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Drug Interactions between asparaginase escherichia coli and chloramphenicol / hydrocortisone / polymyxin b ophthalmic

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

asparaginase Escherichia coli chloramphenicol ophthalmic

Applies to: asparaginase escherichia coli and chloramphenicol / hydrocortisone / polymyxin b ophthalmic

GENERALLY AVOID: Coadministration of topical chloramphenicol with other agents that can cause bone marrow depression, aplastic anemia, or agranulocytosis may increase the risk and/or severity of hematologic toxicity. Chloramphenicol may be absorbed systemically from the eye, ear, and vagina. Bone marrow hypoplasia, including aplastic anemia and death, has been reported following topical use of chloramphenicol. However, systemic absorption following topical, ophthalmic, otic, and vaginal administration is generally minimal, and data concerning the incidence of blood dyscrasias following the use of topical chloramphenicol are not available.

MANAGEMENT: Concurrent use of topical chloramphenicol formulations with other bone marrow depressing agents should generally be avoided. If concomitant use on a long-term or intermittent basis is considered necessary, patients should be monitored for the development of hematologic adverse effects. Monitoring via full blood counts before and periodically during therapy may also be advisable.

References (5)
  1. Cerner Multum, Inc. "Australian Product Information."
  2. Agencia Española de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
  3. Cerner Multum, Inc (2015) "ANVISA Bulário Eletrônico."
  4. (2023) "Product Information. Chloramphenicol Ophthalmic (chloramphenicol ophthalmic)." Martindale Pharmaceuticals Ltd
  5. (2019) "Product Information. Chloramphenicol Otic (chloramphenicol otic)." Martindale Pharmaceuticals Ltd

Drug and food interactions

Moderate

asparaginase Escherichia coli food

Applies to: asparaginase escherichia coli

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 (13)
  1. (2001) "Product Information. Oncaspar (pegaspargase)." Rhone Poulenc Rorer
  2. (2001) "Product Information. Elspar (asparaginase)." Merck & Co., Inc
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. Cerner Multum, Inc. "Australian Product Information."
  5. "Product Information. Erwinaze (asparaginase Erwinia chrysanthemi)." EUSA Pharma
  6. Cerner Multum, Inc (2015) "ANVISA Bulário Eletrônico."
  7. (2019) "Product Information. Asparlas (calaspargase pegol)." Servier
  8. 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
  9. 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
  10. Jenkins R, Perlin E (1987) "Severe hepatotoxicity from Escherichia coli L-asparaginase." J Natl Med Assoc, 79, p. 775-9
  11. 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
  12. 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
  13. 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

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.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

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