Interactions between Anakinra and Multiple Trace Element

The copper sulfate and manganese sulfate in Multiple Trace Element both have a moderate potential interaction with Biliary Obstruction.

The trace elements, copper and manganese, are excreted in the bile. Copper and manganese doses may need to be adjusted, reduced, or omitted in patients with liver disease or biliary obstruction.

Anakinra has a moderate potential interaction with Immunodeficiency.

Anakinra has been associated with an increased incidence of serious infections in clinical trials in rheumatoid arthritis (RA). RA therapy should be discontinued if a patient develops a serious infection. In neonatal-onset multisystem inflammatory disease (NOMID) and deficiency of interleukin-1 receptor antagonist (DIRA) patients treated with anakinra, the risk of a disease flare when discontinuing this drug should be weighed against the potential risk of continued therapy. Anakinra should not be started in patients with active infections. Safety and efficacy have not been evaluated in immunosuppressed patients or in patients with chronic infections; caution is recommended when using anakinra in these patients.

Drugs that affect the immune system by blocking tumor necrosis factor have been associated with an increased risk of reactivation of latent tuberculosis; it is possible that taking drugs that block interleukin-1 (such as anakinra) increases the risk of tuberculosis or other atypical or opportunistic infections. The current US CDC guidelines should be followed both to evaluate for and to treat possible latent tuberculosis before starting therapy with anakinra.

Anakinra has a moderate potential interaction with Infection.

Anakinra has been associated with an increased incidence of serious infections in clinical trials in rheumatoid arthritis (RA). RA therapy should be discontinued if a patient develops a serious infection. In neonatal-onset multisystem inflammatory disease (NOMID) and deficiency of interleukin-1 receptor antagonist (DIRA) patients treated with anakinra, the risk of a disease flare when discontinuing this drug should be weighed against the potential risk of continued therapy. Anakinra should not be started in patients with active infections. Safety and efficacy have not been evaluated in immunosuppressed patients or in patients with chronic infections; caution is recommended when using anakinra in these patients.

Drugs that affect the immune system by blocking tumor necrosis factor have been associated with an increased risk of reactivation of latent tuberculosis; it is possible that taking drugs that block interleukin-1 (such as anakinra) increases the risk of tuberculosis or other atypical or opportunistic infections. The current US CDC guidelines should be followed both to evaluate for and to treat possible latent tuberculosis before starting therapy with anakinra.

Anakinra has a moderate potential interaction with Liver Disease.

No formal studies have been conducted examining the pharmacokinetics of anakinra administered subcutaneously in patients with hepatic dysfunction. Caution is recommended when using anakinra in these patients.

The copper sulfate and manganese sulfate in Multiple Trace Element both have a moderate potential interaction with Liver Disease.

The trace elements, copper and manganese, are excreted in the bile. Copper and manganese doses may need to be adjusted, reduced, or omitted in patients with liver disease or biliary obstruction.

The chromic chloride hexahydrate, copper sulfate, manganese sulfate and zinc sulfate in Multiple Trace Element all have a moderate potential interaction with Malabsorption Syndrome.

The trace metals manganese, chromium, copper, selenium, and zinc are absorbed in the GI tract from dietary sources and following administration of oral supplements. GI absorption may be decreased in patients with malabsorption syndromes. Therefore, larger dosages may be required when these supplements are given orally. Parenteral administration may be appropriate.

Anakinra has a moderate potential interaction with Neutropenia.

The use of anakinra has been associated with a decrease in neutrophil counts. Neutrophil counts should be assessed prior to initiating therapy and while receiving therapy, monthly for 3 months and thereafter quarterly for up to 1 year.

Anakinra has a moderate potential interaction with Renal Dysfunction.

Anakinra is substantially excreted by the kidney. The risk of toxic reactions to this drug may be greater in patients with impaired renal function. Administration of the prescribed dose every other day should be considered for patients who have severe renal dysfunction or end-stage renal disease (defined as CrCl less than 30 mL/min [as estimated from serum creatinine levels]). Caution should be exercised when using anakinra in these patients.

The manganese sulfate in Multiple Trace Element has a moderate potential interaction with Renal Dysfunction.

Manganese sulfate and manganese chloride preparations contain aluminum and may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which also contain aluminum. Patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration. Caution is advised in patients with renal impairment, particularly in premature or neonates patients.

The chromic chloride hexahydrate and zinc sulfate in Multiple Trace Element both have a moderate potential interaction with Renal Dysfunction.

The trace metals, chromium and zinc, are excreted primarily in the urine. Selenium is partially excreted in the urine. Supplemental doses of these agents may need to be adjusted, reduced, or omitted in patients with renal dysfunction.

Anakinra has a moderate potential interaction with Tuberculosis, Latent.

Anakinra has been associated with an increased incidence of serious infections in clinical trials in rheumatoid arthritis (RA). RA therapy should be discontinued if a patient develops a serious infection. In neonatal-onset multisystem inflammatory disease (NOMID) and deficiency of interleukin-1 receptor antagonist (DIRA) patients treated with anakinra, the risk of a disease flare when discontinuing this drug should be weighed against the potential risk of continued therapy. Anakinra should not be started in patients with active infections. Safety and efficacy have not been evaluated in immunosuppressed patients or in patients with chronic infections; caution is recommended when using anakinra in these patients.

Drugs that affect the immune system by blocking tumor necrosis factor have been associated with an increased risk of reactivation of latent tuberculosis; it is possible that taking drugs that block interleukin-1 (such as anakinra) increases the risk of tuberculosis or other atypical or opportunistic infections. The current US CDC guidelines should be followed both to evaluate for and to treat possible latent tuberculosis before starting therapy with anakinra.