Can you take Diltiazem with Irinotecan liposomal?

dilTIAZem has a major potential interaction with Aortic Stenosis.

The use of some calcium channel blockers (CCBs) is contraindicated in patients with advanced aortic stenosis. CCBs whose pharmacologic effect is partially dependent on their ability to reduce afterload (e.g., diltiazem, nicardipine, nifedipine, verapamil) may be of less benefit in these patients due to a fixed impedance to flow across the aortic valve and may, in fact, worsen rather than improve myocardial oxygen balance. Rarely, heart failure has developed following the initiation of these CCBs, particularly in patients receiving concomitant beta-blocker therapy.

dilTIAZem has a major potential interaction with Cardiogenic Shock.

In general, calcium channel blockers (CCBs) should not be used in patients with hypotension (systolic pressure < 90 mm Hg) or cardiogenic shock. Due to potential negative inotropic and peripheral vasodilating effects, the use of CCBs may further depress cardiac output and blood pressure, which can be detrimental in these patients. The use of verapamil and diltiazem is specifically contraindicated under these circumstances.

Irinotecan liposomal has a major potential interaction with Diarrhea.

Irinotecan liposomal can cause severe and life-threatening diarrhea. Do not administer Irinotecan liposomal to patients with bowel obstruction. It is recommended to withhold treatment with irinotecan liposomal for Grade 2-4 diarrhea and to initiate appropriate clinical measures for diarrhea of any severity. The dose of irinotecan liposomal should be reduced according to manufacturer indications following recovery to Grade 1 diarrhea. Care should be exercised when using this agent in patients at risk of diarrhea episodes.

Irinotecan liposomal has a major potential interaction with Fever.

Irinotecan liposomal can cause severe or life-threatening neutropenia and fatal neutropenic sepsis. In patients receiving irinotecan liposomal in combination with 5-FU and LV, the incidence of Grade 3 or 4 neutropenia and neutropenic fever/neutropenic sepsis was higher among Asian patients compared to White patients. Individuals who are homozygous for the UGT1A1*28 allele are at increased risk for neutropenia. It is recommended to monitor complete blood cell counts on Days 1 and 8 of every cycle and more frequently if clinically indicated and to withhold treatment if the absolute neutrophil count is below 1500/mm ^3 or if neutropenic fever occurs. Therapy could be resumed when the ANC is 1500/mm^ 3 or above. The dose of irinotecan liposomal should be reduced according to manufacturer indications for Grade 3-4 neutropenia or neutropenic fever following a recovery in subsequent cycles. Care is recommended when using this agent in neutropenic patients and in those patients homozygous for the UGT1A1*28 allele.

dilTIAZem has a major potential interaction with Heart Attack.

Diltiazem has demonstrated a negative inotropic effect in isolated animal tissue preparations but rarely in clinical situations. Hemodynamic studies in humans with normal ventricular function and in patients with a compromised myocardium have not shown a reduction in cardiac index nor consistent negative effects on contractility. However, worsening of congestive heart failure has been reported in patients with preexisting impairment of ventricular function. Therapy with diltiazem should be administered cautiously, if at all, in patients with severe left ventricular dysfunction (e.g., ejection fraction < 30%) or moderate to severe symptoms of cardiac failure and in patients with any degree of ventricular dysfunction if they are receiving a beta-adrenergic blocker. Likewise, diltiazem should not be given to patients with acute myocardial infarction and pulmonary congestion documented by X-ray on admission, since associated heart failure may be acutely worsened. Mild symptoms of cardiac failure should be under control, if possible, prior to initiating diltiazem therapy.

dilTIAZem has a major potential interaction with Heart Block.

The use of some calcium channel blockers (CCBs) is contraindicated in patients with severe bradyarrhythmia, sick sinus syndrome (unless a functioning pacemaker is present), or heart block greater than the first degree (unless a functioning pacemaker is present). CCBs like bepridil, diltiazem and verapamil have a negative effect on AV conduction and the SA node and may exacerbate these conditions.

dilTIAZem has a major potential interaction with Heart Failure.

Diltiazem has demonstrated a negative inotropic effect in isolated animal tissue preparations but rarely in clinical situations. Hemodynamic studies in humans with normal ventricular function and in patients with a compromised myocardium have not shown a reduction in cardiac index nor consistent negative effects on contractility. However, worsening of congestive heart failure has been reported in patients with preexisting impairment of ventricular function. Therapy with diltiazem should be administered cautiously, if at all, in patients with severe left ventricular dysfunction (e.g., ejection fraction < 30%) or moderate to severe symptoms of cardiac failure and in patients with any degree of ventricular dysfunction if they are receiving a beta-adrenergic blocker. Likewise, diltiazem should not be given to patients with acute myocardial infarction and pulmonary congestion documented by X-ray on admission, since associated heart failure may be acutely worsened. Mild symptoms of cardiac failure should be under control, if possible, prior to initiating diltiazem therapy.

dilTIAZem has a major potential interaction with Hypotension.

In general, calcium channel blockers (CCBs) should not be used in patients with hypotension (systolic pressure < 90 mm Hg) or cardiogenic shock. Due to potential negative inotropic and peripheral vasodilating effects, the use of CCBs may further depress cardiac output and blood pressure, which can be detrimental in these patients. The use of verapamil and diltiazem is specifically contraindicated under these circumstances.

Irinotecan liposomal has a major potential interaction with Intestinal Obstruction.

Irinotecan liposomal can cause severe and life-threatening diarrhea. Do not administer Irinotecan liposomal to patients with bowel obstruction. It is recommended to withhold treatment with irinotecan liposomal for Grade 2-4 diarrhea and to initiate appropriate clinical measures for diarrhea of any severity. The dose of irinotecan liposomal should be reduced according to manufacturer indications following recovery to Grade 1 diarrhea. Care should be exercised when using this agent in patients at risk of diarrhea episodes.

dilTIAZem has a major potential interaction with Ischemic Heart Disease.

Increased frequency, duration, and/or severity of angina, as well as acute myocardial infarction, have rarely developed during initiation or dosage increase of calcium channel blockers (CCBs), particularly in patients with severe obstructive coronary artery disease and those treated with immediate-release formulations. The mechanism of this effect is not established. Therapy with CCBs should be administered cautiously in patients with significant coronary artery disease.

dilTIAZem has a major potential interaction with Liver Disease.

Calcium channel blockers (CCBs) are extensively metabolized by the liver. The half-lives of CCBs may be prolonged substantially in patients with severe hepatic impairment, with the potential for significant drug accumulation. In addition, the use of some CCBs has been associated with elevations in serum transaminases, both with and without concomitant elevations in alkaline phosphatase and bilirubin. While these effects may be transient and reversible, some patients have developed cholestasis or hepatocellular injury. Therapy with CCBs should be administered cautiously and often at reduced dosages in patients with significantly impaired hepatic function. Periodic monitoring of liver function is advised.

Irinotecan liposomal has a moderate potential interaction with Liver Disease.

The metabolism of irinotecan liposomal has not been evaluated. Irinotecan is primary metabolized by the liver to a biologically active metabolite. The pharmacokinetic disposition of irinotecan liposomal in patients with hepatic impairment has not been formally assessed. Therapy with irinotecan liposomal should be administered cautiously to patients with or predisposed to compromised hepatic function. Clinical monitoring of hepatic function is recommended.

Irinotecan liposomal has a major potential interaction with Neutropenia.

Irinotecan liposomal can cause severe or life-threatening neutropenia and fatal neutropenic sepsis. In patients receiving irinotecan liposomal in combination with 5-FU and LV, the incidence of Grade 3 or 4 neutropenia and neutropenic fever/neutropenic sepsis was higher among Asian patients compared to White patients. Individuals who are homozygous for the UGT1A1*28 allele are at increased risk for neutropenia. It is recommended to monitor complete blood cell counts on Days 1 and 8 of every cycle and more frequently if clinically indicated and to withhold treatment if the absolute neutrophil count is below 1500/mm ^3 or if neutropenic fever occurs. Therapy could be resumed when the ANC is 1500/mm^ 3 or above. The dose of irinotecan liposomal should be reduced according to manufacturer indications for Grade 3-4 neutropenia or neutropenic fever following a recovery in subsequent cycles. Care is recommended when using this agent in neutropenic patients and in those patients homozygous for the UGT1A1*28 allele.

dilTIAZem has a major potential interaction with Preexcitation Syndrome.

The use of intravenous diltiazem is contraindicated for the management of atrial flutter or fibrillation in patients with an accessory AV tract (e.g., those with Wolff-Parkinson-White or Lown-Ganong-Levine syndrome). Diltiazem can cause ventricular fibrillation and cardiac arrest in such patients, the mechanism of which is related to the drug's ability to shorten the refractory period and accelerate antegrade conduction within the accessory pathway.

Irinotecan liposomal has a moderate potential interaction with Pulmonary Impairment.

Irinotecan can cause severe and fatal interstitial pulmonary disease (IPD). Risk factors include preexisting-existing lung disease. It is recommended to withhold treatment with irinotecan in patients with new or progressive dyspnea, cough, and fever, pending diagnostic evaluation and to discontinue treatment in patients with a confirmed diagnosis of IPD. Exercise caution when using this agent in patients presenting symptoms of dyspnea and patients with pulmonary impairment.

dilTIAZem has a moderate potential interaction with Renal Dysfunction.

Diltiazem is extensively metabolized by the liver and subsequently excreted in the urine, primarily as metabolites. Limited data suggest that the pharmacokinetic disposition of diltiazem is not altered in the presence of renal insufficiency or even end-stage renal disease. However, the effects of possible metabolite accumulation have not been studied. The manufacturers recommend that therapy with diltiazem be administered cautiously in patients with impaired renal function. Laboratory parameters of renal function should be monitored at regular intervals.

Irinotecan liposomal has a moderate potential interaction with Renal Dysfunction.

Population pharmacokinetic analyses suggest that no dose adjustment of irinotecan liposomal is required for patients with mild-to-moderate renal impairment. Caution is recommended when using this agent in patients with severe renal impairment as there is insufficient data to assess its effect.

Irinotecan liposomal has a major potential interaction with Sepsis.

Irinotecan liposomal can cause severe or life-threatening neutropenia and fatal neutropenic sepsis. In patients receiving irinotecan liposomal in combination with 5-FU and LV, the incidence of Grade 3 or 4 neutropenia and neutropenic fever/neutropenic sepsis was higher among Asian patients compared to White patients. Individuals who are homozygous for the UGT1A1*28 allele are at increased risk for neutropenia. It is recommended to monitor complete blood cell counts on Days 1 and 8 of every cycle and more frequently if clinically indicated and to withhold treatment if the absolute neutrophil count is below 1500/mm ^3 or if neutropenic fever occurs. Therapy could be resumed when the ANC is 1500/mm^ 3 or above. The dose of irinotecan liposomal should be reduced according to manufacturer indications for Grade 3-4 neutropenia or neutropenic fever following a recovery in subsequent cycles. Care is recommended when using this agent in neutropenic patients and in those patients homozygous for the UGT1A1*28 allele.

dilTIAZem has a major potential interaction with Sinus Node Dysfunction.

The use of some calcium channel blockers (CCBs) is contraindicated in patients with severe bradyarrhythmia, sick sinus syndrome (unless a functioning pacemaker is present), or heart block greater than the first degree (unless a functioning pacemaker is present). CCBs like bepridil, diltiazem and verapamil have a negative effect on AV conduction and the SA node and may exacerbate these conditions.

dilTIAZem has a major potential interaction with Ventricular Arrhythmia.

The use of intravenous diltiazem or verapamil is contraindicated in patients with ventricular tachycardia. IV administration of a calcium channel blocker can precipitate cardiac arrest in such patients. Marked hemodynamic deterioration and ventricular fibrillation have occurred in patients with wide-complex ventricular tachycardia (QRS >= 0.12 seconds) treated with IV verapamil.