Can you take Bcg vaccine with Pemetrexed?

PEMEtrexed has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

Pemetrexed can cause severe myelosuppression resulting in the need for transfusion and which may lead to neutropenic infection. The risk of myelosuppression is increased in patients who do not receive vitamin supplementation (including oral folic acid and IM vitamin B12). Patients with myelosuppression should be monitored carefully. A CBC should be obtained at the beginning of each cycle and as needed. Treatment should not be initiated unless the absolute neutrophil count is at least 1500 cells/mm3 and platelet count is at least 100,000 cells/mm3.

BCG vaccine has a major potential interaction with Fever.

The use of BCG vaccine is contraindicated in patients with fever unless the cause has been determined and evaluated. If the fever is due to an infection, administration of BCG vaccine should be deferred until the patient is afebrile and done with antimicrobial therapy. When BCG vaccine is used for immunization against tuberculosis, the presence of existing infection, especially if moderate or severe, may increase the risk of an adverse host reaction and/or vaccine failure. BCG vaccine is not for the treatment of active tuberculosis. When administered intravesically for the treatment of bladder cancer, concomitant antimicrobial therapy can interfere with the effectiveness of the vaccine. Antimicrobial therapy should be evaluated to assess the effects on BCG activity. Finally, since BCG vaccine contains live bacteria, it can potentially cause a systemic BCG infection, particularly in acutely ill patients. Disseminated BCG infection has been fatal in some cases.

PEMEtrexed has a moderate potential interaction with History, Radiation Therapy.

Radiation recall can occur with pemetrexed in patients who have received radiation weeks to years previously. Patients should be monitored for inflammation/blistering in areas of previous radiation treatment; they should be advised to immediately contact their health care provider if inflammation/blisters develop in a previously irradiated area. Pemetrexed should be permanently discontinued for signs of radiation recall.

BCG vaccine has a major potential interaction with Immunodeficiency.

The use of BCG vaccine is contraindicated in patients with congenital or acquired immunodeficiency, including those with severe combined immunodeficiency, hypogammaglobulinemia or agammaglobulinemia, HIV infection, altered immune states (due to diseases such as leukemia, lymphoma, or generalized malignancy), or immunosuppression due to drug or other treatments (e.g., corticosteroids, alkylating agents, antimetabolites, or radiation). BCG vaccine contains live bacteria. The absence of immune competence may potentiate the replication of vaccine virus and cause a systemic BCG infection, which has been fatal in some cases. In addition, when used for immunization against tuberculosis, serum antibody response may be compromised. BCG vaccine should also not be administered to anyone with a family history of congenital or hereditary immunodeficiency until the individual's immune status can be assessed and is determined to be adequate.

BCG vaccine has a major potential interaction with Infection.

The use of BCG vaccine is contraindicated in patients with fever unless the cause has been determined and evaluated. If the fever is due to an infection, administration of BCG vaccine should be deferred until the patient is afebrile and done with antimicrobial therapy. When BCG vaccine is used for immunization against tuberculosis, the presence of existing infection, especially if moderate or severe, may increase the risk of an adverse host reaction and/or vaccine failure. BCG vaccine is not for the treatment of active tuberculosis. When administered intravesically for the treatment of bladder cancer, concomitant antimicrobial therapy can interfere with the effectiveness of the vaccine. Antimicrobial therapy should be evaluated to assess the effects on BCG activity. Finally, since BCG vaccine contains live bacteria, it can potentially cause a systemic BCG infection, particularly in acutely ill patients. Disseminated BCG infection has been fatal in some cases.

PEMEtrexed has a moderate potential interaction with Liver Disease.

No formal studies have been conducted to examine pemetrexed in patients with liver dysfunction. Caution is advised.

PEMEtrexed has a major potential interaction with Pulmonary Impairment.

Serious interstitial pneumonitis (including fatal case) can occur with pemetrexed. Care should be exercised when using pemetrexed in patients with preexisting pulmonary impairment. Pemetrexed should be withheld for acute onset of new/progressive unexplained pulmonary symptoms; if pneumonitis is confirmed, pemetrexed should be permanently discontinued.

PEMEtrexed has a major potential interaction with Renal Dysfunction.

Pemetrexed can cause severe (and sometimes fatal) renal toxicity. Pemetrexed is primarily eliminated by the kidneys; decreased renal function results in decreased clearance and increased pemetrexed exposure compared with normal renal function. No dose is recommended for patients with CrCl less than 45 mL/min. CrCl should be determined before each dose and renal function should be monitored periodically during therapy. Pemetrexed should be withheld in patients with renal toxicity until CrCl is 45 mL/min or greater.

BCG vaccine has a major potential interaction with Tuberculosis, Active.

The use of BCG vaccine is contraindicated in patients with fever unless the cause has been determined and evaluated. If the fever is due to an infection, administration of BCG vaccine should be deferred until the patient is afebrile and done with antimicrobial therapy. When BCG vaccine is used for immunization against tuberculosis, the presence of existing infection, especially if moderate or severe, may increase the risk of an adverse host reaction and/or vaccine failure. BCG vaccine is not for the treatment of active tuberculosis. When administered intravesically for the treatment of bladder cancer, concomitant antimicrobial therapy can interfere with the effectiveness of the vaccine. Antimicrobial therapy should be evaluated to assess the effects on BCG activity. Finally, since BCG vaccine contains live bacteria, it can potentially cause a systemic BCG infection, particularly in acutely ill patients. Disseminated BCG infection has been fatal in some cases.