Can you take Bortezomib with Chloramphenicol / hydrocortisone / polymyxin b ophthalmic?

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.

Bortezomib has a moderate potential interaction with Dehydration.

There was an incidence of 8% of hypotension in patients receiving bortezomib therapy. Caution should be used when treating patients with history of hypotension, syncope, dehydration, or taking antihypertensive medication.

Bortezomib has a moderate potential interaction with Diabetes Mellitus.

Hypoglycemia and hyperglycemia was reported during clinical trials in diabetic patients in treatment with oral hypoglycemics and receiving bortezomib. Patients on oral antidiabetic agents may require close monitoring of their blood glucose levels and adjustment of the dose of their antidiabetic medication when using bortezomib.

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.

Bortezomib has a moderate potential interaction with Heart Disease.

Acute development or exacerbation of congestive heart failure and new onset of decreased left ventricular ejection fraction have occurred during treatment with bortezomib, including in patients with no risk factors. Patients with risk factors for, or existing heart disease should be closely monitored. There have also been isolated cases of QT interval prolongation but causality has not been established.

Bortezomib has a moderate potential interaction with Hypotension.

There was an incidence of 8% of hypotension in patients receiving bortezomib therapy. Caution should be used when treating patients with history of hypotension, syncope, dehydration, or taking antihypertensive medication.

Bortezomib has a moderate potential interaction with Liver Disease.

Cases of acute liver failure and other hepatic reactions such as hepatitis, increases in liver enzymes, and hyperbilirubinemia have been reported in patients receiving bortezomib. Monitoring is recommended and caution should be used when using bortezomib in patients with hepatic impairment. The exposure of bortezomib is increased in patients with moderate and severe hepatic impairment, and starting dose should be reduced in those patients.

Bortezomib has a moderate potential interaction with Peripheral Neuropathy.

Bortezomib can cause peripheral neuropathy that is predominantly sensory; however cases of severe sensory and motor peripheral neuropathy have been also reported. Patients with preexisting symptoms (numbness, pain or burning feeling in hands or feet) may experience worsening symptoms during treatment. Patients should be monitored for symptoms of neuropathy, and a dose adjustment might be required in those patients that experience them.

Bortezomib has a moderate potential interaction with Pulmonary Heart or Vascular Disease.

There have been reports of Acute Respiratory Distress Syndrome (ARDS) and acute diffuse infiltrative pulmonary disease of unknown etiology in patients receiving bortezomib. Additionally, there have been reports of pulmonary hypertension associated with bortezomib administration in the absence of left heart failure or significant pulmonary disease. Treatment interruption should be considered in the event of new or worsening cardiopulmonary symptoms until a comprehensive diagnostic evaluation is conducted. Caution should be exercised when using bortezomib in patients with cardiopulmonary pathologies.