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

Ipilimumab has a major potential interaction with Adrenal Insufficiency.

Immune-mediated endocrinopathies, including severe to life-threatening cases, have occurred with ipilimumab therapy. It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Clinical chemistries (including adrenocorticotropic hormone [ACTH] level and thyroid function) should be evaluated at baseline and before each dose. Medical management should be started promptly, including specialty consultation as appropriate. Ipilimumab should be withheld or permanently discontinued depending on severity of endocrinopathies.

Ipilimumab has a major potential interaction with Allergies.

Ipilimumab can cause immune-mediated rash or dermatitis (including bullous and exfoliative dermatitis, Stevens-Johnson syndrome [SJS], toxic epidermal necrolysis [TEN], and drug rash with eosinophilia and systemic symptoms [DRESS]). Topical emollients and/or topical corticosteroids may be adequate to treat mild to moderate non-bullous/exfoliative rashes. Ipilimumab should be withheld for suspected SJS, TEN, or DRESS and permanently discontinued for confirmed SJS, TEN, or DRESS.

Ipilimumab has a major potential interaction with Autoimmune Disorders.

Ipilimumab can cause immune-mediated adverse reactions, which may be severe or fatal. Immune-mediated adverse reactions can occur in any organ system or tissue. Care should be exercised when using ipilimumab in patients with preexisting immune system disorders (e.g., ulcerative colitis, Crohn's disease, lupus). It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Clinical chemistries (including liver enzymes, creatinine, adrenocorticotropic hormone [ACTH] level, and thyroid function) should be evaluated at baseline and before each dose. Medical management should be started promptly, including specialty consultation as appropriate. Ipilimumab should be withheld or permanently discontinued depending on severity.

Ipilimumab has a major potential interaction with Autonomic Neuropathy.

Ipilimumab can cause immune-mediated adverse reactions, which may be severe or fatal. Immune-mediated adverse reactions can occur in any organ system or tissue. Care should be exercised when using ipilimumab in patients with preexisting immune system disorders (e.g., ulcerative colitis, Crohn's disease, lupus). It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Clinical chemistries (including liver enzymes, creatinine, adrenocorticotropic hormone [ACTH] level, and thyroid function) should be evaluated at baseline and before each dose. Medical management should be started promptly, including specialty consultation as appropriate. Ipilimumab should be withheld or permanently discontinued depending on severity.

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.

Ipilimumab has a major potential interaction with Bone Marrow Transplantation.

Fatal or serious graft-versus-host disease (GVHD) can occur in patients who receive ipilimumab either before or after allogeneic hematopoietic stem cell transplantation (HSCT). These complications may occur despite intervening therapy between cytotoxic T-lymphocyte antigen 4 (CTLA-4) receptor blocking antibody and allogeneic HSCT. It is recommended to monitor patients closely for evidence of GVHD and intervene promptly. The benefit versus risks of treatment with ipilimumab after allogeneic HSCT should be considered.

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.

Ipilimumab has a major potential interaction with Dermatitis Herpetiformis.

Ipilimumab can cause immune-mediated rash or dermatitis (including bullous and exfoliative dermatitis, Stevens-Johnson syndrome [SJS], toxic epidermal necrolysis [TEN], and drug rash with eosinophilia and systemic symptoms [DRESS]). Topical emollients and/or topical corticosteroids may be adequate to treat mild to moderate non-bullous/exfoliative rashes. Ipilimumab should be withheld for suspected SJS, TEN, or DRESS and permanently discontinued for confirmed SJS, TEN, or DRESS.

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.

Ipilimumab has a major potential interaction with Hyperthyroidism.

Immune-mediated endocrinopathies, including severe to life-threatening cases, have occurred with ipilimumab therapy. It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Clinical chemistries (including adrenocorticotropic hormone [ACTH] level and thyroid function) should be evaluated at baseline and before each dose. Medical management should be started promptly, including specialty consultation as appropriate. Ipilimumab should be withheld or permanently discontinued depending on severity of endocrinopathies.

Ipilimumab has a major potential interaction with Infectious Gastroenteritis.

Ipilimumab can cause immune-mediated colitis, which may be fatal. CMV infection/reactivation has been reported in patients with corticosteroid-refractory immune-mediated colitis; repeating infectious workup should be considered in these patients to exclude alternative etiologies. Ipilimumab should be withheld or permanently discontinued depending on severity of colitis.

Ipilimumab has a major potential interaction with Inflammatory Bowel Disease.

Ipilimumab can cause immune-mediated colitis, which may be fatal. CMV infection/reactivation has been reported in patients with corticosteroid-refractory immune-mediated colitis; repeating infectious workup should be considered in these patients to exclude alternative etiologies. Ipilimumab should be withheld or permanently discontinued depending on severity of colitis.

Ipilimumab has a major potential interaction with Liver Disease.

Ipilimumab can cause immune-mediated adverse reactions, which may be severe or fatal. Immune-mediated hepatitis has occurred with ipilimumab therapy. It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Clinical chemistries (including liver enzymes) should be evaluated at baseline and before each dose. Ipilimumab should be withheld or permanently discontinued depending on severity of hepatitis.

Ipilimumab has a moderate potential interaction with Liver Disease.

Care should be exercised when using ipilimumab in patients with moderate (total bilirubin greater than 1.5 to 3 times the upper limit of normal [1.5 to 3 x ULN] and any AST) or severe (total bilirubin greater than 3 x ULN and any AST) liver dysfunction as ipilimumab has not been studied in these patients. Mild liver dysfunction (total bilirubin greater than 1 to 1.5 x ULN or AST greater than ULN) had no clinically significant effect on the clearance of ipilimumab.

Ipilimumab has a moderate potential interaction with Organ Transplant.

Solid organ transplant rejection has been reported during postmarketing experience with ipilimumab. Care should be exercised when using ipilimumab in patients who have received a solid organ transplant.

Ipilimumab has a moderate potential interaction with Pulmonary Impairment.

Ipilimumab can cause immune-mediated pneumonitis. Care should be exercised when using ipilimumab in patients with preexisting pulmonary impairment. Ipilimumab should be withheld or permanently discontinued depending on severity of pneumonitis.

Ipilimumab has a major potential interaction with Underactive Thyroid.

Immune-mediated endocrinopathies, including severe to life-threatening cases, have occurred with ipilimumab therapy. It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Clinical chemistries (including adrenocorticotropic hormone [ACTH] level and thyroid function) should be evaluated at baseline and before each dose. Medical management should be started promptly, including specialty consultation as appropriate. Ipilimumab should be withheld or permanently discontinued depending on severity of endocrinopathies.

Ipilimumab has a major potential interaction with Visual Defect/Disturbance.

Ipilimumab can cause immune-mediated adverse reactions, which may be severe or fatal. It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Ipilimumab should be permanently discontinued for a Grade 2, 3, or 4 ophthalmologic adverse reaction that does not improve to Grade 1 within 2 weeks while receiving topical therapy or if systemic therapy is required.