Can you take Ceritinib with Triam-A?
1 drug interaction and 56 additional warnings found for the following 2 drugs:
- ceritinib
- Triam-A (triamcinolone)
Drug interactions
Major drug interactions
Major:
triamcinolone ceritinib
Applies to: Triam-A (triamcinolone) and ceritinib
Ceritinib may significantly increase the blood levels of triamcinolone.
You may be more likely to experience side effects such as:
- swelling
- weight gain
- high blood pressure
- high blood glucose
- muscle weakness
- depression
- acne
- thinning skin
- stretch marks
- easy bruising
- bone density loss
- cataracts
- menstrual irregularities
- excessive growth of facial or body hair
- abnormal distribution of body fat, especially in the face, neck, back, and waist
Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
Other side effects that may occur include:
- decreased ability to fight infections
- increased risk of developing infections
- inadequate response to stress such as infection, surgery, trauma, or a severe asthma attack
Children may experience a reduced growth rate due to excessive effects of triamcinolone.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Major food/lifestyle interactions
Major:
ceritinib Food/Lifestyle
Applies to: ceritinib
Do not consume grapefruit or grapefruit juice during treatment with ceritinib unless directed otherwise by your doctor.
Grapefruit juice can increase the blood levels of ceritinib to dangerous levels, increasing the risk of an irregular heart rhythm that may be serious. Other, more common side effects such as diarrhea, nausea, vomiting, abdominal pain, and hyperglycemia (high blood sugar) may also increase.
You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with ceritinib.
Food may also increase the blood levels of ceritinib. Therefore, you should take ceritinib on an empty stomach, meaning no food should be eaten for at least two hours before or after taking ceritinib.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate food/lifestyle interactions
Moderate:
triamcinolone Food/Lifestyle
Applies to: Triam-A (triamcinolone)
Using triamcinolone together with alcohol or grapefruit may increase the risk of side effects of triamcinolone.
You may want to limit your consumption of grapefruit, grapefruit juice, and/or alcohol during treatment with triamcinolone.
Talk to your doctor if you have any questions or concerns.
You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as:
- dizziness
- lightheadedness
- red or black, tarry stools
- coughing up or vomiting fresh or dried blood that looks like coffee grounds
- severe headache
- weakness
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
54 potential interactions Applies to: 50 conditions, including High Blood Pressure, High Cholesterol, Depression, Underactive Thyroid, and Heart Failure.
Abnormal Glucose Tolerance
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Abnormal Glucose Tolerance.
Corticosteroids can raise blood glucose level by antagonizing the action and suppressing the secretion of insulin, which results in inhibition of peripheral glucose uptake and increased gluconeogenesis. Therapy with corticosteroids should be administered cautiously in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Patients with diabetes mellitus should be monitored more closely during corticosteroid therapy, and their antidiabetic regimen adjusted accordingly.
Adrenal Tumor
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Adrenal Tumor.
Corticosteroids mimic the effects of endogenous cortisol and aldosterone. Use of these agents may aggravate conditions of hyperadrenocorticalism in a dose-dependent manner.
Cataract
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate 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. Long-term therapy with corticosteroids should be administered cautiously in patients with a history of cataracts, glaucoma, or increased intraocular pressure.
Cirrhosis
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Cirrhosis.
Corticosteroids may have enhanced effects on patients with cirrhosis due to decreased metabolism of these agents. Patients with cirrhosis should be monitored more closely for excessive cortisol effects. Dosage adjustments may be required in these patients.
Depression
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Depression.
Corticosteroids may aggravate the symptoms of psychosis and emotional instability. Patients with these conditions should be monitored for increased or worsened symptoms during corticosteroid therapy.
Diabetes Mellitus
Moderate:
ceritinib
Ceritinib has a moderate potential interaction with Diabetes Mellitus.
The use of ceritinib causes hyperglycemia. It is recommended to monitor fasting serum glucose prior to the start of therapy and periodically thereafter as clinically indicated. Initiate or optimize antihyperglycemic medications as clinically appropriate, and withhold therapy until hyperglycemia is adequately controlled, then resume at a reduced dose as clinically appropriate. If adequate hyperglycemic control cannot be achieved with optimal medical management, permanently discontinue treatment with ceritinib. Care should be exercised when using this agent in diabetic patients.
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Diabetes Mellitus.
Corticosteroids can raise blood glucose level by antagonizing the action and suppressing the secretion of insulin, which results in inhibition of peripheral glucose uptake and increased gluconeogenesis. Therapy with corticosteroids should be administered cautiously in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Patients with diabetes mellitus should be monitored more closely during corticosteroid therapy, and their antidiabetic regimen adjusted accordingly.
Diarrhea
Moderate:
ceritinib
Ceritinib has a moderate potential interaction with Diarrhea.
Severe gastrointestinal toxicity has been reported in patients treated with ceritinib. It is recommended to monitor and manage patients using standards of care, or withhold ceritinib with resumption at a reduced dose as per clinical guidelines. Care and close monitoring is recommended in patients reporting diarrhea, vomiting, or abdominal pain.
Diverticulitis
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Diverticulitis.
Corticosteroids may cause gastrointestinal perforation and hemorrhage, usually when given in high dosages or for prolonged periods. They may also mask symptoms of complications such as peritonitis or intraabdominal sepsis. Therapy with corticosteroids should be avoided or administered cautiously in patients with diverticulitis, nonspecific ulcerative colitis (if there is a probability of impending perforation, abscess, or other pyogenic infection), or recent intestinal anastomoses.
Electrolyte Abnormalities
Major:
ceritinib
Ceritinib has a major potential interaction with Electrolyte Abnormalities.
Ceritinib can cause dose dependent QT prolongation which may lead to an increased risk for ventricular arrhythmias, including Torsade de Pointes. When possible, avoid use of ceritinib in patients with congenital long QT syndrome. It is recommended to conduct periodic monitoring with electrocardiograms (ECGs) in patients with congestive heart failure, bradyarrhythmias, electrolyte abnormalities, or those who are taking medications that are known to prolong the QTc interval. Withhold ceritinib in patients who develop a QTc interval greater than 500 msec on at least 2 separate ECGs until the QTc interval is less than 481 msec or recovery to baseline if the QTc interval is greater than or equal to 481 msec, then resume therapy at a reduced dose as clinically indicated. Permanently discontinue ceritinib in patients who develop QTc interval prolongation in combination with Torsade de pointes or polymorphic ventricular tachycardia or signs/symptoms of serious arrhythmia. This drug should be used with caution in patients with a known history of QT prolongation or patients who are taking medications known to prolong the QT interval.
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Electrolyte Abnormalities.
Corticosteroids can cause hypernatremia, hypokalemia, and fluid retention. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. All corticosteroids also increase excretion of calcium and can cause hypocalcemia. Therapy with corticosteroids should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.
Fluid Retention
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Fluid Retention.
Corticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure. Large doses of any corticosteroid can demonstrate these effects, particularly if given for longer periods. Therapy with corticosteroids should be administered cautiously in patients with preexisting fluid retention, hypertension, congestive heart failure, and/or renal dysfunction. Dietary sodium restriction and potassium supplementation may be advisable.
Glaucoma/Intraocular Hypertension
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate 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. Long-term therapy with corticosteroids should be administered cautiously in patients with a history of cataracts, glaucoma, or increased intraocular pressure.
Heart Attack
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Heart Attack.
The use of corticosteroids may be associated with left ventricular free-wall rupture in patients who have had a recent myocardial infarction. Pharmacologic dosages of corticosteroids should be administered with great caution in such patients.
Heart Block
Moderate:
ceritinib
Ceritinib has a moderate potential interaction with Heart Block.
The use of ceritinib may cause bradycardia. It is recommended to monitor heart rate and blood pressure regularly and in cases of symptomatic bradycardia that is not life-threatening, withhold therapy until recovery and adjust the dose of ceritinib. It might be necessary to permanently discontinue ceritinib for life-threatening bradycardia if no contributing concomitant medication is identified; however, if associated with a concomitant medication known to cause bradycardia or hypotension, withhold therapy until recovery and resume therapy at a reduced dose with frequent monitoring. Care and close monitoring is recommended.
Heart Failure
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Heart Failure.
Corticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure. Large doses of any corticosteroid can demonstrate these effects, particularly if given for longer periods. Therapy with corticosteroids should be administered cautiously in patients with preexisting fluid retention, hypertension, congestive heart failure, and/or renal dysfunction. Dietary sodium restriction and potassium supplementation may be advisable.
Herpetic Keratitis
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Herpetic Keratitis.
Pharmacologic dosages of corticosteroids should be used cautiously in patients with ocular herpes simplex because of the risk of corneal perforation. Corticosteroids are not recommended for patients with active ocular herpes simplex.
High Blood Pressure
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with High Blood Pressure.
Corticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure. Large doses of any corticosteroid can demonstrate these effects, particularly if given for longer periods. Therapy with corticosteroids should be administered cautiously in patients with preexisting fluid retention, hypertension, congestive heart failure, and/or renal dysfunction. Dietary sodium restriction and potassium supplementation may be advisable.
High Cholesterol
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with High Cholesterol.
Corticosteroids may elevate serum triglyceride and LDL cholesterol levels if used for longer than brief periods. Patients with preexisting hyperlipidemia may require closer monitoring during prolonged corticosteroid therapy, and adjustments made accordingly in their lipid-lowering regimen.
History, Peptic Ulcer
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with History, Peptic Ulcer.
Corticosteroids may cause peptic ulcer disease and gastrointestinal (GI) hemorrhage, usually when given in high dosages or for prolonged periods. However, even conventional dosages may aggravate symptoms in patients with a history of peptic ulcers. Delayed healing of ulcers has also been reported. Therapy with corticosteroids should be avoided or administered cautiously in patients with active or latent peptic ulcers or other risk factors for GI bleeding. Some clinicians recommend the use of prophylactic antacids or H2-antagonists between meals when large doses of corticosteroids are necessary.
History, Thrombotic/Thromboembolic Disorder
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with History, Thrombotic/Thromboembolic Disorder.
Corticosteroids may increase blood coagulability and have rarely been associated with the development of intravascular thrombosis, thromboembolism, and thrombophlebitis. Therapy with corticosteroids should be administered cautiously in patients who have or may be predisposed to thrombotic or thromboembolic disorders.
History, Tuberculosis
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with History, Tuberculosis.
In patients with latent tuberculosis or tuberculin reactivity, the use of pharmacologic dosages of corticosteroids may cause a reactivation of the disease. Close monitoring for signs and symptoms of tuberculosis is recommended if corticosteroid therapy is administered to patients with a history of tuberculosis or tuberculin reactivity. During prolonged corticosteroid therapy, tuberculosis chemoprophylaxis may be considered.
Hyperadrenocorticism
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Hyperadrenocorticism.
Corticosteroids mimic the effects of endogenous cortisol and aldosterone. Use of these agents may aggravate conditions of hyperadrenocorticalism in a dose-dependent manner.
Hyperaldosteronism
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Hyperaldosteronism.
Corticosteroids mimic the effects of endogenous cortisol and aldosterone. Use of these agents may aggravate conditions of hyperadrenocorticalism in a dose-dependent manner.
Hypernatremia
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Hypernatremia.
Corticosteroids can cause hypernatremia, hypokalemia, and fluid retention. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. All corticosteroids also increase excretion of calcium and can cause hypocalcemia. Therapy with corticosteroids should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.
Hypocalcemia
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Hypocalcemia.
Corticosteroids can cause hypernatremia, hypokalemia, and fluid retention. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. All corticosteroids also increase excretion of calcium and can cause hypocalcemia. Therapy with corticosteroids should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.
Hypokalemia
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Hypokalemia.
Corticosteroids can cause hypernatremia, hypokalemia, and fluid retention. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. All corticosteroids also increase excretion of calcium and can cause hypocalcemia. Therapy with corticosteroids should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.
Infection
Major:
Triam-A
The triamcinolone in Triam-A has a major potential interaction with Infection.
The immunosuppressant and anti-inflammatory effects of corticosteroids, particularly at higher dosages, may reduce resistance to infectious agents, increase the risk of disseminated infections, mask symptoms of infection, and reactivate or exacerbate latent/resolved infections; fatal cases have been reported. Avoid use of corticosteroids in patients with cerebral malaria. Screen patients for active (or history of) infection with tuberculosis, hepatitis, varicella, measles, and amebiasis, especially prior to prolonged treatment. Closely monitor for reactivation of latent infections; chemoprophylaxis may be required. In general, corticosteroids should not be used in patients with active infections, especially systemic fungal infections, unless medically necessary to control drug reactions. However, for corticosteroid-dependent patients who develop a severe or life-threatening infection, continuation of corticosteroid therapy with at least physiologic replacement dosages should be considered, since these patients may have secondary adrenocortical insufficiency. Removal of external steroid during periods of stress may be detrimental to these patients.
Interstitial Lung Disease
Moderate:
ceritinib
Ceritinib has a moderate potential interaction with Interstitial Lung Disease.
The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.
Intestinal Anastomoses
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Intestinal Anastomoses.
Corticosteroids may cause gastrointestinal perforation and hemorrhage, usually when given in high dosages or for prolonged periods. They may also mask symptoms of complications such as peritonitis or intraabdominal sepsis. Therapy with corticosteroids should be avoided or administered cautiously in patients with diverticulitis, nonspecific ulcerative colitis (if there is a probability of impending perforation, abscess, or other pyogenic infection), or recent intestinal anastomoses.
Liver Disease
Moderate:
ceritinib
Ceritinib has a moderate potential interaction with Liver Disease.
Ceritinib is eliminated primarily via the liver. Patients with hepatic impairment may have increased exposure and drug-induced hepatotoxicity. Based on results of population pharmacokinetic analysis no dose adjustment is needed for patients with mild hepatic impairment. The pharmacokinetics of ceritinib has not been studied in patients with moderate to severe hepatic impairment; therefore, a recommended dose has not been determined for these patients. It is recommended to monitor liver function tests including ALT, AST, and total bilirubin once a month and as clinically indicated, with more frequent testing in patients who develop transaminase elevations. In some cases, it might be necessary to withhold ceritinib and resume therapy at a reduced dose, or permanently discontinue treatment.
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Liver Disease.
Corticosteroids are primarily metabolized by the liver and may have enhanced effects in patients with liver disease. Dosage adjustments may be necessary in these patients.
Long QT Syndrome
Major:
ceritinib
Ceritinib has a major potential interaction with Long QT Syndrome.
Ceritinib can cause dose dependent QT prolongation which may lead to an increased risk for ventricular arrhythmias, including Torsade de Pointes. When possible, avoid use of ceritinib in patients with congenital long QT syndrome. It is recommended to conduct periodic monitoring with electrocardiograms (ECGs) in patients with congestive heart failure, bradyarrhythmias, electrolyte abnormalities, or those who are taking medications that are known to prolong the QTc interval. Withhold ceritinib in patients who develop a QTc interval greater than 500 msec on at least 2 separate ECGs until the QTc interval is less than 481 msec or recovery to baseline if the QTc interval is greater than or equal to 481 msec, then resume therapy at a reduced dose as clinically indicated. Permanently discontinue ceritinib in patients who develop QTc interval prolongation in combination with Torsade de pointes or polymorphic ventricular tachycardia or signs/symptoms of serious arrhythmia. This drug should be used with caution in patients with a known history of QT prolongation or patients who are taking medications known to prolong the QT interval.
Myasthenia Gravis
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Myasthenia Gravis.
Although corticosteroids are commonly used in the treatment of myasthenia gravis to increase muscle strength, these agents should nevertheless be administered with caution in such setting. Patients should be treated in an intensive care unit and receive respiratory support, since muscle strength may markedly decrease initially, particularly with high dosages. Preferably, therapy should begin with relatively low dosages (15 to 25 mg/day of prednisone or equivalent) and be increased stepwise as tolerated (approximately 5 mg/day of prednisone or equivalent at 2- to 3-day intervals until marked clinical improvement or a dosage of 50 mg/day is reached). Improvement may be delayed and gradual. Thus, it is important not to discontinue therapy prematurely.
Myoneural Disorder
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Myoneural Disorder.
Toxic myopathy has been observed with the chronic use or the administration of large doses of corticosteroids, often in patients with disorders of neuromuscular transmission such as myasthenia gravis or in patients receiving neuromuscular blocking agents. Fluorinated corticosteroids such as betamethasone, dexamethasone, and triamcinolone appear to cause more severe muscle atrophy and weakness than the nonfluorinated agents. Moreover, multiple-daily doses are more toxic than once-daily or, preferably, alternate-day morning doses. Steroid myopathy is generalized and sometimes accompanied by respiratory weakness and dyspnea. In some cases, it has resulted in quadriparesis. Elevations of creatine kinase (CK) may also occur, albeit infrequently. After withdrawal of corticosteroid therapy, recovery may be slow and incomplete. Therapy with corticosteroids should be administered cautiously in patients with preexisting myopathy or myoneural disorders since these conditions may confound the diagnosis of steroid-induced myopathy. The presence of a normal serum CK level, minimal/no changes of myopathy on electromyography, and type 2 muscle fiber atrophy on biopsy are helpful in suggesting steroid-induced weakness. If steroid myopathy is suspected, a dosage reduction or discontinuation of the steroid should be considered.
Myopathy
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Myopathy.
Toxic myopathy has been observed with the chronic use or the administration of large doses of corticosteroids, often in patients with disorders of neuromuscular transmission such as myasthenia gravis or in patients receiving neuromuscular blocking agents. Fluorinated corticosteroids such as betamethasone, dexamethasone, and triamcinolone appear to cause more severe muscle atrophy and weakness than the nonfluorinated agents. Moreover, multiple-daily doses are more toxic than once-daily or, preferably, alternate-day morning doses. Steroid myopathy is generalized and sometimes accompanied by respiratory weakness and dyspnea. In some cases, it has resulted in quadriparesis. Elevations of creatine kinase (CK) may also occur, albeit infrequently. After withdrawal of corticosteroid therapy, recovery may be slow and incomplete. Therapy with corticosteroids should be administered cautiously in patients with preexisting myopathy or myoneural disorders since these conditions may confound the diagnosis of steroid-induced myopathy. The presence of a normal serum CK level, minimal/no changes of myopathy on electromyography, and type 2 muscle fiber atrophy on biopsy are helpful in suggesting steroid-induced weakness. If steroid myopathy is suspected, a dosage reduction or discontinuation of the steroid should be considered.
Osteoporosis
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Osteoporosis.
Corticosteroids reduce osteoblastic function and inhibit the absorption of intestinal calcium, which can result in bone resorption and bone loss during prolonged therapy. In addition, bone matrix may be affected by the protein-catabolic effects of corticosteroids, especially when given in high dosages or for prolonged periods, leading to aseptic necrosis and fractures. Long-term or high-dose corticosteroid therapy should be administered cautiously and only if necessary in patients with or at risk for osteoporosis. Adverse skeletal effects may be minimized by alternate-day or intermittent administration. Any patient receiving prolonged therapy with the equivalent of 7.5 mg prednisone/day or more are at risk for glucocorticoid-induced osteoporosis and should be managed according to The American College of Rheumatology (ACR) guidelines.
Pancreatitis
Moderate:
ceritinib
Ceritinib has a moderate potential interaction with Pancreatitis.
Pancreatitis, including a fatal case has occurred in patients receiving ceritinib. It is recommended to monitor lipase and amylase prior to the start of therapy with ceritinib and periodically thereafter as clinically indicated. It might be necessary to withhold the dose of ceritinib based on the severity of the laboratory abnormalities and resume therapy at a reduced dose per clinical guidelines. Care is recommended when using this agent in patients at risk.
Peptic Ulcer
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Peptic Ulcer.
Corticosteroids may cause peptic ulcer disease and gastrointestinal (GI) hemorrhage, usually when given in high dosages or for prolonged periods. However, even conventional dosages may aggravate symptoms in patients with a history of peptic ulcers. Delayed healing of ulcers has also been reported. Therapy with corticosteroids should be avoided or administered cautiously in patients with active or latent peptic ulcers or other risk factors for GI bleeding. Some clinicians recommend the use of prophylactic antacids or H2-antagonists between meals when large doses of corticosteroids are necessary.
Post MI Syndrome
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Post MI Syndrome.
The use of corticosteroids may be associated with left ventricular free-wall rupture in patients who have had a recent myocardial infarction. Pharmacologic dosages of corticosteroids should be administered with great caution in such patients.
Prematurity/Underweight in Infancy
Major:
Triam-A
The triamcinolone in Triam-A has a major potential interaction with Prematurity/Underweight in Infancy.
The use of certain parenteral formulations of dexamethasone, hydrocortisone, methylprednisolone, prednisolone and triamcinolone is considered by the drug manufacturers to be contraindicated in neonates, particularly premature infants and infants of low birth weight. Some formulations of these drugs contain benzyl alcohol which, when used in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions, has been associated with fatalities and severe respiratory and metabolic complications in low-birth-weight premature infants. However, many experts feel that, in the absence of benzyl alcohol-free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. Continuous infusions of high dosages of medications containing benzyl alcohol may, however, cause toxicity and should be avoided if possible.
Psychosis
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Psychosis.
Corticosteroids may aggravate the symptoms of psychosis and emotional instability. Patients with these conditions should be monitored for increased or worsened symptoms during corticosteroid therapy.
Pulmonary Impairment
Moderate:
ceritinib
Ceritinib has a moderate potential interaction with Pulmonary Impairment.
The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.
Renal Dysfunction
Moderate:
ceritinib
Ceritinib has a moderate potential interaction with Renal Dysfunction.
Based on results of population pharmacokinetic analyses ceritinib exposures are similar between patients with mild to moderate renal impairment and patients with normal renal function. No dose adjustment is needed for these patients. Caution and monitoring is needed when using this agent in patients with severe renal impairment as no information is available.
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Renal Dysfunction.
Corticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure. Large doses of any corticosteroid can demonstrate these effects, particularly if given for longer periods. Therapy with corticosteroids should be administered cautiously in patients with preexisting fluid retention, hypertension, congestive heart failure, and/or renal dysfunction. Dietary sodium restriction and potassium supplementation may be advisable.
Seizures
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Seizures.
Corticosteroids can cause hypernatremia, hypokalemia, and fluid retention. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. All corticosteroids also increase excretion of calcium and can cause hypocalcemia. Therapy with corticosteroids should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.
Sinus Node Dysfunction
Moderate:
ceritinib
Ceritinib has a moderate potential interaction with Sinus Node Dysfunction.
The use of ceritinib may cause bradycardia. It is recommended to monitor heart rate and blood pressure regularly and in cases of symptomatic bradycardia that is not life-threatening, withhold therapy until recovery and adjust the dose of ceritinib. It might be necessary to permanently discontinue ceritinib for life-threatening bradycardia if no contributing concomitant medication is identified; however, if associated with a concomitant medication known to cause bradycardia or hypotension, withhold therapy until recovery and resume therapy at a reduced dose with frequent monitoring. Care and close monitoring is recommended.
Strongyloidiasis
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Strongyloidiasis.
Unlike most helminths, Strongyloides stercoralis has the ability to replicate in the human host. In patients with strongyloidiasis, the use of pharmacologic or immunosuppressive dosages of corticosteroids may result in Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative septicemia. Therapy with corticosteroids should be administered with extreme caution, if at all, in these patients. For patients on corticosteroids who develop known or suspected Strongyloides infestation, withdrawal of corticosteroids or reduction of the dose of corticosteroids is recommended.
Systemic Sclerosis
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Systemic Sclerosis.
In patients with scleroderma, corticosteroids may precipitate renal crisis with malignant hypertension, possibly via steroid-induced increases in renin substrate and angiotensin II levels and decreases in vasodilator prostaglandin production. Renal failure may ensue. Therapy with corticosteroids should be administered cautiously in patients with scleroderma. In addition, they should be limited to short-term use.
Thrombotic/Thromboembolic Disorder
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Thrombotic/Thromboembolic Disorder.
Corticosteroids may increase blood coagulability and have rarely been associated with the development of intravascular thrombosis, thromboembolism, and thrombophlebitis. Therapy with corticosteroids should be administered cautiously in patients who have or may be predisposed to thrombotic or thromboembolic disorders.
Tuberculosis, Latent
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Tuberculosis, Latent.
In patients with latent tuberculosis or tuberculin reactivity, the use of pharmacologic dosages of corticosteroids may cause a reactivation of the disease. Close monitoring for signs and symptoms of tuberculosis is recommended if corticosteroid therapy is administered to patients with a history of tuberculosis or tuberculin reactivity. During prolonged corticosteroid therapy, tuberculosis chemoprophylaxis may be considered.
Ulcerative Colitis
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Ulcerative Colitis.
Corticosteroids may cause gastrointestinal perforation and hemorrhage, usually when given in high dosages or for prolonged periods. They may also mask symptoms of complications such as peritonitis or intraabdominal sepsis. Therapy with corticosteroids should be avoided or administered cautiously in patients with diverticulitis, nonspecific ulcerative colitis (if there is a probability of impending perforation, abscess, or other pyogenic infection), or recent intestinal anastomoses.
Underactive Thyroid
Moderate:
Triam-A
The triamcinolone in Triam-A has a moderate potential interaction with Underactive Thyroid.
Corticosteroids may have enhanced effects in hypothyroidism due to decreased metabolism of these agents. Patients with hypothyroidism should be monitored more closely for excessive cortisol effects. Dosage adjustments may be required secondary to changes in their thyroid condition.
Vomiting
Moderate:
ceritinib
Ceritinib has a moderate potential interaction with Vomiting.
Severe gastrointestinal toxicity has been reported in patients treated with ceritinib. It is recommended to monitor and manage patients using standards of care, or withhold ceritinib with resumption at a reduced dose as per clinical guidelines. Care and close monitoring is recommended in patients reporting diarrhea, vomiting, or abdominal pain.
More resources
ceritinib
A total of 783 drugs are known to interact with ceritinib.
- Ceritinib is in the drug class multikinase inhibitors.
- Ceritinib is used to treat Non Small Cell Lung Cancer.
Triam-A
A total of 658 drugs are known to interact with Triam-A.
- Triam-a is in the drug class glucocorticoids.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
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