Interactions between Deferasirox and Mitride

The acetaminophen in Mitride has a major potential interaction with Alcoholism.

Chronic alcohol abusers may be at increased risk of hepatotoxicity during treatment with acetaminophen (APAP). Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously, if at all, in patients who consume three or more alcoholic drinks a day. In general, patients should avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure. They should also be advised to seek medical attention if they experience signs and symptoms of liver injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

The acetaminophen in Mitride has a major potential interaction with Dehydration.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

The dichloralphenazone in Mitride has a major potential interaction with Depression.

A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Deferasirox has a major potential interaction with Dermatitis, Drug-Induced.

Fatal cases of severe cutaneous reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and erythema multiforme have occurred in patients treated with deferasirox. The risk of other skin reactions cannot be excluded. It is recommended that if SJS or TEN is suspected to interrupt therapy until the etiology of the reaction has been determined, and if SJS or TEN is confirmed to permanently discontinue treatment with deferasirox. Monitor patients for the development of these severe cutaneous reactions, discontinue deferasirox if clinically appropriate and do not reintroduce therapy. For severe cases of rash, interrupt treatment and consider reintroducing therapy after resolution of the rash at a lower dose with dose escalation as appropriate.

Deferasirox has a moderate potential interaction with Esophageal Ulceration with Bleeding.

Gastrointestinal hemorrhage, ulcerations, perforations, including deaths have been documented in patients using deferasirox, especially in elderly patients who had advanced hematologic malignancies and/or low platelet counts. The risk of gastrointestinal hemorrhage may be increased when administering deferasirox in combination with drugs that have ulcerogenic or hemorrhagic potential, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, oral bisphosphonates, or anticoagulants. It is recommended to monitor patients and discontinue therapy for suspected GI ulceration or hemorrhage. Care is recommended when using this agent in patients at risk of GI complications.

The isometheptene mucate in Mitride has a major potential interaction with Glaucoma/Intraocular Hypertension.

The use of combination drugs that have isometheptene mucate may be contraindicated in patients with glaucoma and/or severe cases of renal disease, hypertension, organic heart disease, or hepatic disease.

The dichloralphenazone in Mitride has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

Deferasirox has a moderate potential interaction with Hearing Loss.

Auditory disturbances (high-frequency hearing loss, decreased hearing), and ocular disturbances (lens opacities, cataracts, elevations in intraocular pressure, and retinal disorders) have been reported in patients using deferasirox. It is recommended to perform auditory and ophthalmic testing (including slit lamp examinations and dilated fundoscopy) before starting therapy with deferasirox and thereafter as clinically indicated. If disturbances are noted, consider dose reduction or interruption if appropriate.

The isometheptene mucate in Mitride has a major potential interaction with High Blood Pressure.

The use of combination drugs that have isometheptene mucate may be contraindicated in patients with glaucoma and/or severe cases of renal disease, hypertension, organic heart disease, or hepatic disease.

Deferasirox has a major potential interaction with Immunodeficiency.

The use of deferasirox is contraindicated in patients with platelet counts below 50 x 109/L. Cytopenias, worsening anemia, and thrombocytopenia, including fatal events, have been reported in patients treated with deferasirox. Preexisting hematologic disorders may increase this risk. It is recommended to monitor blood counts in all patients and to interrupt treatment in patients who develop cytopenias until the cause of the cytopenia has been determined.

Deferasirox has a major potential interaction with Liver Disease.

The use of deferasirox should be avoided in patients with severe hepatic impairment. The starting dose of deferasirox should be reduced by 50% in patients with moderate hepatic impairment. It is recommended to measure serum transaminases and bilirubin in all patients prior to initiating treatment, every 2 weeks during the first month, and at least monthly or more frequently as clinically appropriate. Closely monitor patients with mild or moderate hepatic impairment for efficacy and adverse reactions that may require dose titration.

The acetaminophen in Mitride has a major potential interaction with Liver Disease.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

The isometheptene mucate in Mitride has a major potential interaction with Liver Disease.

The use of combination drugs that have isometheptene mucate may be contraindicated in patients with glaucoma and/or severe cases of renal disease, hypertension, organic heart disease, or hepatic disease.

The dichloralphenazone in Mitride has a moderate potential interaction with Liver Disease.

In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.

The acetaminophen in Mitride has a major potential interaction with Malnourishment.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

The acetaminophen in Mitride has a moderate potential interaction with Phenylketonuria.

Several oral acetaminophen and acetaminophen-combination products, particularly flavored chewable tablets, contain the artificial sweetener, aspartame (NutraSweet). Aspartame is converted to phenylalanine in the gastrointestinal tract following ingestion. Chewable and effervescent formulations of acetaminophen products may also contain phenylalanine. The aspartame/phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

Deferasirox has a major potential interaction with Renal Dysfunction.

The use of deferasirox is contraindicated in patients with serum creatinine greater than two times the age-appropriate upper limit of normal or creatinine clearance less than 40 mL/min. The starting dose of deferasirox should be reduced by 50% in patients with creatine clearance 40 to 60 mL/min. It is recommended to measure serum creatine and calculate clearance in duplicate prior to initiating treatment in all patients and monitor renal function at least monthly or more frequently as clinically appropriate. Consider dose reduction, interruption, or discontinuation of deferasirox based on increases in serum creatinine.

The isometheptene mucate in Mitride has a major potential interaction with Renal Dysfunction.

The use of combination drugs that have isometheptene mucate may be contraindicated in patients with glaucoma and/or severe cases of renal disease, hypertension, organic heart disease, or hepatic disease.

Deferasirox has a major potential interaction with Thrombocytopenia.

The use of deferasirox is contraindicated in patients with platelet counts below 50 x 109/L. Cytopenias, worsening anemia, and thrombocytopenia, including fatal events, have been reported in patients treated with deferasirox. Preexisting hematologic disorders may increase this risk. It is recommended to monitor blood counts in all patients and to interrupt treatment in patients who develop cytopenias until the cause of the cytopenia has been determined.

Deferasirox has a moderate potential interaction with Thrombocytopenia.

Gastrointestinal hemorrhage, ulcerations, perforations, including deaths have been documented in patients using deferasirox, especially in elderly patients who had advanced hematologic malignancies and/or low platelet counts. The risk of gastrointestinal hemorrhage may be increased when administering deferasirox in combination with drugs that have ulcerogenic or hemorrhagic potential, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, oral bisphosphonates, or anticoagulants. It is recommended to monitor patients and discontinue therapy for suspected GI ulceration or hemorrhage. Care is recommended when using this agent in patients at risk of GI complications.

The dichloralphenazone in Mitride has a moderate potential interaction with Urinary Retention.

Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

Deferasirox has a moderate potential interaction with Visual Defect/Disturbance.

Auditory disturbances (high-frequency hearing loss, decreased hearing), and ocular disturbances (lens opacities, cataracts, elevations in intraocular pressure, and retinal disorders) have been reported in patients using deferasirox. It is recommended to perform auditory and ophthalmic testing (including slit lamp examinations and dilated fundoscopy) before starting therapy with deferasirox and thereafter as clinically indicated. If disturbances are noted, consider dose reduction or interruption if appropriate.