Can you take Axicabtagene ciloleucel with Chloramphenicol / hydrocortisone / polymyxin b ophthalmic?

Axicabtagene ciloleucel has a major potential interaction with Autoimmune Disorders.

Drugs directed against B cells, such as axicabtagene ciloleucel, and tisagenlecleuce should not be administered to patients with inflammatory disorders. Cytokine Release Syndrome, including fatal or life-threatening reactions, occurred in patients receiving these agents. Axicabtagene ciloleucel and tisagenlecleuce are CD19-directed genetically modified autologous T cell immunotherapy that bind to CD19-expressing cancer cells and normal B cells and through a series of cascades, lead T cell activation and secretions of inflammatory cytokines.

The chloramphenicol ophthalmic in chloramphenicol / hydrocortisone / polymyxin b ophthalmic has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

Chloramphenicol may cause bone marrow depression and other hematologic toxicities, which can be irreversible or reversible. The former type is independent of dose and results in aplastic anemia with a high rate of mortality, generally from hemorrhage or infection. It has been reported following both systemic and topical administration of chloramphenicol and has an estimated incidence of 1 in 25,000 to 1 in 40,000 courses of therapy. Bone marrow aplasia or hypoplasia may occur after a single dose but more often develops weeks or months after the drug has been discontinued. A reversible myelosuppression occurs much more frequently and is characterized by anemia, vacuolation of red blood cells, decreased reticulocyte count, leukopenia, thrombocytopenia, increased serum iron concentrations, and increased serum iron-binding capacity. It is dose-dependent, occurring regularly at chloramphenicol dosages exceeding 4 g/day (in adults) or at plasma drug concentrations >= 25 mcg/mL, and usually responds to withdrawal of the drug. Therapy with chloramphenicol should be administered cautiously, if at all, in patients with preexisting blood dyscrasias and/or bone marrow depression. Complete blood counts and differential reticulocyte counts should be performed in all patients prior to initiating therapy and approximately every 2 days during therapy. Marked depression of blood counts and/or development of other hematologic abnormalities may be indication for withdrawal of chloramphenicol therapy.

The hydrocortisone ophthalmic in chloramphenicol / hydrocortisone / polymyxin b ophthalmic has a major potential interaction with Cataract.

Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with ophthalmic corticosteroids should be administered cautiously in patients with a history of cataracts, glaucoma, or increased intraocular pressure. If these agents are used for more than 10 days, the manufacturers recommend that intraocular pressure be routinely monitored, including in children. The equatorial and posterior subcapsular portions of the lens should be examined for changes.

The hydrocortisone ophthalmic in chloramphenicol / hydrocortisone / polymyxin b ophthalmic has a major potential interaction with Eye Conditions.

The use of ophthalmic corticosteroids is contraindicated in most viral diseases of the cornea and conjunctiva, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella; fungal diseases of ocular structures; mycobacterial infections, including tuberculosis, of the eye; and any acute, purulent, untreated ocular infections. Corticosteroids may decrease host resistance to infectious agents, thus prolonging the course and/or exacerbating the severity of the infection while encouraging the development of new or secondary infection. In addition, administration of ophthalmic corticosteroids in severe ocular disease, especially acute herpes simplex keratitis, may lead to excessive corneal and scleral thinning, increasing the risk for perforation. In less serious ocular infections, therapy with ophthalmic corticosteroids may be administered but only with caution and accompanied by appropriate antimicrobial agents. Besides compromising host immune response, corticosteroids may also mask the symptoms of infection, thus hindering the recognition of potential ineffectiveness of the antibiotic therapy. If infection does not improve or becomes worse during administration of an ophthalmic corticosteroid, the drug should be discontinued and other appropriate therapy initiated.

The hydrocortisone ophthalmic in chloramphenicol / hydrocortisone / polymyxin b ophthalmic has a major potential interaction with Glaucoma/Intraocular Hypertension.

Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with ophthalmic corticosteroids should be administered cautiously in patients with a history of cataracts, glaucoma, or increased intraocular pressure. If these agents are used for more than 10 days, the manufacturers recommend that intraocular pressure be routinely monitored, including in children. The equatorial and posterior subcapsular portions of the lens should be examined for changes.

Axicabtagene ciloleucel has a major potential interaction with Infection.

Drugs directed against B cells, such as axicabtagene ciloleucel, and tisagenlecleucel should not be administered to patients with clinically significant active systemic infections. Severe or life-threatening infections, including febrile neutropenia, were observed in patients after treatment with these agents and may be concurrent with Cytokine Release Syndrome (CRS). It is recommended to monitor patients for signs and symptoms of infection before and after infusion and administer prophylactic antimicrobials as appropriate. Counsel patients to seek immediate medical attention should signs, or symptoms of CRS occur at any time. At the first sign of CRS, institute treatment with supportive care according to medical practices.

Axicabtagene ciloleucel has a major potential interaction with Infectious Hepatitis.

The use of drugs directed against B cells, such as axicabtagene ciloleucel, and tisagenlecleucel is associated with hepatitis B reactivation, some cases have resulted in fulminant hepatitis, hepatic failure, and death. Close monitoring is recommended when using these agents in patients with a history of hepatitis infection. It is recommended to screen patients for HBV, HCV, and HIV in accordance with clinical guidelines before collection of cells for manufacturing.

Axicabtagene ciloleucel has a major potential interaction with Neurological Disorders.

Neurologic toxicities, that were fatal or life-threatening, occurred following treatment with drugs directed against B cells, such as axicabtagene ciloleucel, and tisagenlecleucel which may be concurrent with Cytokine Release Syndrome (CRS) or after CRS resolution. Care should be exercised when using these agents in patients with neurologic disorders. It is recommended to monitor patients for signs and symptoms of neurologic toxicities after infusion and provide supportive care and/or corticosteroids as needed.

Axicabtagene ciloleucel has a moderate potential interaction with Vaccination.

The safety of immunization with live viral vaccines during or following treatment with drugs directed against B cells, such as axicabtagene ciloleucel, and tisagenlecleucel has not been studied. Vaccination with live virus vaccines is not recommended for at least 6 weeks prior to the start of lymphodepleting chemotherapy, during treatment, and until immune recovery following treatment with these agents.