Interactions between Cabazitaxel and Topotecan

Cabazitaxel has a major potential interaction with Anemia.

The use of cabazitaxel is contraindicated in patients with neutrophils count less than or equal to 1,500/mm3. The use of cabazitaxel may cause bone marrow suppression manifested as neutropenia, anemia, thrombocytopenia and/or pancytopenia. Prophylaxis therapy should be considered in patients with high-risk clinical features (age >65 years, poor performance status, previous episodes of febrile neutropenia, extensive prior radiation ports, poor nutritional status, or other serious comorbidities) that predispose them to increased complications from prolonged neutropenia. Cautions should be exercised in patients using cabazitaxel with hemoglobin counts of less than 10 g/dL. It is recommended to monitor complete blood counts on a weekly basis during cycle 1 and before each treatment cycle thereafter so that the dose can be adjusted, if needed.

Topotecan has a major potential interaction with Bleeding Disorder.

Topotecan induces myelosuppression. Severe thrombocytopenia (< 25,000/mm3) has been reported during topotecan therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bleeding such as petechiae, purpura, hematuria, or melena. Close clinical monitoring of hematopoietic function is recommended. Therapy with topotecan should not be initiated in patients with platelet counts < 100,000/mm3. Subsequent courses of topotecan should be withheld until platelet counts exceed 100,000/mm3.

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

The use of cabazitaxel is contraindicated in patients with neutrophils count less than or equal to 1,500/mm3. The use of cabazitaxel may cause bone marrow suppression manifested as neutropenia, anemia, thrombocytopenia and/or pancytopenia. Prophylaxis therapy should be considered in patients with high-risk clinical features (age >65 years, poor performance status, previous episodes of febrile neutropenia, extensive prior radiation ports, poor nutritional status, or other serious comorbidities) that predispose them to increased complications from prolonged neutropenia. Cautions should be exercised in patients using cabazitaxel with hemoglobin counts of less than 10 g/dL. It is recommended to monitor complete blood counts on a weekly basis during cycle 1 and before each treatment cycle thereafter so that the dose can be adjusted, if needed.

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

Topotecan induces myelosuppression. Severe neutropenia (< 500/mm3), severe thrombocytopenia (< 25,000/mm3), and severe anemia (< 8 g/dl) have been reported frequently. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended. Therapy with topotecan should not be initiated in patients with neutrophil counts < 1500/mm3 and/or platelet counts < 100,000/mm3. Subsequent courses of topotecan should be withheld until neutrophil counts exceed 1000/mm3, platelet counts exceed 100,000/mm3, and/or hemoglobin levels are at least 9 g/dl.

Cabazitaxel has a major potential interaction with Dehydration.

Renal failure, sometimes with fatal outcomes has been documented with the use of cabazitaxel in clinical studies and most cases have occurred in association with sepsis, dehydration, or obstructive uropathy. Care and appropriate measures should be taken when prescribing this agent to these patients.

Topotecan has a moderate potential interaction with Diarrhea.

Topotecan capsules can cause severe and life-threatening diarrhea that may require hospitalization. It is recommended to withhold treatment for severe diarrhea. Manage diarrhea caused by topotecan aggressively and do no administer topotecan capsules to patients with Grade 3 or 4 diarrhea. Reduce the dose of therapy after recovery to Grade 1 or less. Close monitoring is recommended.

Cabazitaxel has a major potential interaction with Fever.

The use of cabazitaxel is contraindicated in patients with neutrophils count less than or equal to 1,500/mm3. The use of cabazitaxel may cause bone marrow suppression manifested as neutropenia, anemia, thrombocytopenia and/or pancytopenia. Prophylaxis therapy should be considered in patients with high-risk clinical features (age >65 years, poor performance status, previous episodes of febrile neutropenia, extensive prior radiation ports, poor nutritional status, or other serious comorbidities) that predispose them to increased complications from prolonged neutropenia. Cautions should be exercised in patients using cabazitaxel with hemoglobin counts of less than 10 g/dL. It is recommended to monitor complete blood counts on a weekly basis during cycle 1 and before each treatment cycle thereafter so that the dose can be adjusted, if needed.

Topotecan has a major potential interaction with Fever.

Topotecan induces myelosuppression. Severe neutropenia (< 500/mm3), severe thrombocytopenia (< 25,000/mm3), and severe anemia (< 8 g/dl) have been reported frequently. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended. Therapy with topotecan should not be initiated in patients with neutrophil counts < 1500/mm3 and/or platelet counts < 100,000/mm3. Subsequent courses of topotecan should be withheld until neutrophil counts exceed 1000/mm3, platelet counts exceed 100,000/mm3, and/or hemoglobin levels are at least 9 g/dl.

Cabazitaxel has a moderate potential interaction with Gastrointestinal Hemorrhage.

Gastrointestinal hemorrhage and perforation, ileus, enterocolitis, neutropenic enterocolitis, including fatal outcome, have been reported in patients treated with cabazitaxel. Risk may be increased with neutropenia, age, steroid use, concomitant use of NSAIDs, anti-platelet therapy or anti-coagulants, and patients with a prior history of pelvic radiotherapy, adhesions, ulceration and GI bleeding. It is recommended to monitor closely for early manifestations of serious gastrointestinal toxicity and to delay or discontinue treatment if necessary, in particular if patients experience Grade >=3 diarrhea.

Cabazitaxel has a moderate potential interaction with Gastrointestinal Obstruction.

Gastrointestinal hemorrhage and perforation, ileus, enterocolitis, neutropenic enterocolitis, including fatal outcome, have been reported in patients treated with cabazitaxel. Risk may be increased with neutropenia, age, steroid use, concomitant use of NSAIDs, anti-platelet therapy or anti-coagulants, and patients with a prior history of pelvic radiotherapy, adhesions, ulceration and GI bleeding. It is recommended to monitor closely for early manifestations of serious gastrointestinal toxicity and to delay or discontinue treatment if necessary, in particular if patients experience Grade >=3 diarrhea.

Cabazitaxel has a moderate potential interaction with Hemodialysis.

Cabazitaxel is minimally excreted via the kidney and its use does not require dosage adjustment in patients with renal impairment not requiring hemodialysis. Patients presenting with end-stage renal disease should be monitored carefully during treatment with cabazitaxel.

Cabazitaxel has a major potential interaction with Infection.

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

Topotecan has a major potential interaction with Infection.

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

Cabazitaxel has a moderate potential interaction with Infection.

Interstitial lung disease/pneumonitis and acute respiratory distress syndrome have been reported with the use of cabazitaxel. Patients with underlying lung disease may be at higher risk for these events. Acute respiratory distress syndrome may occur in the setting of infection. Treatment interruption or discontinuation may be necessary if new or worsening of pulmonary symptoms develop. Close monitoring is recommended. The benefits of resuming therapy should be carefully evaluated.

Cabazitaxel has a moderate potential interaction with Interstitial Lung Disease.

Interstitial lung disease/pneumonitis and acute respiratory distress syndrome have been reported with the use of cabazitaxel. Patients with underlying lung disease may be at higher risk for these events. Acute respiratory distress syndrome may occur in the setting of infection. Treatment interruption or discontinuation may be necessary if new or worsening of pulmonary symptoms develop. Close monitoring is recommended. The benefits of resuming therapy should be carefully evaluated.

Cabazitaxel has a major potential interaction with Liver Disease.

Cabazitaxel is extensively metabolized in the liver and is contraindicated in patients with severe hepatic impairment. Caution and close monitoring is recommended when prescribing this agent to patients with mild or moderate hepatic impairment and dosage reduction should be considered for these patients.

Cabazitaxel has a moderate potential interaction with Neutropenia.

Gastrointestinal hemorrhage and perforation, ileus, enterocolitis, neutropenic enterocolitis, including fatal outcome, have been reported in patients treated with cabazitaxel. Risk may be increased with neutropenia, age, steroid use, concomitant use of NSAIDs, anti-platelet therapy or anti-coagulants, and patients with a prior history of pelvic radiotherapy, adhesions, ulceration and GI bleeding. It is recommended to monitor closely for early manifestations of serious gastrointestinal toxicity and to delay or discontinue treatment if necessary, in particular if patients experience Grade >=3 diarrhea.

Cabazitaxel has a moderate potential interaction with Peptic Ulcer.

Gastrointestinal hemorrhage and perforation, ileus, enterocolitis, neutropenic enterocolitis, including fatal outcome, have been reported in patients treated with cabazitaxel. Risk may be increased with neutropenia, age, steroid use, concomitant use of NSAIDs, anti-platelet therapy or anti-coagulants, and patients with a prior history of pelvic radiotherapy, adhesions, ulceration and GI bleeding. It is recommended to monitor closely for early manifestations of serious gastrointestinal toxicity and to delay or discontinue treatment if necessary, in particular if patients experience Grade >=3 diarrhea.

Cabazitaxel has a moderate potential interaction with Pulmonary Impairment.

Interstitial lung disease/pneumonitis and acute respiratory distress syndrome have been reported with the use of cabazitaxel. Patients with underlying lung disease may be at higher risk for these events. Acute respiratory distress syndrome may occur in the setting of infection. Treatment interruption or discontinuation may be necessary if new or worsening of pulmonary symptoms develop. Close monitoring is recommended. The benefits of resuming therapy should be carefully evaluated.

Topotecan has a moderate potential interaction with Pulmonary Impairment.

Fatal cases of interstitial lung disease (ILD) have occurred with the use of topotecan. Risk factors include a history of ILD, pulmonary fibrosis, lung cancer, thoracic radiation, and use of pneumotoxic drugs and/or colony stimulating factors. It is recommended to monitor patients for pulmonary symptoms indicative of ILD and permanently discontinue treatment for confirmed ILD.

Topotecan has a major potential interaction with Renal Dysfunction.

Topotecan is partially eliminated by the kidney. Approximately 30% of topotecan is excreted in the urine. Plasma clearance of topotecan was reduced 33% in patients with mild renal impairment (creatinine clearance of 40 to 60 mL/min) and 66% in patients with moderate renal impairment (creatinine clearance of 20 to 40 mL/min). Therapy with topotecan should be administered cautiously and at a reduced dosage in patients with moderate to severe renal dysfunction.

Cabazitaxel has a major potential interaction with Sepsis.

Renal failure, sometimes with fatal outcomes has been documented with the use of cabazitaxel in clinical studies and most cases have occurred in association with sepsis, dehydration, or obstructive uropathy. Care and appropriate measures should be taken when prescribing this agent to these patients.

Cabazitaxel has a major potential interaction with Urinary Tract Obstruction.

Renal failure, sometimes with fatal outcomes has been documented with the use of cabazitaxel in clinical studies and most cases have occurred in association with sepsis, dehydration, or obstructive uropathy. Care and appropriate measures should be taken when prescribing this agent to these patients.