Drug Interactions between asparaginase erwinia chrysanthemi and deferasirox
This report displays the potential drug interactions for the following 2 drugs:
- asparaginase erwinia chrysanthemi
- deferasirox
Interactions between your drugs
deferasirox asparaginase Erwinia chrysanthemi
Applies to: deferasirox and asparaginase erwinia chrysanthemi
MONITOR: Concomitant use of asparaginase with other hepatotoxic agents may potentiate the risk of liver injury. Asparaginase-associated hepatotoxicity has been reported more commonly in adults than in children and has been strongly associated with obesity. Hepatomegaly, acute severe hepatotoxicity, and fatal liver failure have been reported with asparaginase treatment in adults. Also, asparaginase may increase the toxicity of drugs bound to plasma proteins or metabolized by the liver.
MANAGEMENT: The risk of additive hepatotoxicity should be considered when asparaginase is used with other hepatotoxic agents (e.g., alcohol, androgens, antituberculosis agents, azole antifungal agents, ACE inhibitors, macrolide antibiotics, nonsteroidal anti-inflammatory agents, nucleoside reverse transcriptase inhibitors, sulfonamides, thiazolidinediones, and statins). Liver function tests should be monitored at regular intervals during asparaginase treatment with or without other hepatotoxic drugs. Patients should be advised to seek medical attention if they experience potential symptoms of hepatotoxicity such as right upper quadrant pain, increasing abdominal size, fever, rash, itching, anorexia, nausea, vomiting, fatigue, malaise, dark urine, pale stools, and jaundice.
References
- (2001) "Product Information. Oncaspar (pegaspargase)." Rhone Poulenc Rorer
- (2001) "Product Information. Elspar (asparaginase)." Merck & Co., Inc
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- "Product Information. Erwinaze (asparaginase Erwinia chrysanthemi)." EUSA Pharma
- Cerner Multum, Inc (2015) "ANVISA Bulário Eletrônico."
- (2019) "Product Information. Asparlas (calaspargase pegol)." Servier
- Al-Nawakil C, Willems L, Mauprivez C, et al. (2014) "Successful treatment of l-asparaginase-induced severe acute hepatotoxicity using mitochondrial cofactors." Leuk Lymphoma, 55, p. 1670-4
- Christ TN, Stock W, Knoebel RW (2018) "Incidence of asparaginase-related hepatotoxicity, pancreatitis, and thrombotic events in adults with acute lymphoblastic leukemia treated with a pediatric-inspired regimen." J Oncol Pharm Pract, 24, p. 299-308
- Jenkins R, Perlin E (1987) "Severe hepatotoxicity from Escherichia coli L-asparaginase." J Natl Med Assoc, 79, p. 775-9
- Lu G, Karur V, Herrington JD, Walker MG (2016) "Successful treatment of pegaspargase-induced acute hepatotoxicity with vitamin B complex and L-carnitine" Proc (Bayl Univ Med Cent), 29, p. 46-7
- Bodmer M, Sulz M, Stadlmann S, Droll A, Terracciano L, Krahenbuhl S (2006) "Fatal liver failure in an adult patient with acute lymphoblastic leukemia following treatment with L-asparaginase." Digestion, 74, epub
- Burke PW, Aldoss I, Lunning MA, et al. (2013) "High-grade PEGylated asparaginase-related hepatotoxicity occurrence in a pediatric-inspired adult acute lymphoblastic leukemia regimen does not necessarily predict recurrent hepatotoxicity in subsequent cycles." Blood, 122, p. 2671
Drug and food interactions
deferasirox food
Applies to: deferasirox
ADJUST DOSING INTERVAL: According to product labeling, the bioavailability of deferasirox was variably increased when taken with a meal.
MANAGEMENT: To ensure consistent plasma drug levels, deferasirox should be taken on an empty stomach 30 minutes before eating preferably at the same time everyday.
References
- (2005) "Product Information. Exjade (deferasirox)." Novartis Pharmaceuticals
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
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
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