Drug Interactions between dinutuximab and fluticasone / salmeterol

GENERALLY AVOID: Coadministration of dinutuximab or dinutuximab beta with corticosteroids may potentiate the risk of infections due to additive immunosuppressive activity. Infections, including sepsis, pneumonia, herpes virus infection, myelitis, and encephalomyelitis as well as hematologic toxicities, including thrombocytopenia and neutropenia, have been reported with both dinutuximab and dinutuximab beta therapy.

MANAGEMENT: The manufacturer of dinutuximab beta recommends that, except for life threatening conditions, concomitant use of dinutuximab beta and corticosteroids should be avoided for 2 weeks prior to the first course of dinutuximab beta and for 1 week after the last course (UK). If concomitant use is required, close clinical and laboratory monitoring for the development of systemic infections and severe hematologic adverse effects is recommended both during and after discontinuation of therapy.

Although they are often combined in clinical practice, the concomitant use of beta-2 adrenergic agonists and corticosteroids may result in additive hypokalemic effects. Since beta-2 agonists can sometimes cause QT interval prolongation, the development of hypokalemia may potentiate the risk of ventricular arrhythmias including torsade de pointes. However, clinical data are limited, and the potential significance is unknown. Patients who are receiving systemic or nebulized formulations of beta-2 agonists, high dosages of inhaled beta-2 agonists, or systemic corticosteroid therapy may be at a greater risk of developing hypokalemia.