onset or worsening diabetic macular edema with decreased visual acuity have been reported in postmarketing reports in some diabetic patients who were taking thiazolidinedione drugs. Some patients presented with blurred vision or decreased visual acuity, but some patients appear to have been diagnosed on routine ophthalmologic examination. Most patients had peripheral edema at the time macular edema was diagnosed. Some patients had improvement in their macular edema after discontinuation of their thiazolidinedione. Patients with diabetes should have regular eye exams by an ophthalmologist according to current standards of care. Additionally, any diabetic who reports any kind of visual symptom should be promptly referred to an ophthalmologist, regardless of the patient's underlying medications or other physical findings.

The pioglitazone in Actos has a moderate potential interaction with Fluid Retention.

Thiazolidinediones can cause dose-related edema. Therapy with thiazolidinediones should be administered cautiously in patients at risk for congestive heart failure as well as those with fluid overload or other conditions that may be adversely affected by excess fluid such as hypertension. Patients should be monitored for signs and symptoms of heart failure such as dyspnea, swelling of legs or ankles, and weight gain.

The brentuximab vedotin in brentuximab has a moderate potential interaction with Gastrointestinal Obstruction.

Fatal and serious events of acute pancreatitis have been reported with brentuximab vedotin. Other fatal and serious gastrointestinal (GI) complications include perforation, hemorrhage, erosion, ulcer, intestinal obstruction, enterocolitis, neutropenic colitis, and ileus. Lymphoma with preexisting GI involvement may increase the risk of perforation. If new or worsening GI symptoms (including severe abdominal pain) develop, it is recommended to perform a prompt diagnostic evaluation and treat appropriately.

The pioglitazone in Actos has a major potential interaction with Heart Failure.

The use of thiazolidinediones, alone or in combination with other antidiabetic agents, has been associated with fluid retention and new onset or exacerbation of heart failure. An increased risk of cardiovascular events (heart failure worsening; new or worsening edema; new or worsening dyspnea; increases in heart failure medication; myocardial infarction; angina; cardiovascular hospitalization and deaths) has been reported with rosiglitazone therapy in type II diabetic patients with New York Heart Association (NYHA) Class I or II congestive heart failure compared to placebo. Likewise, overnight hospitalization for CHF was observed in 9.9% of diabetic patients with NYHA Class II and III heart failure on pioglitazone compared to 4.7% of patients on glyburide. An increased incidence of cardiovascular adverse events including edema and cardiac failure has also been reported in patients receiving a thiazolidinedione in combination with insulin relative to insulin and placebo. Therapy with thiazolidinediones should be administered cautiously and initiated at the lowest recommended dosage in patients with congestive heart failure. Thiazolidinediones are contraindicated for the treatment of patients with NYHA Class III or IV cardiac status. Patients should be monitored for signs of worsening heart failure such as increased dyspnea, edema, and weight gain. Therapy should be discontinued if any deterioration in cardiac status occurs.

The pioglitazone in Actos has a moderate potential interaction with High Blood Pressure.

Thiazolidinediones can cause dose-related edema. Therapy with thiazolidinediones should be administered cautiously in patients at risk for congestive heart failure as well as those with fluid overload or other conditions that may be adversely affected by excess fluid such as hypertension. Patients should be monitored for signs and symptoms of heart failure such as dyspnea, swelling of legs or ankles, and weight gain.

The brentuximab vedotin in brentuximab has a major potential interaction with Infection.

Serious infections and opportunistic infections (e.g., pneumonia, bacteremia, sepsis/septic shock [including fatalities]) have been reported in patients treated with brentuximab vedotin. Patients should be monitored closely for the emergence of any infection during treatment with this agent. John Cunningham virus (JC virus) infection resulting in progressive multifocal leukoencephalopathy (PML) has been reported in patients treated with this agent. A diagnosis of PML should be considered in any patient presenting with new-onset signs/symptoms of CNS abnormalities. Therapy should be held for any suspected case of PML and discontinued if a diagnosis of PML is confirmed.

The pioglitazone in Actos has a moderate potential interaction with Liver Disease.

Initiation of rosiglitazone or pioglitazone therapy is not recommended in patients who exhibit clinical evidence of active liver disease or increased baseline serum transaminase levels (ALT exceeding 2.5 times upper limit of normal). Use of these agents is also not recommended in patients who have experienced jaundice during treatment with troglitazone. The use of troglitazone, another agent in the thiazolidinedione class, has been associated with clinically significant elevations in liver enzymes, reversible jaundice, and idiosyncratic hepatocellular injury including rare cases of liver failure, liver transplants, and death. Injury has occurred after both short- and long-term treatment. While these effects have not been associated with other thiazolidinediones in clinical trials, concerns exist because of their structural similarities. In addition, isolated cases of hepatitis and hepatic enzyme elevations to 3 or more times the upper limit of normal have been reported with both rosiglitazone and pioglitazone during postmarketing use. Rarely, these events have involved hepatic failure with and without fatal outcome, although causality has not been established. Until more safety data are available, patients who are prescribed thiazolidinedione therapy should have serum transaminase levels checked at baseline and periodically thereafter as clinically necessary. Mild to moderate elevations (ALT less than or equal to 2.5 times ULN) require cautious use with more frequent monitoring to determine if the elevations resolve or worsen. Patients who develop potential symptoms of hepatic injury such as unexplained nausea, vomiting, abdominal pain, fatigue, anorexia, and dark urine should have liver enzymes checked. Therapy should be withdrawn if ALT is elevated and persists above 3 times ULN or if jaundice develops.

The brentuximab vedotin in brentuximab has a moderate potential interaction with Liver Disease.

The use of brentuximab vedotin should be avoided in patients with moderate or severe liver dysfunction (Child-Pugh B or C). The frequency of grade 3 or higher adverse reactions and deaths was greater in patients with moderate and severe liver dysfunction compared to those with normal liver function. Fatal and serious cases of hepatotoxicity have occurred in patients receiving this agent. Preexisting liver disease, elevated baseline liver enzymes, and concomitant medications may increase the risk. Liver enzymes and bilirubin should be monitored. Patients experiencing new, worsening, or recurrent hepatotoxicity may require a delay, change in dose, or discontinuation of brentuximab vedotin.

The brentuximab vedotin in brentuximab has a moderate potential interaction with Peripheral Neuropathy.

Peripheral neuropathy, predominantly sensory neuropathy, has occurred in patients treated with brentuximab vedotin. Patients should be monitored for symptoms of neuropathy, and those experiencing new or worsening peripheral neuropathy may require a delay, change in dosage, or discontinuation of brentuximab vedotin.

The pioglitazone in Actos has a moderate potential interaction with Pleural Effusion.

Thiazolidinediones can cause dose-related edema. Therapy with thiazolidinediones should be administered cautiously in patients at risk for congestive heart failure as well as those with fluid overload or other conditions that may be adversely affected by excess fluid such as hypertension. Patients should be monitored for signs and symptoms of heart failure such as dyspnea, swelling of legs or ankles, and weight gain.

The pioglitazone in Actos has a moderate potential interaction with Premenopausal Anovulation.

In premenopausal, anovulatory patients with insulin resistance, treatment with thiazolidinediones may result in resumption of ovulation. Due to improved insulin sensitivity, pregnancy can occur if adequate contraception is not used.

The pioglitazone in Actos has a moderate potential interaction with Pulmonary Edema.

Thiazolidinediones can cause dose-related edema. Therapy with thiazolidinediones should be administered cautiously in patients at risk for congestive heart failure as well as those with fluid overload or other conditions that may be adversely affected by excess fluid such as hypertension. Patients should be monitored for signs and symptoms of heart failure such as dyspnea, swelling of legs or ankles, and weight gain.

The brentuximab vedotin in brentuximab has a moderate potential interaction with Pulmonary Impairment.

Fatal and serious events of noninfectious pulmonary toxicity including pneumonitis, interstitial lung disease, and acute respiratory distress syndrome, have been reported with the use of brentuximab vedotin. Care should be taken when using this agent in patients at risk of pulmonary events. Patients should be monitored for signs/symptoms of pulmonary toxicity (including cough and dyspnea). If new or worsening pulmonary symptoms develop, brentuximab vedotin dosing should be held during evaluation and until symptomatic improvement.

The brentuximab vedotin in brentuximab has a moderate potential interaction with Renal Dysfunction.

The use of brentuximab vedotin should be avoided in patients with severe renal dysfunction (CrCl less than 30 mL/min). The frequency of grade 3 or higher adverse reactions and deaths was greater in patients with severe renal dysfunction compared to those with normal renal function.

The brentuximab vedotin in brentuximab has a major potential interaction with Tumor Lysis Syndrome.

Tumor lysis syndrome (TLS), which may be life-threatening or fatal, has occurred in patients receiving certain monoclonal antibodies. Patients with high tumor burden and/or high circulating lymphocyte counts (greater than 25 x 10[9]/L) are at greater risk for developing TLS. Tumor lysis prophylaxis with anti-hyperuricemics and hydration prior to infusion may be recommended or should be considered. Electrolyte abnormalities should be corrected, and renal function and fluid balance should be monitored in patients who develop TLS. It is recommended to monitor for signs/symptoms of TLS, and temporary interruption or discontinuation of therapy might be required.

The pioglitazone in Actos has a moderate potential interaction with Weight Loss.

Thiazolidinediones can cause dose-related weight gain, which may be undesirable in obese patients attempting to lose weight. The mechanism of weight gain is unclear but probably involves a combination of fluid retention and fat accumulation. In postmarketing experience with rosiglitazone, there have been reports of unusually rapid increases in weight, greater than those generally observed in clinical trials. Patients who experience such increases should be assessed for fluid retention and volume-related events such as excessive edema and congestive heart failure.

The brentuximab vedotin in brentuximab has a moderate potential interaction with Weight Loss.

Serious events of hyperglycemia (e.g., new-onset hyperglycemia, exacerbation of preexisting diabetes mellitus, ketoacidosis [including fatalities]) have been reported in brentuximab vedotin-treated patients. Hyperglycemia occurred more frequently in patients with high body mass index or diabetes. Serum glucose should be monitored and if hyperglycemia develops, antihyperglycemic agents should be administered as clinically indicated.