Drug Interactions between cytarabine liposomal / daunorubicin liposomal and rilonacept

MONITOR: The concomitant or sequential administration of multiple antineoplastic agents may result in additive toxicities, particularly in the bone marrow, gastrointestinal tract and heart.

MANAGEMENT: Close clinical and laboratory monitoring for hematologic and nonhematologic toxicities are recommended when antineoplastic agents are administered concurrently or during close intervals. Dosing adjustments may be necessary. The manufacturers' recommendations and institutional protocols for dosage, treatment regimens, monitoring, and management of toxicities should be consulted.

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GENERALLY AVOID: The use of interleukin-1 blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Interleukin-1 blockade alone may cause neutropenia and serious infections, and the risk may be increased in the presence of other immunosuppressive therapy. Agents that may be significantly myelo- or immunosuppressive include antineoplastic agents, radiation, zidovudine, linezolid, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents (greater than 10 mg/day to 1 mg/kg/day, whichever is less, of prednisone or equivalent for more than 2 weeks), and long-term topical or inhaled corticosteroids.

MANAGEMENT: The safety and efficacy of interleukin-1 blockers in immunosuppressed patients have not been established. Until more information is available, interleukin-1 blockers should preferably not be administered to immunosuppressed patients, or they should be prescribed with extreme caution. Interleukin-1 blockers should be discontinued if neutropenia or serious infection occurs.

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