Interactions between Aqua Gem-E and Ocrelizumab

The vitamin E in Aqua Gem-E has a major potential interaction with Biliary Obstruction.

Vitamin E is fat soluble and many oral formulations require bile for adequate intestinal absorption. Hepatic and/or biliary dysfunction decrease the absorption of vitamin E. Water- miscible vitamin E formulations may be better absorbed from the GI tract under these conditions. Vitamin E is metabolized by the liver and primarily excreted in bile and feces. Hepatic and/or biliary impairment can alter the metabolic and therapeutic activity of vitamin E.

Ocrelizumab has a moderate potential interaction with Infection.

Ocrelizumab may increase the risk for upper respiratory tract infections, lower respiratory tract infections, skin infections, and herpes-related infections. It is recommended to delay the use of ocrelizumab in patients with an active infection until the infection is resolved.

Ocrelizumab has a major potential interaction with Infectious Hepatitis.

The use of ocrelizumab is contraindicated in patients with an active hepatitis B virus (HBV) infection. Patients should be screened for HBV prior to treatment initiation. It is recommended to consult a liver disease expert before starting and during treatment with ocrelizumab in patients who are negative for surface antigen [HBsAg] and positive for HB core antibody [HBcAb+] or are carriers of HBV [HBsAg+].

The vitamin E in Aqua Gem-E has a major potential interaction with Liver Disease.

Vitamin E is fat soluble and many oral formulations require bile for adequate intestinal absorption. Hepatic and/or biliary dysfunction decrease the absorption of vitamin E. Water- miscible vitamin E formulations may be better absorbed from the GI tract under these conditions. Vitamin E is metabolized by the liver and primarily excreted in bile and feces. Hepatic and/or biliary impairment can alter the metabolic and therapeutic activity of vitamin E.

The vitamin E in Aqua Gem-E has a minor potential interaction with Malabsorption Syndrome.

Vitamin E is readily absorbed from the intestinal tract in the presence of bile. Prolonged fat malabsorption (cystic fibrosis, hepatic cirrhosis, sprue) or malabsorption syndromes (celiac disease, GI resection) can decrease the absorption of many oral formulations of vitamin E. A water- miscible formulation of vitamin E may be better absorbed in these conditions.

Ocrelizumab has a moderate potential interaction with Neoplasia, Estrogen Dependent.

Ocrelizumab may increase the risk of malignancies, including breast cancer. It is recommended to follow standard breast cancer screening guidelines. Exercise care when using this agent in patients with a history of breast cancer or other type of malignancy. Monitor closely for the development of any sign or symptom suggestive of a malignancy and treat appropriately.

Ocrelizumab has a moderate potential interaction with Vaccination.

The use of live-attenuated or live vaccines is not recommended during treatment with ocrelizumab and until B-cell repletion is confirmed. It is recommended to administer all immunizations according to immunization guidelines at least 4 weeks prior to initiation of ocrelizumab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks prior to initiation of treatment for non-live vaccines. Ocrelizumab may interfere with the effectiveness of non-live vaccines.