Can you take Bleo 15k with Nivolumab?

Nivolumab has a moderate potential interaction with Autoimmune Disorders.

Programmed death receptor-1/ligand-1 (PD-1/PD-L1) blocking antibodies can cause immune-mediated adverse reactions, which may be severe or fatal. Immune-mediated adverse reactions can occur in any organ system or tissue at any time after starting therapy. This may be considered when using PD-1/PD-L1 blocking antibodies in patients with immune system disorders (e.g., ulcerative colitis, Crohn's disease, lupus) or with conditions affecting the nervous system (e.g., myasthenia gravis, Guillain-Barre syndrome). It is recommended to monitor patients closely for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions.

Nivolumab has a moderate potential interaction with Bone Marrow Transplantation.

Fatal and other serious complications can occur in patients who receive allogeneic hematopoietic stem cell transplantation (HSCT) before or after being treated with a programmed death receptor-1/ligand-1 (PD-1/PD-L1) blocking antibody. Transplant-related complications include hyperacute graft-versus-host disease (GVHD), acute GVHD, chronic GVHD, hepatic veno-occlusive disease after reduced intensity conditioning, and steroid-requiring febrile syndrome (without an identified infectious cause). These complications may occur despite intervening therapy between PD-1/PD-L1 blockade and allogeneic HSCT. It is recommended to follow patients closely for evidence of transplant-related complications and intervene promptly. The benefit versus risks of treatment with a PD-1/PD-L1 blocking antibody before or after an allogeneic HSCT should be considered.

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

Nivolumab-containing products can cause immune-mediated pneumonitis. In patients treated with other programmed death receptor-1/ligand-1 (PD-1/PD-L1) blocking antibodies, the incidence of pneumonitis was higher in patients who have received prior thoracic radiation.

The bleomycin in Bleo 15k has a moderate potential interaction with Liver Disease.

The effect of hepatic insufficiency on the pharmacokinetics of bleomycin has not been evaluated. However, hepatic toxicity, beginning as a deterioration in liver function tests, has been reported. These toxicities may occur at any time after initiation of therapy. Caution and monitoring is advised if bleomycin is used in patients with liver impairment.

Nivolumab has a moderate potential interaction with Liver Disease.

Nivolumab has not been studied in patients with severe liver dysfunction (total bilirubin greater than 3 times the upper limit of normal and any AST). Mild and moderate liver dysfunction had no clinically significant effect on the clearance of IV nivolumab; data not available for subcutaneous nivolumab.

Nivolumab has a moderate potential interaction with Multiple Myeloma.

The use of programmed death receptor-1/ligand-1 (PD-1/PD-L1) blocking antibodies in combination with a thalidomide analog plus dexamethasone is not recommended in patients with multiple myeloma outside of controlled trials. In randomized clinical trials in patients with multiple myeloma, the addition of a PD-1/PD-L1 blocking antibody to a thalidomide analog plus dexamethasone (a use for which no PD-1 or PD-L1 blocking antibody is indicated) resulted in increased mortality.

Nivolumab has a moderate potential interaction with Organ Transplant.

Solid organ transplant rejection and other transplant (including corneal graft) rejection have been reported with the use of programmed death receptor-1/ligand-1 (PD-1/PD-L1) blocking antibodies. This may be considered when using PD-1/PD-L1 blocking antibodies in patients who have received a solid organ or other transplant.

The bleomycin in Bleo 15k has a major potential interaction with Pulmonary Impairment.

Pulmonary pneumonitis occurs in 10% of patients during bleomycin therapy and 1% progress to pulmonary fibrosis and death. Although pulmonary toxicity is age and dose related, occurring primarily in patients over 70 years of age and in those receiving a total dose > 400 units, it has occurred in younger patients at a lower dose. Extreme caution should be exercised when administering bleomycin in patients with compromised pulmonary function. Patients should be instructed to immediately report symptoms of dyspnea, cough, or congestion. Close clinical monitoring of pulmonary function is recommended.

The bleomycin in Bleo 15k has a major potential interaction with Renal Dysfunction.

Bleomycin is primarily eliminated by the kidney. Approximately 60% to 70% of bleomycin is excreted in the urine as active drug. Moderate renal failure reduces elimination to < 20% of the drug. Extreme caution should be exercised when administering bleomycin in patients with existing or predisposition to significantly compromised renal function. Close clinical monitoring of renal function is recommended.