Drug Interactions between bupivacaine / dexamethasone / epinephrine and nadofaragene firadenovec

GENERALLY AVOID: Administration of intravesical nadofaragene firadenovec during immunosuppressant therapy may be associated with a risk of disseminated adenovirus infection due to possible low levels of replication-competent adenovirus from nadofaragene firadenovec in the presence of diminished immune competence. Patients may be immunosuppressed if they have recently received or are receiving alkylating agents, antimetabolites, radiation, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents (e.g., greater than or equal to 2 mg/kg/day or 20 mg/day of prednisone or equivalent for 14 consecutive days or more), or long-term topical or inhaled corticosteroids.

MANAGEMENT: Use of intravesical nadofaragene firadenovec in immunosuppressed patients with congenital or acquired immune deficiencies, including those due to concurrent disease (e.g., AIDS, leukemia, lymphoma), cancer therapy (e.g., cytotoxic drugs, radiation) or immunosuppressive therapy (e.g., corticosteroids), should generally be avoided.