Can you take Arava with Fidanacogene elaparvovec?
1 drug interaction and 20 additional warnings found for the following 2 drugs:
- Arava (leflunomide)
- fidanacogene elaparvovec
Drug interactions
Major drug interactions
Major:
leflunomide fidanacogene elaparvovec
Applies to: Arava (leflunomide) and fidanacogene elaparvovec
Leflunomide may cause liver problems, and using it with other medications that can also affect the liver such as fidanacogene elaparvovec may increase that risk. Because leflunomide can stay in your blood for a prolonged period after the last dose, interactions with other drugs may occur for some time even after you have stopped taking it. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark colored urine, light colored stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. 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
Moderate food/lifestyle interactions
Moderate:
leflunomide Food/Lifestyle
Applies to: Arava (leflunomide)
Leflunomide can be taken with or without food. It is important to take leflunomide regularly to get the most benefit. Discuss with your doctor the use of alcohol while taking leflunomide. Alcohol and leflunomide can both be damaging to the liver.
Moderate:
fidanacogene elaparvovec Food/Lifestyle
Applies to: fidanacogene elaparvovec
After receiving fidanacogene elaparvovec, alcohol consumption should be limited for at least 1 year. Fidanacogene elaparvovec can cause liver problems, which may make the medication less effective in treating your condition. Consuming other substances that can also affect the liver such as alcohol after receiving fidanacogene elaparvovec may increase that risk. Symptoms of liver problems include fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes. Blood tests to monitor liver function should be performed before and after treatment with fidanacogene elaparvovec. Talk to your doctor if you have any questions or concerns. 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
18 potential interactions Applies to: 16 conditions, including High Blood Pressure, Peripheral Neuropathy, HIV-1 Infection, Diabetes Mellitus, and Liver Disease.
Alcoholic Cirrhosis
Moderate:
fidanacogene elaparvovec
Fidanacogene elaparvovec has a moderate potential interaction with Alcoholic Cirrhosis.
Fidanacogene elaparvovec, a liver-targeting gene therapy, may carry the theoretical risk of hepatocellular carcinoma development. Patients with risk factors for hepatocellular carcinoma (e.g., hepatitis B or C, non-alcoholic fatty liver disease, chronic alcohol consumption, non-alcoholic steatohepatitis, advanced age) should be monitored with regular liver ultrasound (e.g., annually) and alpha-fetoprotein testing for 5 years following treatment.
Alcoholic Liver Damage
Moderate:
fidanacogene elaparvovec
Fidanacogene elaparvovec has a moderate potential interaction with Alcoholic Liver Damage.
Fidanacogene elaparvovec, a liver-targeting gene therapy, may carry the theoretical risk of hepatocellular carcinoma development. Patients with risk factors for hepatocellular carcinoma (e.g., hepatitis B or C, non-alcoholic fatty liver disease, chronic alcohol consumption, non-alcoholic steatohepatitis, advanced age) should be monitored with regular liver ultrasound (e.g., annually) and alpha-fetoprotein testing for 5 years following treatment.
Alcoholism
Moderate:
fidanacogene elaparvovec
Fidanacogene elaparvovec has a moderate potential interaction with Alcoholism.
Fidanacogene elaparvovec, a liver-targeting gene therapy, may carry the theoretical risk of hepatocellular carcinoma development. Patients with risk factors for hepatocellular carcinoma (e.g., hepatitis B or C, non-alcoholic fatty liver disease, chronic alcohol consumption, non-alcoholic steatohepatitis, advanced age) should be monitored with regular liver ultrasound (e.g., annually) and alpha-fetoprotein testing for 5 years following treatment.
Bone Marrow Depression/Low Blood Counts
Major:
Arava
The leflunomide in Arava has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
Pancytopenia, agranulocytosis and thrombocytopenia have been reported in patients receiving leflunomide. Leflunomide is an immunomodulatory agent with antiproliferative activity. The use of leflunomide is not recommended in patients with severe immunodeficiency, bone marrow dysplasia, or severe, uncontrolled infections because of the theoretical potential for immunosuppression. Care should be taken when using this agent in patients with a prior history of a significant hematologic abnormality. It is recommended to monitor blood levels at baseline and regularly during the course of therapy. If evidence of bone marrow suppression occurs, stop treatment and institute appropriate measures according to clinical guidelines.
Diabetes Mellitus
Major:
Arava
The leflunomide in Arava has a major potential interaction with Diabetes Mellitus.
Peripheral neuropathy has been reported during leflunomide therapy. Patients older than 60 years, patients taking concomitant neurotoxic medications, and diabetics may be at an increased risk for peripheral neuropathy. Therapy with leflunomide should be administered cautiously in these patients. Patients should be monitored for symptoms of neuropathy and if confirmed, consider discontinuing therapy and taking measures according to clinical practice.
High Blood Pressure
Moderate:
Arava
The leflunomide in Arava has a moderate potential interaction with High Blood Pressure.
Hypertension was reported as an adverse reaction in patients on leflunomide. Blood pressure should be monitored during treatment and periodically thereafter as this agent can increase the blood pressure in these patients.
HIV-1 Infection
Moderate:
fidanacogene elaparvovec
Fidanacogene elaparvovec has a moderate potential interaction with HIV-1 Infection.
There is limited information on the safety and effectiveness of fidanacogene elaparvovec in patients with HIV infection. Perform HIV testing prior to infusion, and do not administer this product to patients with either CD4+ cell count less than 200 mm3 or viral load equal to or greater than 20 copies/mL in case of serological evidence of HIV-1 or HIV-2 infection.
Immunodeficiency
Major:
Arava
The leflunomide in Arava has a major potential interaction with Immunodeficiency.
Pancytopenia, agranulocytosis and thrombocytopenia have been reported in patients receiving leflunomide. Leflunomide is an immunomodulatory agent with antiproliferative activity. The use of leflunomide is not recommended in patients with severe immunodeficiency, bone marrow dysplasia, or severe, uncontrolled infections because of the theoretical potential for immunosuppression. Care should be taken when using this agent in patients with a prior history of a significant hematologic abnormality. It is recommended to monitor blood levels at baseline and regularly during the course of therapy. If evidence of bone marrow suppression occurs, stop treatment and institute appropriate measures according to clinical guidelines.
Infection
Major:
Arava
The leflunomide in Arava has a major potential interaction with Infection.
Pancytopenia, agranulocytosis and thrombocytopenia have been reported in patients receiving leflunomide. Leflunomide is an immunomodulatory agent with antiproliferative activity. The use of leflunomide is not recommended in patients with severe immunodeficiency, bone marrow dysplasia, or severe, uncontrolled infections because of the theoretical potential for immunosuppression. Care should be taken when using this agent in patients with a prior history of a significant hematologic abnormality. It is recommended to monitor blood levels at baseline and regularly during the course of therapy. If evidence of bone marrow suppression occurs, stop treatment and institute appropriate measures according to clinical guidelines.
Infectious Hepatitis
Moderate:
fidanacogene elaparvovec
Fidanacogene elaparvovec has a moderate potential interaction with Infectious Hepatitis.
Fidanacogene elaparvovec, a liver-targeting gene therapy, may carry the theoretical risk of hepatocellular carcinoma development. Patients with risk factors for hepatocellular carcinoma (e.g., hepatitis B or C, non-alcoholic fatty liver disease, chronic alcohol consumption, non-alcoholic steatohepatitis, advanced age) should be monitored with regular liver ultrasound (e.g., annually) and alpha-fetoprotein testing for 5 years following treatment.
Liver Disease
Major:
Arava
The leflunomide in Arava has a major potential interaction with Liver Disease.
Severe liver injury, including fatal liver failure, has been reported in patients treated with leflunomide. Leflunomide is contraindicated in patients with severe hepatic impairment. Leflunomide has been commonly associated with elevations in liver enzymes, primarily ALT and AST. Marked elevations occurred infrequently and reversed with dose reduction or discontinuation of treatment. Leflunomide also must be metabolized by the liver into the active compound which is responsible for the in vivo activity. Therapy with leflunomide is not recommended in patients with preexisting liver disease. Dosage adjustment or discontinuation is recommended for patients experiencing liver enzyme elevations while on leflunomide.
Moderate:
fidanacogene elaparvovec
Fidanacogene elaparvovec has a moderate potential interaction with Liver Disease.
Fidanacogene elaparvovec has not been studied in patients with liver dysfunction. Furthermore, administration of this product can lead to liver transaminase elevations and hepatocyte injury. Patients should undergo a liver health assessment prior to treatment, which includes liver function tests, screening for active hepatitis B or C, and elastography and/or ultrasound to assess liver fibrosis. This product should not be administered to patients with current liver-related coagulopathy, hypoalbuminemia, persistent jaundice, or cirrhosis, portal hypertension, splenomegaly, hepatic encephalopathy, hepatic fibrosis, or active viral hepatitis.
Peripheral Neuropathy
Major:
Arava
The leflunomide in Arava has a major potential interaction with Peripheral Neuropathy.
Peripheral neuropathy has been reported during leflunomide therapy. Patients older than 60 years, patients taking concomitant neurotoxic medications, and diabetics may be at an increased risk for peripheral neuropathy. Therapy with leflunomide should be administered cautiously in these patients. Patients should be monitored for symptoms of neuropathy and if confirmed, consider discontinuing therapy and taking measures according to clinical practice.
Pulmonary Impairment
Major:
Arava
The leflunomide in Arava has a major potential interaction with Pulmonary Impairment.
The use of leflunomide has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), and worsening of preexisting interstitial lung disease have been reported. Caution is recommended when using this agent in patients with a history of ILD or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as cough and dyspnea, with or without associated fever. If ILD is confirmed, consider discontinuing therapy and institute appropriate measures according to clinical guidelines.
Renal Dysfunction
Major:
Arava
The leflunomide in Arava has a major potential interaction with Renal Dysfunction.
The active metabolite of leflunomide is elevated in the plasma of patients with renal impairment. Therapy with leflunomide should be administered cautiously in patients with renal insufficiency.
Moderate:
fidanacogene elaparvovec
Fidanacogene elaparvovec has a moderate potential interaction with Renal Dysfunction.
Fidanacogene elaparvovec has not been studied in patients with renal dysfunction.
Tuberculosis, Active
Major:
Arava
The leflunomide in Arava has a major potential interaction with Tuberculosis, Active.
Patients should be evaluated for active and latent tuberculosis (TB) infection prior to leflunomide treatment. Leflunomide has not been studied in patients with a positive tuberculosis screen, and the safety of leflunomide in individuals with latent tuberculosis infection is unknown. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy with leflunomide and monitored carefully during leflunomide treatment for possible reactivation of the infection.
Tuberculosis, Latent
Major:
Arava
The leflunomide in Arava has a major potential interaction with Tuberculosis, Latent.
Patients should be evaluated for active and latent tuberculosis (TB) infection prior to leflunomide treatment. Leflunomide has not been studied in patients with a positive tuberculosis screen, and the safety of leflunomide in individuals with latent tuberculosis infection is unknown. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy with leflunomide and monitored carefully during leflunomide treatment for possible reactivation of the infection.
More resources
Arava
A total of 721 drugs are known to interact with Arava.
- Arava is in the following drug classes: antirheumatics, selective immunosuppressants.
- Arava is used to treat Rheumatoid Arthritis.
fidanacogene elaparvovec
A total of 312 drugs are known to interact with fidanacogene elaparvovec.
- Fidanacogene elaparvovec is in the drug class miscellaneous coagulation modifiers.
- Fidanacogene elaparvovec is used to treat Hemophilia B.
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
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.