Drug Interactions between dinutuximab and moxifloxacin / triamcinolone

MONITOR CLOSELY: Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism is unknown. Tendinitis and tendon rupture have most frequently involved the Achilles tendon, although cases involving the rotator cuff (the shoulder), the hand, the biceps, and the thumb have also been reported. Some have required surgical repair or resulted in prolonged disability. Tendon rupture can occur during or up to several months after completion of fluoroquinolone therapy.

MANAGEMENT: Caution is recommended if fluoroquinolones are prescribed in combination with corticosteroids, particularly in patients with other concomitant risk factors (e.g., age over 60 years; recipient of kidney, heart, and/or lung transplant). Patients should be advised to stop taking the fluoroquinolone, avoid exercise and use of the affected area, and promptly contact their physician if they experience pain, swelling, or inflammation of a tendon. In general, fluoroquinolones should only be used to treat conditions that are proven or strongly suspected to be caused by bacteria and only if the benefits outweigh the risks.

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.