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

Carfilzomib has a moderate potential interaction with Bleeding Disorder.

Fatal or serious cases of hemorrhage have been reported in patients treated with carfilzomib. Hemorrhage has been reported in patients having either low or normal platelet counts. Hemorrhage has also been reported in patients who were not on antiplatelet therapy or anticoagulation. Care should be exercised when using this agent in patients at risk of hemorrhagic events. Promptly evaluate signs and symptoms of blood loss. It is recommended to monitor platelet counts frequently during treatment and to reduce or withhold dose as appropriate.

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.

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.

Carfilzomib has a moderate potential interaction with Heart Disease.

Carfilzomib can cause new onset or worsening of preexisting cardiac failure, restrictive cardiomyopathy, myocardial ischemia, and myocardial infarction. Patients with preexisting heart problems might be at a greater risk of cardiac toxicity. It is recommended to monitor patients for clinical signs or symptoms of cardiac failure or cardiac ischemia. Evaluate promptly if cardiac toxicity is suspected. Withhold therapy for Grade 3 or 4 cardiac adverse events until recovery, and consider whether to restart at 1 dose level reduction based on a benefit/risk assessment.

Carfilzomib has a moderate potential interaction with Heart Disease.

Dyspnea was reported in patients treated with carfilzomib. Evaluate dyspnea to exclude cardiopulmonary conditions including cardiac failure and pulmonary syndromes. Withhold therapy with carfilzomib for Grade 3 or 4 dyspnea until resolved or returned to baseline. Consider whether to restart therapy based on a benefit/risk assessment.

Carfilzomib has a moderate potential interaction with Hemolytic Uremic Syndrome.

Cases of thrombotic microangiopathy, including thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) have been reported with the use of carfilzomib. Monitor for signs and symptoms of TTP/HUS. If the diagnosis is suspected, stop therapy and evaluate patients. If the diagnosis of TTP/HUS is excluded, therapy may be restarted. The safety of reinitiating carfilzomib therapy in patients previously experiencing TTP/HUS is not known.

Carfilzomib has a moderate potential interaction with High Blood Pressure.

The use of carfilzomib has been associated with hypertension, including hypertensive crisis and hypertensive emergency. It is recommended to monitor blood pressure regularly in all patients, especially in hypertensive patients. Care should be taken and if hypertension cannot be adequately controlled, withhold therapy and consider whether to restart therapy based on a benefit/risk assessment.

Carfilzomib has a moderate potential interaction with History, Thrombotic/Thromboembolic Disorder.

Carfilzomib should be used with caution in patients with a history of venous thromboembolic events, including deep venous thrombosis and pulmonary embolism. Thromboprophylaxis is recommended for patients being treated with the combination of carfilzomib with dexamethasone or with lenalidomide plus dexamethasone. The thromboprophylaxis regimen should be based on an assessment of the patient's underlying risks. Patients using oral contraceptives or a hormonal method of contraception associated with a risk of thrombosis should consider an alternative method of effective contraception during treatment with carfilzomib in combination with dexamethasone or lenalidomide plus dexamethasone.

Carfilzomib has a moderate potential interaction with Liver Disease.

Cases of hepatic failure, including fatal cases, have been reported in patients receiving treatment with carfilzomib. The pharmacokinetics and safety of carfilzomib were evaluated in patients with normal hepatic function, or mild, moderate, or severe hepatic impairment. The AUC of carfilzomib increased by approximately 50% in patients with mild and moderate hepatic impairment compared to patients with normal hepatic function. PK data were not collected in patients with severe hepatic impairment. It is recommended to reduce the dose of carfilzomib by 25% in patients with mild or moderate hepatic impairment. Dosing recommendation cannot be made for patients with severe hepatic function. Monitor liver enzymes regularly, regardless of baseline values, and modify dose based on toxicity. Therapy with this agent can cause increased serum transaminases. Monitor liver enzymes regularly, regardless of baseline values. It is recommended to reduce or withhold dose as appropriate.

Carfilzomib has a moderate potential interaction with Posterior Reversible Encephalopathy Syndrome.

Cases of posterior reversible encephalopathy syndrome (PRES) have been reported with the use carfilzomib. Discontinue therapy if PRES is suspected and evaluate. Care should be exercised as the safety of reinitiating carfilzomib therapy in patients previously experiencing PRES is not known.

Carfilzomib has a moderate potential interaction with Pulmonary Arterial Hypertension.

Pulmonary arterial hypertension was reported in patients treated with carfilzomib. It is recommended to evaluate patients with cardiac imaging and/or other tests as indicated. Care should be exercised in patients with existing pulmonary hypertension. Withhold carfilzomib therapy for pulmonary hypertension until resolved or returned to baseline, and consider whether to restart based on a benefit/risk assessment.

Carfilzomib has a moderate potential interaction with Pulmonary Embolism.

Carfilzomib should be used with caution in patients with a history of venous thromboembolic events, including deep venous thrombosis and pulmonary embolism. Thromboprophylaxis is recommended for patients being treated with the combination of carfilzomib with dexamethasone or with lenalidomide plus dexamethasone. The thromboprophylaxis regimen should be based on an assessment of the patient's underlying risks. Patients using oral contraceptives or a hormonal method of contraception associated with a risk of thrombosis should consider an alternative method of effective contraception during treatment with carfilzomib in combination with dexamethasone or lenalidomide plus dexamethasone.

Carfilzomib has a moderate potential interaction with Pulmonary Impairment.

Dyspnea was reported in patients treated with carfilzomib. Evaluate dyspnea to exclude cardiopulmonary conditions including cardiac failure and pulmonary syndromes. Withhold therapy with carfilzomib for Grade 3 or 4 dyspnea until resolved or returned to baseline. Consider whether to restart therapy based on a benefit/risk assessment.

Carfilzomib has a moderate potential interaction with Pulmonary Impairment.

The use of carfilzomib has been associated with pulmonary toxicity. Patients presenting pulmonary symptoms should be carefully assessed for pulmonary toxicity. It is recommended to discontinue treatment in the event of drug-induced pulmonary toxicity.

Carfilzomib has a moderate potential interaction with Renal Dysfunction.

Cases of acute renal failure have occurred in patients receiving carfilzomib. The risk was greater in patients with a baseline reduced estimated creatinine clearance. It is recommended to monitor renal function with regular measurement of the serum creatinine and/or estimated creatinine clearance. Consider reducing or withholding dose as appropriate.

Carfilzomib has a moderate potential interaction with Thrombocytopenia.

Fatal or serious cases of hemorrhage have been reported in patients treated with carfilzomib. Hemorrhage has been reported in patients having either low or normal platelet counts. Hemorrhage has also been reported in patients who were not on antiplatelet therapy or anticoagulation. Care should be exercised when using this agent in patients at risk of hemorrhagic events. Promptly evaluate signs and symptoms of blood loss. It is recommended to monitor platelet counts frequently during treatment and to reduce or withhold dose as appropriate.

Carfilzomib has a moderate potential interaction with Thrombotic/Thromboembolic Disorder.

Carfilzomib should be used with caution in patients with a history of venous thromboembolic events, including deep venous thrombosis and pulmonary embolism. Thromboprophylaxis is recommended for patients being treated with the combination of carfilzomib with dexamethasone or with lenalidomide plus dexamethasone. The thromboprophylaxis regimen should be based on an assessment of the patient's underlying risks. Patients using oral contraceptives or a hormonal method of contraception associated with a risk of thrombosis should consider an alternative method of effective contraception during treatment with carfilzomib in combination with dexamethasone or lenalidomide plus dexamethasone.

Carfilzomib has a moderate potential interaction with Thrombotic Thrombocytopenic Purpura.

Cases of thrombotic microangiopathy, including thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) have been reported with the use of carfilzomib. Monitor for signs and symptoms of TTP/HUS. If the diagnosis is suspected, stop therapy and evaluate patients. If the diagnosis of TTP/HUS is excluded, therapy may be restarted. The safety of reinitiating carfilzomib therapy in patients previously experiencing TTP/HUS is not known.

Carfilzomib has a major potential interaction with Tumor Lysis Syndrome.

Cases of tumor lysis syndrome (TLS), including fatal outcomes, have been reported in patients receiving carfilzomib. Patients with multiple myeloma and a high tumor burden should be considered at a greater risk for TLS. Ensure that patients are well hydrated before administration of therapy in Cycle 1, and in subsequent cycles as recommended by the manufacturer. Consider uric acid-lowering drugs in patients at risk for TLS. It is recommended to monitor for evidence of TLS during treatment and manage promptly, including interruption of therapy until resolution of TLS.