Can you take Dimethyl fumarate with Thymoglobulin?

The anti-thymocyte globulin (rabbit) in Thymoglobulin has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

The use of anti-thymocyte globulin [rabbit] is contraindicated in patients who have active acute or chronic infections that contraindicate any additional immunosuppression. To prevent over-immunosuppression, physicians may wish to decrease the dose of the maintenance immunosuppression regimen during the period of therapy use. Low counts of platelets and white blood cells (including low counts of lymphocytes and neutrophils) have been identified and are reversible following dose adjustments. It is recommended to monitor patients carefully and administer appropriate anti-infective treatment when indicated. Also, total white blood cell and platelet counts should be monitored.

The anti-thymocyte globulin (rabbit) in Thymoglobulin has a major potential interaction with Immunodeficiency.

The use of anti-thymocyte globulin [rabbit] is contraindicated in patients who have active acute or chronic infections that contraindicate any additional immunosuppression. To prevent over-immunosuppression, physicians may wish to decrease the dose of the maintenance immunosuppression regimen during the period of therapy use. Low counts of platelets and white blood cells (including low counts of lymphocytes and neutrophils) have been identified and are reversible following dose adjustments. It is recommended to monitor patients carefully and administer appropriate anti-infective treatment when indicated. Also, total white blood cell and platelet counts should be monitored.

Dimethyl fumarate has a moderate potential interaction with Immunodeficiency.

Progressive multifocal leukoencephalopathy (PML) has occurred in patients with multiple sclerosis (MS) treated with dimethyl fumarate; PML is an opportunistic viral infection of the brain caused by the John Cunningham virus (JC virus) that generally only occurs in immunocompromised patients and usually leads to death or severe disability. Caution and monitoring are advised in patients with MS. Dimethyl fumarate should be withheld at the first sign/symptom suggestive of PML and an appropriate diagnostic evaluation should be performed.

The anti-thymocyte globulin (rabbit) in Thymoglobulin has a major potential interaction with Infection.

The use of anti-thymocyte globulin [rabbit] is contraindicated in patients who have active acute or chronic infections that contraindicate any additional immunosuppression. To prevent over-immunosuppression, physicians may wish to decrease the dose of the maintenance immunosuppression regimen during the period of therapy use. Low counts of platelets and white blood cells (including low counts of lymphocytes and neutrophils) have been identified and are reversible following dose adjustments. It is recommended to monitor patients carefully and administer appropriate anti-infective treatment when indicated. Also, total white blood cell and platelet counts should be monitored.

Dimethyl fumarate has a moderate potential interaction with Infection.

The use of dimethyl fumarate may decrease lymphocyte counts. Dimethyl fumarate has not been studied in patients with preexisting low lymphocyte counts; caution is advised in these patients. CBC (including lymphocyte count) should be obtained before initiating treatment with dimethyl fumarate, 6 months after starting treatment, every 6 to 12 months thereafter, and as clinically indicated. Interruption of therapy in patients with lymphocyte counts less than 0.5 x 10(9) cells/L persisting for more than 6 months and withholding treatment from patients with serious infections until resolution should be considered. Caution is recommended and decisions about whether or not to restart dimethyl fumarate should be individualized based on clinical circumstances.

Dimethyl fumarate has a moderate potential interaction with Infection.

Serious cases of herpes zoster have occurred in patients treated with dimethyl fumarate; patients should be monitored for signs/symptoms of herpes zoster while on dimethyl fumarate. Other serious opportunistic infections have occurred with dimethyl fumarate, including cases of serious viral, fungal, and bacterial infections. Patients with signs/symptoms consistent with any of these infections should undergo prompt diagnostic evaluation and receive appropriate treatment. Withholding dimethyl fumarate treatment in patients with herpes zoster or other serious infections until the infection has resolved should be considered.

Dimethyl fumarate has a moderate potential interaction with Liver Disease.

Dimethyl fumarate has not been studied in patients with liver dysfunction; although no dosage adjustment is needed, caution is recommended when using dimethyl fumarate in these patients. Clinically significant cases of liver injury have been reported in patients treated with dimethyl fumarate in the postmarketing setting. Signs/symptoms of liver injury, including elevation of serum aminotransferases to greater than 5-fold the upper limit of normal (ULN) and elevation of total bilirubin to greater than 2-fold ULN have been observed; these abnormalities resolved upon treatment discontinuation. Elevations of hepatic transaminases (most no greater than 3 times ULN) were observed during controlled trials. Serum aminotransferase, alkaline phosphatase, and total bilirubin levels should be obtained prior to and during treatment with dimethyl fumarate, as clinically indicated. Therapy should be discontinued if clinically significant liver injury induced by dimethyl fumarate is suspected.

Dimethyl fumarate has a moderate potential interaction with Lymphocytopenia.

The use of dimethyl fumarate may decrease lymphocyte counts. Dimethyl fumarate has not been studied in patients with preexisting low lymphocyte counts; caution is advised in these patients. CBC (including lymphocyte count) should be obtained before initiating treatment with dimethyl fumarate, 6 months after starting treatment, every 6 to 12 months thereafter, and as clinically indicated. Interruption of therapy in patients with lymphocyte counts less than 0.5 x 10(9) cells/L persisting for more than 6 months and withholding treatment from patients with serious infections until resolution should be considered. Caution is recommended and decisions about whether or not to restart dimethyl fumarate should be individualized based on clinical circumstances.

Dimethyl fumarate has a moderate potential interaction with Renal Dysfunction.

Dimethyl fumarate has not been studied in patients with renal dysfunction; although no dosage adjustment is needed, caution is recommended when using dimethyl fumarate in these patients.

The anti-thymocyte globulin (rabbit) in Thymoglobulin has a major potential interaction with Vaccination.

Patients recently treated with anti-thymocyte globulin [rabbit] should not receive immunizations with live viral vaccines.