Interactions between Belimumab and Roflumilast

Roflumilast has a moderate potential interaction with Anxiety and Stress.

The use of roflumilast is associated with an increase in psychiatric adverse reactions. Instances of suicidal ideation and behavior, including completed suicide, have been observed in clinical trials. Before using roflumilast in patients with a history of depression and/or suicidal thoughts or behavior, prescribers should carefully weigh the risks and benefits of treatment in all patients. Close monitoring for the emergence or worsening of insomnia, anxiety, depression, suicidal thoughts or other mood changes is recommended.

Belimumab has a moderate potential interaction with Depression.

In clinical trials, depression and suicidality were reported in patients receiving belimumab. Before treatment with belimumab, the risk of depression and suicide should be assessed, considering the patient's medical history and current psychiatric status; patients should continue to be monitored during therapy. Patients receiving belimumab (and caregivers, if applicable) should be instructed to contact their health care provider if they experience new or worsening depression, suicidal thoughts or behaviors, or other mood changes. The risk and benefit of continued therapy should be considered for patients who develop such symptoms.

Roflumilast has a moderate potential interaction with Depression.

The use of roflumilast is associated with an increase in psychiatric adverse reactions. Instances of suicidal ideation and behavior, including completed suicide, have been observed in clinical trials. Before using roflumilast in patients with a history of depression and/or suicidal thoughts or behavior, prescribers should carefully weigh the risks and benefits of treatment in all patients. Close monitoring for the emergence or worsening of insomnia, anxiety, depression, suicidal thoughts or other mood changes is recommended.

Roflumilast has a moderate potential interaction with Failure to Thrive.

Weight loss is a common adverse reaction with the use of roflumilast. Patients treated with roflumilast should have their weight monitored regularly. If unexplained or clinically significant weight loss occurs, weight loss should be evaluated, and discontinuation of treatment should be considered. Care should be exercised when using this agent in patients at risk of weight loss.

Belimumab has a moderate potential interaction with Immunodeficiency.

Cases of John Cunningham virus (JC virus)-associated progressive multifocal leukoencephalopathy (PML) resulting in neurological deficits (including fatal cases) have been reported in patients with systemic lupus erythematosus receiving immunosuppressants (including belimumab). Risk factors for PML include treatment with immunosuppressant therapies and impairment of immune function. The diagnosis of PML should be considered in any patient presenting with new-onset or deteriorating neurological signs/symptoms; a neurologist or other appropriate specialist should be consulted as clinically indicated. If PML is confirmed, belimumab should be discontinued.

Belimumab has a moderate potential interaction with Infection.

Serious and sometimes fatal infections have been reported in patients receiving immunosuppressive agents (including belimumab). Overall, while the incidence of serious infections in controlled trials was similar between belimumab and placebo, fatal infection occurred more often with belimumab. The risk and benefit should be considered before starting treatment with belimumab in patients with severe or chronic infections. Interruption of therapy should be considered in patients who develop a new infection while receiving belimumab and these patients should be monitored closely.

Roflumilast has a major potential interaction with Liver Disease.

Roflumilast is contraindicated in patients with moderate to severe liver impairment (Child-Pugh B or C). Roflumilast is extensively metabolized via Phase I (cytochrome P450) and Phase II (conjugation) reactions. Clinicians should consider the risk-benefit of administering roflumilast to patients with mild liver impairment (Child-Pugh A).

Belimumab has a moderate potential interaction with Psychiatric Disorders.

In clinical trials, depression and suicidality were reported in patients receiving belimumab. Before treatment with belimumab, the risk of depression and suicide should be assessed, considering the patient's medical history and current psychiatric status; patients should continue to be monitored during therapy. Patients receiving belimumab (and caregivers, if applicable) should be instructed to contact their health care provider if they experience new or worsening depression, suicidal thoughts or behaviors, or other mood changes. The risk and benefit of continued therapy should be considered for patients who develop such symptoms.