Interactions between Asparlas and Etrasimod

The calaspargase pegol in Asparlas has a major potential interaction with Bleeding Disorder.

Hemorrhage associated with increased prothrombin time (PT), increased partial thromboplastin time (PTT), and hypofibrinogenemia have been reported in patients receiving calaspargase pegol. Evaluate patients with signs and symptoms of hemorrhage with coagulation parameters including PT, PTT, fibrinogen. Consider appropriate replacement therapy in any patients with severe or symptomatic coagulopathy. The use of calaspargase pegol is contraindicated in patients with any history of serious hemorrhagic events during a previous L-asparaginase therapy.

Etrasimod has a major potential interaction with Cardiovascular Conditions and Disorders.

Etrasimod is contraindicated in patients who have experienced in the last 6 months myocardial infarction, unstable angina pectoris, stroke, transient ischemic attack, decompensated heart failure requiring hospitalization, and Class III or IV heart failure. It is also contraindicated in patients with history of Mobitz type II second or third-degree atrioventricular (AV) block, sick sinus syndrome, or sino-atrial block, unless the patient has a functioning pacemaker. Advice from a cardiologist should be sought if treatment is being considered in patients with significant QT prolongation, arrhythmias requiring treatment with Class Ia or Class II anti-arrhythmic drugs or QT prolonging drugs, unstable ischemic heart disease, Class I or III heart failure, history of cardiac arrest, cerebrovascular disease, uncontrolled hypertension, resting heart rate less than 50 beats per minute, symptomatic bradycardia, recurrent cardiogenic syncope, severe untreated sleep apnea, history of Mobitz type I second degree AV block, unless the patient has a functioning pacemaker.

The calaspargase pegol in Asparlas has a major potential interaction with Coagulation Defects and Disorders.

Hemorrhage associated with increased prothrombin time (PT), increased partial thromboplastin time (PTT), and hypofibrinogenemia have been reported in patients receiving calaspargase pegol. Evaluate patients with signs and symptoms of hemorrhage with coagulation parameters including PT, PTT, fibrinogen. Consider appropriate replacement therapy in any patients with severe or symptomatic coagulopathy. The use of calaspargase pegol is contraindicated in patients with any history of serious hemorrhagic events during a previous L-asparaginase therapy.

Etrasimod has a major potential interaction with Heart Disease.

Etrasimod is contraindicated in patients who have experienced in the last 6 months myocardial infarction, unstable angina pectoris, stroke, transient ischemic attack, decompensated heart failure requiring hospitalization, and Class III or IV heart failure. It is also contraindicated in patients with history of Mobitz type II second or third-degree atrioventricular (AV) block, sick sinus syndrome, or sino-atrial block, unless the patient has a functioning pacemaker. Advice from a cardiologist should be sought if treatment is being considered in patients with significant QT prolongation, arrhythmias requiring treatment with Class Ia or Class II anti-arrhythmic drugs or QT prolonging drugs, unstable ischemic heart disease, Class I or III heart failure, history of cardiac arrest, cerebrovascular disease, uncontrolled hypertension, resting heart rate less than 50 beats per minute, symptomatic bradycardia, recurrent cardiogenic syncope, severe untreated sleep apnea, history of Mobitz type I second degree AV block, unless the patient has a functioning pacemaker.

Etrasimod has a moderate potential interaction with Infection.

Etrasimod increases the risk of infections as it decreases the peripheral lymphocyte counts. Treatment initiation should be delayed in patients with an active infection until the infection is resolved. Patients without a confirmed history of varicella (chickenpox), or without documentation of a full course of vaccination against varicella zoster virus, should be tested for antibodies before initiating treatment. Avoid the use of live attenuated vaccines during and for up to 5 weeks after treatment.

The calaspargase pegol in Asparlas has a major potential interaction with Liver Disease.

The use of calaspargase pegol is contraindicated in patients with severe hepatic impairment. Caution and monitoring is advised in patients with liver impairment as hepatotoxicity and abnormal liver function, including elevations of transaminase, bilirubin (direct and indirect), reduced serum albumin, and plasma fibrinogen can occur. Evaluate bilirubin and transaminases at least weekly, during cycles of treatment that include calaspargase pegol, through 6 weeks after the last dose. In the event of serious liver toxicity, discontinue treatment and provide supportive care.

Etrasimod has a moderate potential interaction with Liver Disease.

Elevations of transaminases have been reported in patients receiving etrasimod. Additionally, this drug undergoes extensive hepatic metabolism, and its exposure was found increased in subjects with severe hepatic dysfunction (Child-Pugh C). The use of etrasimod is not recommended on these patients. No dosage adjustment is needed in mild to moderate hepatic dysfunction.

The calaspargase pegol in Asparlas has a major potential interaction with Pancreatitis.

Cases of pancreatitis have been reported in clinical trials with calaspargase pegol with an incidence as high as 16%. Caution is advised if used in patients with a history of pancreatitis. Inform patients of the signs and symptoms of pancreatitis, which, if left untreated, could be fatal. Assess serum amylase and/or lipase levels to identify early signs of pancreatic inflammation. Discontinue calaspargase pegol if pancreatitis is suspected; if pancreatitis is confirmed, do not resume treatment. Calaspargase pegol is contraindicated in patients with a history of pancreatitis due to any previous asparaginase therapy.

Etrasimod has a moderate potential interaction with Skin Cancer.

Cases of malignancies, including skin malignancies have been reported in patients treated with some sphingosine -1-receptor (S1P) receptor modulators. Skin examinations are recommended prior and during treatment in all patients, particularly in those with risk factors for skin cancer. Suspicious skin lesions should be promptly evaluated, and patients at increased risk should wear protective clothing and use sunscreen with high protection factor.

Etrasimod has a moderate potential interaction with Vaccination.

Etrasimod increases the risk of infections as it decreases the peripheral lymphocyte counts. Treatment initiation should be delayed in patients with an active infection until the infection is resolved. Patients without a confirmed history of varicella (chickenpox), or without documentation of a full course of vaccination against varicella zoster virus, should be tested for antibodies before initiating treatment. Avoid the use of live attenuated vaccines during and for up to 5 weeks after treatment.