Drug Interactions between aldesleukin and hydroxyzine

Alcohol can increase the nervous system side effects of hydrOXYzine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with hydrOXYzine. Do not use more than the recommended dose of hydrOXYzine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Aldesleukin may exacerbate existing or activate quiescent autoimmune disease. Therapy with aldesleukin should be administered cautiously in patients with autoimmune diseases.

Aldesleukin induces myelosuppression, primarily thrombocytopenia and anemia. Leukopenia has been reported. Therapy with aldesleukin should be administered cautiously in patients with compromised bone marrow reserve. Clinical monitoring of hematopoietic function is recommended. Subsequent treatment with aldesleukin is contraindicated in patients requiring surgery for GI bleeding or in those patients with bowel ischemia/perforation.

Aldesleukin induces myelosuppression, primarily thrombocytopenia and anemia. Leukopenia has been reported. Therapy with aldesleukin should be administered cautiously in patients with compromised bone marrow reserve. Clinical monitoring of hematopoietic function is recommended. Subsequent treatment with aldesleukin is contraindicated in patients requiring surgery for GI bleeding or in those patients with bowel ischemia/perforation.

The use of aldesleukin is contraindicated in patients with abnormal cardiac function as indicated by a thallium stress test. Therapy with aldesleukin should be administered with extreme caution in patients with a normal thallium stress test who have a history of cardiac disease. Close clinical monitoring of cardiac function is required. When adverse events occur that require dosage modification, dosages should be withheld rather than reduced . Subsequent treatment with aldesleukin is contraindicated in patients with sustained ventricular tachycardia, rhythm disturbances uncontrolled or unresponsive to management, recurrent chest pain with ECG changes consistent with angina or myocardial infarction, or pericardial tamponade.

A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Aldesleukin can cause Capillary Leak Syndrome resulting in ascites or pulmonary edema. Administration of IV fluids may be necessary to maintain organ perfusion and blood pressure. Aldesleukin should be administered cautiously in patients with fixed fluid requirements and/or those adversely affected by fluid overload.

Aldesleukin induces myelosuppression, primarily thrombocytopenia and anemia. Leukopenia has been reported. Therapy with aldesleukin should be administered cautiously in patients with compromised bone marrow reserve. Clinical monitoring of hematopoietic function is recommended. Subsequent treatment with aldesleukin is contraindicated in patients requiring surgery for GI bleeding or in those patients with bowel ischemia/perforation.

Hydroxyzine is contraindicated in patients with a QT prolonged interval. Cases of QT prolongation and Torsade de Pointes have been reported during postmarketing studies. Most of the cases reported occurred in patients with other risk factors for QT prolongation, such as preexisting heart disease, electrolyte imbalances or arrhythmogenic drug use. Therefore, hydroxyzine should be used with caution in patients with risk factors for QT prolongation, congenital long QT syndrome, family history of long QT syndrome or other predisposing conditions, as well as myocardial infarction, uncompensated heart failure, and bradyarrhythmias.

Hypotension, primarily associated with capillary leak syndrome, has been reported in 85% of patients administered aldesleukin. Seventy-one percent of patients with hypotension required pressor management. Therapy with aldesleukin should be administered cautiously in patients predisposed to hypotension.

The use of aldesleukin may be contraindicated in patients with infections, particularly bacterial diseases. Aldesleukin can interfere with neutrophil chemotaxis and increase the risk of disseminated infections, including bacterial endocarditis and sepsis. Therefore, preexisting bacterial infections should be adequately treated prior to initiation of aldesleukin therapy. Close clinical monitoring of hematopoietic function is recommended during therapy. Since there is increasing evidence that neutrophils may also play important roles in viral and other infections, it may be reasonable in some cases to defer aldesleukin treatment in patients with active nonbacterial infections.

Hepatotoxicity such as elevated bilirubin, transaminase and alkaline phosphatase levels have been reported in over 55% of patients administered aldesleukin. Hepatotoxicity is generally reversible, however, hepatic failure resulting in death has been reported. Therapy with aldesleukin should be administered cautiously in patients with compromised hepatic function. When adverse events occur that require dosage modification, dosages should be withheld rather than reduced. Clinical monitoring of hepatic function is recommended.

Hydroxyzine is contraindicated in patients with a QT prolonged interval. Cases of QT prolongation and Torsade de Pointes have been reported during postmarketing studies. Most of the cases reported occurred in patients with other risk factors for QT prolongation, such as preexisting heart disease, electrolyte imbalances or arrhythmogenic drug use. Therefore, hydroxyzine should be used with caution in patients with risk factors for QT prolongation, congenital long QT syndrome, family history of long QT syndrome or other predisposing conditions, as well as myocardial infarction, uncompensated heart failure, and bradyarrhythmias.

Hydroxyzine is contraindicated in patients with a QT prolonged interval. Cases of QT prolongation and Torsade de Pointes have been reported during postmarketing studies. Most of the cases reported occurred in patients with other risk factors for QT prolongation, such as preexisting heart disease, electrolyte imbalances or arrhythmogenic drug use. Therefore, hydroxyzine should be used with caution in patients with risk factors for QT prolongation, congenital long QT syndrome, family history of long QT syndrome or other predisposing conditions, as well as myocardial infarction, uncompensated heart failure, and bradyarrhythmias.

The use of aldesleukin is contraindicated in patients with allograft organ transplants. Aldesleukin possesses immunoregulatory properties that may increase the risk of organ rejection, including enhancement of lymphocyte mitogenesis and cytotoxicity and induction of killer cell activity.

The use of aldesleukin should be restricted to patients with adequate ventilatory function (baseline FEV1 > 2 L or >= 75% of the predicted value based on height and age). Extreme caution should be used in treating patients with normal test results but have a history of pulmonary disease. Pulmonary congestion and dyspnea have been reported in over 50% of patients receiving the recommended dosage of aldesleukin. Respiratory adverse effects are often associated with the capillary leak syndrome induced by aldesleukin and may also include pulmonary edema, respiratory failure requiring intubation, tachypnea, pleural effusion, wheezing, apnea, pneumothorax, hemoptysis, respiratory arrest, and pulmonary emboli. During therapy, pulmonary function should be monitored regularly by clinical examination, assessment of vital signs and pulse oximetry, and arterial blood gas determinations as needed. When toxicities occur that require a dosage modification, doses should be withheld rather than reduced. Subsequent treatment with aldesleukin is contraindicated in patients who develop respiratory failure requiring intubation for longer than 72 hours.

Renal toxicity such as oliguria/anuria and elevated BUN and serum creatinine has been reported in > 60% of patients during aldesleukin therapy. Renal toxicity is generally reversible, however, patients with renal impairment are at increased risk for more severe and prolonged renal dysfunction. Therapy with aldesleukin should be administered cautiously in patients with compromised renal function. Clinical monitoring of renal function is recommended. When adverse events occur that require dosage modification, dosages should be withheld rather than reduced. Subsequent treatment with aldesleukin is contraindicated in patients experiencing renal dysfunction that requires greater than seventy-two hours of dialysis.

Aldesleukin can induce seizures. Therapy with aldesleukin should be administered with extreme caution in patients with or predisposition to seizure disorders. When adverse events occur that require dosage modification, dosages should be withheld rather than reduced . Subsequent treatment with aldesleukin is contraindicated in patients with repetitive or difficult to control seizures.

Hydroxyzine is contraindicated in patients with a QT prolonged interval. Cases of QT prolongation and Torsade de Pointes have been reported during postmarketing studies. Most of the cases reported occurred in patients with other risk factors for QT prolongation, such as preexisting heart disease, electrolyte imbalances or arrhythmogenic drug use. Therefore, hydroxyzine should be used with caution in patients with risk factors for QT prolongation, congenital long QT syndrome, family history of long QT syndrome or other predisposing conditions, as well as myocardial infarction, uncompensated heart failure, and bradyarrhythmias.

It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.

Mental status changes such as lethargy, somnolence, depression, confusion or agitation were reported in over 70% of patients administered aldesleukin. Therapy with aldesleukin should be administered cautiously to patients with or predisposition to altered mental status. When adverse events occur that require dosage modification, dosages should be withheld rather than reduced. Clinical monitoring of mental status is recommended.

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.

In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.

Some anxiolytics, sedatives and hypnotics are extensively metabolized by the liver, and excreted in the urine. Patients with impaired renal and/or hepatic function may be at greater risk for adverse effects, including central nervous system and respiratory depression, due to drug and metabolite accumulation. Therapy with these drugs should be administered cautiously in such patients, with careful dose selection usually starting at the low end of the dosing range.

Mental status changes such as lethargy, somnolence, depression, confusion or agitation were reported in over 70% of patients administered aldesleukin. Therapy with aldesleukin should be administered cautiously to patients with or predisposition to altered mental status. When adverse events occur that require dosage modification, dosages should be withheld rather than reduced. Clinical monitoring of mental status is recommended.

Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.

Some anxiolytics, sedatives and hypnotics are extensively metabolized by the liver, and excreted in the urine. Patients with impaired renal and/or hepatic function may be at greater risk for adverse effects, including central nervous system and respiratory depression, due to drug and metabolite accumulation. Therapy with these drugs should be administered cautiously in such patients, with careful dose selection usually starting at the low end of the dosing range.

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.